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- Obamacare
Comprehensive health care reform legislation signed into law by President Obama on March 23, 2010. Also known as the Patient Protection and Affordable Care Act (PPACA) or the Affordable Care Act (ACA).
- Open Access HMO
An HMO that allows enrollees to receive services outside the network, but at higher costs. The additional costs may be in the form of higher deductibles, copayments, or coinsurance.
- Open Enrollment Period
A period of time when employees may elect or change the benefit options available through their employer, such as health, dental and life insurance and ancillary or Voluntary Benefits such as legal services or pet insurance.
- Out-of-Network Provider
A health plan will cover treatment for doctors, clinics, hospitals and other providers who are out-of-network, but covered employees will pay more out-of-pocket to use out-of-network providers than for in-network providers.
- Out-of-Pocket Limit
The most an employee could pay during a coverage period (usually one year) for his or her share of the costs of covered services, including Co-payments and Coinsurance. Until the limit is reached, the plan and the member share in the cost of covered expenses. After the limit is reached, the insurer pays all covered expenses, often up to a lifetime maximum.