Glossary
Beneficiary (Primary): A primary beneficiary is the beneficiary or beneficiaries you name to receive the benefits if they are living at the time of your death. Primary beneficiaries are the first in line to receive death benefits.
Beneficiary (Contingent): Contingent beneficiaries, or secondary beneficiaries, are those named to receive the insurance proceeds if no primary beneficiary is alive at the time of your death.
Coinsurance: Once you meet the plan’s deductible, we share the cost for your medical expenses through coinsurance. For example, in the Blue and Gold plans, you pay 10% of the total cost for seeing a provider in the Cigna network. Children’s Mercy pays the remaining 90%.
Deductible: This is the amount you pay before your medical plan starts paying benefits. You can use the money in your Health Reimbursement Account (HRA) or Health Savings Account (HSA) to help pay your deductible.
Dependent Day Care Flexible Spending Account (FSA): This is an optional account you may set up to pay for eligible dependent day care expenses — including child and elder care — with tax-free dollars. You contribute to your FSA through automatic, before-tax payroll deductions. A “use it or lose it” rule applies to FSAs, meaning that you will forfeit any money left in your FSA at the end of the plan year. For a full list of eligible expenses, refer to IRS Publication 503, available at www.irs.gov. Highly Compensated Employees may be limited in the amount they can contribute due to nondiscrimination requirements.
Health Reimbursement Account (HRA): The HRA is a special account that Children’s Mercy contributes to, and you can use to pay for eligible medical expenses you incur during the plan year. You do not contribute to the HRA. You are only eligible for the HRA if you elect the Children’s Mercy Blue Plan or Gold Plan.
Any unused dollars in your HRA at the end of the plan year will roll over for you to use in the next plan year. When you and/or your covered spouse complete wellbeing activities, you earn points, which convert to dollars in your HRA at the beginning of the next plan year, assuming you complete the health screening and health assessment by the deadline.
Health Care Flexible Spending Account (FSA): This is an optional account you may set up to pay for out-of-pocket eligible health care expenses — including deductibles and coinsurance for medical, dental and vision care — with tax-free dollars. You contribute to your FSA through automatic, before-tax payroll deductions. A “use it or lose it” rule applies to FSAs, meaning that you will forfeit any money left in your FSA at the end of the plan year (including the 2½-month grace period following the 12-month plan year). If you make contributions to a Health Care FSA, the law prevents you and your spouse from contributing to a Health Savings Account (HSA). For a full list of eligible expenses, refer to IRS Publication 502, available at www.irs.gov.
Health Savings Account (HSA): An HSA is a special tax-advantaged savings account that lets you contribute money on a before-tax basis and then withdraw it tax-free to pay for eligible expenses — now and in the future. In addition, Children’s Mercy contributes to your HSA. You are only eligible to set up an HSA if you elect the Children’s Mercy Green Plan.
Any unused dollars in your HSA at the end of the plan year will roll over for you to use in the next plan year. When you and/or your covered spouse complete wellbeing activities, you earn points, which convert to dollars in your HSA at the beginning of the next plan year, assuming you complete the health screening and health assessment by the deadline.
Lifestyle Spending Account (LSA): An employer-funded benefit to help support everyday needs that may not otherwise be covered by traditional benefits. The employer contribution is for a wide range of personal expenses to help support your everyday needs and lifestyle.
Limited Purpose Health Care Flexible Spending Account (FSA): This is an optional account you may set up if you enroll in the Green Plan and Health Savings Account (HSA). It allows you to pay for out-of-pocket eligible dental, vision and hearing aid expenses with tax-free dollars. You contribute to your FSA through automatic, before-tax payroll deductions. A "use it or lose it" rule applies to FSAs, meaning that you will forfeit any money left in your FSA at the end of the plan year (including the 2 1/2-month grace period following the 12-month plan year). For a full list of eligible expenses, refer to IRS Publication 502, available at www.irs.gov.
Out-of-pocket maximum: This is a limit on the amount you pay for eligible medical expenses out of your pocket during the year. Once you meet your out-of-pocket maximum, your plan pays 100% of covered services for the rest of the plan year.
Payroll deductions: This is the fixed amount that you contribute from each paycheck for coverage.
Preventive care: In-network preventive care is fully covered under Children’s Mercy medical plans, so you pay nothing. Preventive care includes routine care designed to prevent illness or disease, including annual physicals, immunizations and cancer screenings. If the same tests are conducted to diagnose an illness or treat a known condition, they are not considered preventive care and your plan’s normal charges will apply. Review the list of preventive care.