Insurance terms

Welcome to our terminology page! Here, you'll find a comprehensive list of key terms and definitions relevant to the health insurance space.
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Earned Premium

Policyholders usually pay their premiums in advance. However, insurance companies do not immediately account for these premiums in their earnings. Rather, they earn the premium at even rates throughout the term of the policy. Therefore, the portion of premium that applies to the expired portion of the policy becomes the earned premium. Similarly, the portion of premium received that applies to the remaining term of the policy becomes the unearned premium reserve.

Easy Enrollment Program

Think of this as the express lane for insurance sign-up. It's a simplified process that makes it easier for individuals to enroll in health insurance plans without complex paperwork or hurdles.

Easy Pricing

Easy pricing refers to transparent and straightforward pricing structures for healthcare services or insurance plans, helping consumers understand costs easily.

Effective Date

This is the start date for a person’s insurance coverage. It's the date when your insurance policy becomes active and starts providing coverage for healthcare services.

Effectuated Enrollment

This refers to the number of individuals who have successfully enrolled in a health insurance plan and have active coverage.

Electronic Health Record (EHR)

EHRs are electronic versions of patients' medical records containing information about their health history, treatments, medications, and more. They are accessible to healthcare providers.

Electronic Medical Record (EMR)

EMRs contain patients' medical information as recorded by a specific healthcare provider or facility, aiding patient care within that practice or institution.


Eligibility requirements, in the context of insurance, are requirements that an individual must meet in order to qualify for an insurance policy.

Eligibility Period

An eligibility period is the time frame following the eligibility date, usually 31 days, during which potential members of a group may enroll in a benefits program, e.g. health insurance, life insurance, or disability insurance, without evidence of insurability.

Embedded Deductible

An embedded deductible is a feature in family health insurance plans that allows each member to have their own individual deductible within the overall family deductible.

Emergency Room

Both urgent care and emergency rooms provide medical care, but they serve different levels of urgency. The emergency room is for life-threatening emergencies that require immediate medical attention, such as chest pain, difficulty breathing, severe bleeding, broken bones, head injuries, seizures, and poisoning. It provides a wider range of services than urgent care, including CT scans, MRIs, surgery, and intensive care, but has longer wait times and higher costs. The emergency room is open 24/7.

Employer Mandate

It's a provision under the ACA that requires certain employers to provide health insurance coverage to their employees or face penalties.

Employer Shared-Responsibility Payment

This is a penalty imposed on certain large employers if they fail to provide their employees with affordable health insurance that meets minimum coverage standards.

Employer Shared-Responsibility Provision

This is like a rulebook for employers regarding health insurance. It outlines the obligations and requirements for certain large employers under the Affordable Care Act to offer health insurance to their employees.

Employer Tax Credits

Tax credits are available to small businesses that provide health insurance coverage to their employees, helping offset the costs.

Employer-Sponsored Health Insurance

This refers to employers' health insurance plans, which typically provide group coverage at more affordable rates.

Employer-Sponsored Health Plans

These are health insurance plans employers offer their employees, sometimes with multiple options based on individual needs.

Enrollment Period

An enrollment period is a specific time period during which a person can get health insurance, make changes in their policy, or qualify and apply for government subsidies.

Essential Health Benefits

Essential health benefits are a set of services that health insurance plans must cover, including preventive care, prescription drugs, and maternity care, as required by the ACA.


An exclusion refers to specific medical conditions, services, or treatments not covered by an insurance policy.

Explanation of Benefits (EOB)

This is a statement sent by an insurance company to the insured person explaining the healthcare services provided, the amount paid by the insurance, and any remaining costs the patient owes.