A person eligible for benefit under a health insurance policy.
Amount payable by the insurance company to a claimant, assignees, or beneficiary when the insured suffers a loss.
Total dollar amount that a payer will reimburse for covered health care services during a specified period, such as one year.
A physician who has passed examinations given by a medical specialty group and who has, as a result, been certified as a specialist in this area of practice.
A licensed legal representative of the policyholder, who negotiates with an insurance company on behalf of a customer, but is paid a commission by the insurance company.