Health Care Reform: Common Acronyms
There are a growing number of acronyms used in health care reform-related materials today. Here is a list of common acronyms and a definition for each.
ACA: The Affordable Care Act.
Used to refer to the final, amended version of the health care reform legislation.
CDC: The Centers for Disease
Control and Prevention.
CHIP: The Children’s Health
Insurance Program. Program that provides health insuranceto low-income children, and in some states, pregnant women who do not qualify for Medicaid but cannot afford to purchase private health insurance.
DOL: United States
Department of Labor.
EBSA: Employee Benefits
Security Administration. A division of the DOL responsible for compliance assistance regarding benefit plans.
EPO Plan: An exclusive
provider organization plan. A managed care plan that only covers services in the plan’s network of doctors, specialists or hospitals (except in an emergency).
ERRP: The Early Retiree
Reinsurance Program. A temporary program created under health care reform to provide coverage to early retirees.
FPL: Federal poverty level.
A measure of income level issued annually by HHS and used to determine eligibility for certain programs and benefits.
FLSA: The Federal Fair Labor Standards Act.
Amended by PPACA to incorporate health care reform-specific provisions.
FSA: Flexible spending account.
HCERA: The Health Care and Education Reconciliation Act of 2010.
Enacted on March 30, 2010, to amend and supplement PPACA.
HCR: Health care reform.
HDHP: High deductible health plan.
HHS: United StatesDepartment of Health and Human Services.
HMO: Health maintenanceorganization.
A type of health insurance plan that typically limits coverage to care from medical providers who work for or contract with the HMO.
HRA: Health reimbursement arrangement or account.
HSA: Health savings account.
IRO: An independent review organization.
An organization that performs independent external reviews of adverse benefit determinations.
MLR: Medical loss ratio.
Refers to the claims costs and amounts expended on health care quality improvement as a percent of total premiums. This ratio excludes taxes, fees, risk adjustments, risk corridors and reinsurance.
NAIC: The National Association of Insurance Commissioners.
OCIIO: The Office of Consumer Information and Insurance Oversight.
A division of HHS responsible for implementing many of the health care reform provisions.
OOP: Out-of-pocket limit.
The maximum amount you have to pay for covered services in a plan year.
PCE: Pre-existing condition exclusion.
A plan provision imposing an exclusion of benefits due to a pre-existing condition.
PCIP: The Pre-Existing Condition Insurance Plan.
A temporary high-risk insurance pool to provide coverage to eligible individuals until 2014.
POS Plan: Point-of-service plan.
A type of plan in which you pay less if you go to doctors, hospitals and other health care providers that belong to the plan’s network. POS plans require a referral from your primary care doctor to see a specialist.
PPACA: The Patient Protection and Affordable Care Act.
Enacted on March 23, 2010, as the primary health care reform law.
PPO: Preferred provider organization.
A type of health plan that contracts with medical providers (doctors, hospitals) to create a network of participating providers. You pay less when using providers in the plan’s network, but can use providers outside the network for an additional cost.
QHP: Qualified health plan.
A certified health plan that provides an essential health benefits package. Offered by a licensed health insurer.
SHOP Exchange: The Small Business Health Options Program.
A program that each health insurance exchange must create to assist eligible small employers when enrolling their employees in qualified