Glossary - E

EAP (Employee Assistance Program)

An employer benefit program normally provided to employees and their families such as confidential counseling.

EFT (Electronic Funds Transfer)

An arrangement in which payments are transferred electronically rather than by check or cash. Also called ACH or Automated Clearing House.

EOB (Explanation of Benefits)

The medical benefits statement sent to covered individuals itemizing services received, amount billed and paid.

ERISA (Employee Retirement Income Security Act)

The law that regulates the operation of private pensions and benefit plans.

Effective Date

The date health plan coverage becomes active for the individual or family.

Electronic Funds Transfer

See EFT

Eligible Individual

Generally, any individual with qualifying High Deductible Health Plan (HDHP) coverage, as long as the individual does not have any other disqualifying health coverage. Two groups of individuals who are not eligible for a Health Savings Account are individuals claimed as a tax dependent and individuals enrolled in Medicare.

Eligible Medical Expenses

The IRS-designated list‡ of permitted medical expenses in which individuals or families may use funds from their health spending accounts (FSA, HRA, HSA) to cover these specific medical items and/or services. Also known as Qualified Medical Expenses.

Embedded Deductible

An embedded deductible is an individual deductible within the family deductible that is lower than the minimum required deductible for High Deductible Health Plan (HDHP) family coverage.

Employee

An individual who is participating in his employer’s health plan. Also known as enrollee or subscriber.

Employee Assistance Program

See EAP

Employee Retirement Income Security Act

See ERISA

Employer Contribution

The amount an employer contributes to an employee health spending account or insurance premium.

Enrollee

An individual who is enrolled in coverage under a health plan. Also known as employee, individual or subscriber.

Enrollment

The benefits period when health plans “enroll” or set up individuals and groups for health coverage.

Excess Contributions

A contribution that would exceed the sum of the maximum annual family coverage deductible plus the catch-up contribution amount as determined by the IRS. Maximum annual contribution limits may vary depending on whether you have individual or family coverage and your age.

Explanation of Benefits

See EOB