DOI Pat Quinn Governor Andrew Boron, Director

Acronyms for Life, Accident & Health Insurance and Managed Care

Updated Jan 2010

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Note: This information was developed to provide consumers with general information and guidance about insurance coverages and laws. It is not intended to provide a formal, definitive description or interpretation of Department policy. For specific Department policy on any issue, regulated entities (insurance industry) and interested parties should contact the Department.

The following is a list of acronyms commonly used in relation to life, accident and health insurance.

ACD
Accidental Death Benefit
ADA
Americans with Disabilities Act (Federal Act)
AD&D
Accidental Death and Dismemberment
ADB
Accelerated Death Benefit
ADEA
Age Discrimination in Employment Act (Federal Act)
ADL
Activities of Daily Living
ADR
Alternative Dispute Resolution
APL
Automatic Premium Loan
APS
Attending Physician's Statement
ART
Annually Renewable Term (Also YRT—yearly renewable term) Life Insurance
ASO
Administrative Services Only
Cap
Capitation
CFA
Certified Financial Analyst
CFP
Certified Financial Planner
CHAMPUS
Health Insurance Program for Military Personnel (Now TRICARE) (Federal Program)
CHIP
Comprehensive Health Insurance Plan (State Agency)
CLU
Chartered Life Underwriter
CMS
Centers For Medicare & Medicaid Services (Was HCFA) (Federal Agency)
COB
Coordination of Benefits
COC
Certificate of Coverage
COLA
Cost-Of-Living Adjustment
COBRA
Consolidated Omnibus Budget Reconciliation Act (Federal Act)
CPI
Consumer Price Index
CPT
Current Procedural Terminology (Procedure Codes)
CSO
Commissioners Standard Ordinary (Mortality Tables)
DME
Durable Medical Equipment
DO
Doctor of Osteopath
DOB
Date of Birth
DOS
Date of Service
DOL
U.S. Department of Labor (Federal Agency)
DRGs
Diagnostic Related Groups
DX
Diagnosis Code
EAP
Employee Assistance Program
EFT
Electronic Funds Transfer
EOB
Explanation of Benefits
EOI
Evidence of Insurability
EOMB
Explanation of Medicare Benefits
EPO
Exclusive Provider Organization
ERISA
Employee Retirement Income Security Act (Federal Act)
ESRD
End Stage Renal Disease
FCRA
Fair Credit Reporting Act (Federal Act)
FEHBP
Federal Employees Health Benefits Program
FMLA
Family Medical Leave Act (Federal Act)
FPDA
Flexible Premium Deferred Annuity
GI
Guaranteed Insurability Benefit (Life)
GLBA
Gramm-Leach Bliley (Financial Modernization Act) (Federal Act)
GUL
Group Universal Life Insurance
HCFA
Health Care Financing Administration (Now CMS) (Federal Agency)
HCFA-1500
Standardized Physician Billing Form
HIAA
Health Insurance Association of America
HIPAA
Health Insurance Portability and Accountability Act (Federal Act and State Law)
HIPAA CHIP
CHIP plan for uninsurable people at termination of continuation coverage whether it be Illinois continuation or COBRA
HMO
Health Maintenance Organization
ILAHP
Illinois Association of Health Plans
IDEA
Individuals with Disabilities Education Act of 1997 (Federal Act)
ICD-9
International Classification of Diseases (Diagnosis codes)
IME
Independent Medical Exam
IRA
Individual Retirement Account
IPA
Independent Practice Association
JCAHO
Joint Commission on Accreditation of Healthcare Organizations
KIDCARE
Illinois Program for insuring certain children and expectant mothers
LCSW
Licensed Clinical Social Worker
LHSO
Limited Health Service Organization
LTC
Long Term Care
MCO
Managed Care Organization
MSN
Medicare Summary Notice
Medigap
Medicare Supplement Insurance
Medsupp
Medicare Supplement Insurance
MET
Multiple Employer Trust
MEWA
Multiple Employer Welfare Arrangement
MIB
Medical Information Bureau
MIS
Management Information Systems
MSA
Medical Savings Account
MSP
Medicare Second Payer
NAIC
National Association of Insurance Commissioners
NAMCR
National Association of Managed Care Regulators
NCQA
National Committee for Quality Assurance
NICB
National Insurance Crime Bureau
Non-par
Non-participating Provider
OBRA
Omnibus Budget Reconciliation Act of 1993
OCHI
Office of Consumer Health Insurance
OPM
Office of Personnel Management (Federal employee benefits)
OTC
Over the counter
Par
Participating Provider
PCP
Primary Care Physician
PFFS
Private Fee For Service (An alternative form of Medicare)
POA
Power of Attorney
PHO
Physician Hospital Organization
PMPM
Per Member Per Month
POS
Point of Service
PPA
Preferred Provider Arrangement
PPO
Preferred Provider Organization
PWBA
Pension and Welfare Benefits Administration (Federal Agency)
QA
Quality Assurance
QMB
Qualified Medicare Beneficiary
QMCSO
Qualified Medical Child Support Order
RBC
Risk Based Capital
ROC
Review Oversight Committee
RTW
Return to Work (date for disability coverage)
SEC
Securities and Exchange Commission
SEP
Simplified Employee Pension
SHIP
Senior Health Insurance Program
SNF
Skilled Nursing Facility
SPD
Summary Plan Description
SPDA
Single-Premium Deferred Annuity
SPIA
Single-Premium Immediate Annuity
SSDI
Social Security Disability Insurance
TPA
Third Party Administrator
TPPP
Third Party Prescription Program
TRICARE
Health insurance program for military personnel (Was called CHAMPUS) (Federal Program)
UB92
Standardized Hospital Billing Form
U&C, R&C, UCR
Usual and Customary, Reasonable and Customary, Usual Customary and Reasonable
UR
Utilization Review
URAC
Utilization Review Accreditation Commission
VHSP
Voluntary Health Service Plan
VSP
Viatical Settlement Provider
WHCRA
Women's Health and Cancer Rights Act
WP
Waiver of Premium For Disability Benefit
WPHCP
Women's Principal Health Care Provider
YTD
Year-To-Date
YRT
Yearly Renewable Term Insurance (Also ART—annually renewable term ins)

For More Information

Call our Consumer Services Section at (312) 814-2420 or our Office of Consumer Health Toll Free at (877) 527-9431 or visit us on our website at http://insurance.illinois.gov