Glossary

Plain-language definitions for every term you will encounter. Browse by letter or filter by category.

Health Benefits34Retirement27Tax-Advantaged22Leave & Time Off15Insurance59Compliance & Law43

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A

Annual Enrollment

Another term for open enrollment. The yearly window for making benefit elections.

Health Benefits

ACA

Affordable Care Act. The federal health care reform law enacted in 2010 that expanded coverage requirements, established marketplaces, and created employer mandates.

Compliance & Law

Affordable Care Act

The full name for ACA. Also known informally as Obamacare. It significantly changed the landscape of employer-sponsored health benefits.

Compliance & Law

Applicable Large Employer

An employer with 50 or more full-time equivalent employees, subject to the ACA employer mandate. Abbreviated ALE.

Compliance & Law

ALE

Abbreviation for applicable large employer. An employer that must comply with ACA reporting and coverage requirements.

Compliance & Law

Affordability

An ACA standard requiring that the employee's share of the premium for self-only coverage not exceed a specified percentage of their household income.

Compliance & Law

Auto-Enrollment

A plan feature that automatically enrolls eligible employees in the retirement plan at a default contribution rate unless they opt out.

Retirement

Auto-Escalation

A plan feature that automatically increases an employee's contribution rate by a set amount each year, up to a cap. Helps employees save more over time.

Retirement

After-Tax Contribution

Contributions to a retirement plan made with dollars that have already been taxed. Distinguished from Roth contributions, which also grow tax-free.

Retirement

Any Occupation

A stricter disability definition that considers you disabled only if you cannot perform any job for which you are reasonably qualified by education and experience.

Insurance

AD&D

Accidental death and dismemberment insurance. Pays a benefit if the employee dies or loses a limb or function due to an accident.

Insurance

ADA

Americans with Disabilities Act. A federal law that prohibits discrimination against individuals with disabilities in employment, including requirements for reasonable accommodation.

Compliance & Law

Adoption Assistance

An employer benefit that helps cover the costs associated with adopting a child. May include reimbursement for legal fees, agency costs, and travel expenses.

Health Benefits

Appeal

A formal request to have the health plan reconsider a denied claim or coverage decision. Members have the right to appeal under ACA regulations.

Insurance

B

C

COBRA

Consolidated Omnibus Budget Reconciliation Act. A federal law that allows employees and dependents to continue group health coverage for a limited time after a qualifying event.

Health Benefits

Continuation Coverage

The right to maintain group health insurance after a qualifying event such as job loss, reduction in hours, or divorce. COBRA is the primary federal law governing this.

Health Benefits

Creditable Coverage

Prior health insurance coverage that can be used to reduce or eliminate a pre-existing condition exclusion period under a new plan.

Health Benefits

Certificate of Creditable Coverage

A document from a previous health plan proving periods of coverage. Used to demonstrate creditable coverage when enrolling in a new plan.

Health Benefits

Catch-Up Contribution

An additional amount that individuals age 50 and older can contribute to retirement accounts or HSAs beyond the standard annual limit.

Retirement

Carryover

A provision that allows a limited amount of unused FSA funds to roll over into the next plan year. A plan can offer either a grace period or a carryover, not both.

Tax-Advantaged

Copay

A fixed dollar amount the insured pays at the time of receiving a medical service, such as $25 for a doctor visit or $10 for a prescription.

Insurance

Coinsurance

The percentage of covered medical costs the insured pays after meeting the deductible. For example, with 20% coinsurance, the plan pays 80% and the member pays 20%.

Insurance

Cliff Vesting

A vesting schedule where the employee becomes 100% vested in employer contributions after a single specified period, such as 3 years.

Retirement

Certification

A medical certification from a health care provider that supports an employee's request for FMLA leave by documenting the serious health condition.

Leave & Time Off

Cafeteria Plan

Another name for a Section 125 plan. Allows employees to choose from a menu of pre-tax benefit options.

Tax-Advantaged

Contribution Limit

The maximum amount that can be contributed to a tax-advantaged account in a given year, as set by the IRS. Limits are updated annually for inflation.

Retirement

Coordination of Benefits

Rules that determine the order in which multiple insurance plans pay claims when an individual is covered by more than one plan.

Insurance

COBRA Subsidy

A temporary government or employer subsidy that reduces or eliminates the cost of COBRA premiums for eligible individuals. Has been offered during certain economic crises.

Health Benefits

Compliance

Adherence to laws, regulations, and plan rules governing employee benefits. Non-compliance can result in penalties, lawsuits, and loss of tax-favored status.

Compliance & Law

Cafeteria Plan Election

The choices an employee makes under a Section 125 plan regarding which pre-tax benefits to receive. Elections are generally irrevocable for the plan year.

Tax-Advantaged

Continuation of Benefits

The ongoing provision of benefits to an employee during certain types of leave, such as FMLA leave, even though the employee is not actively working.

Health Benefits

Commuter Benefits

Pre-tax benefits that allow employees to set aside money for qualified transportation expenses such as parking, transit passes, and vanpool fees.

Tax-Advantaged

Claim

A request for payment submitted by a healthcare provider or insured person to the health plan for services rendered.

Insurance

D

Dependent

A person who relies on the employee for financial support and is eligible for coverage under the employee's benefit plans, typically a spouse or child.

Health Benefits

Domestic Partner

An unmarried partner who may be eligible for benefits coverage depending on the employer's plan and state laws.

Health Benefits

DCFSA

Dependent care flexible spending account. A pre-tax account used to pay for eligible dependent care expenses such as daycare, preschool, and elder care.

Tax-Advantaged

Dependent Care FSA

The full term for DCFSA. The annual limit is set per household, not per employee.

Tax-Advantaged

Deductible

The amount an insured person must pay out of pocket for covered services before the insurance plan begins to pay.

Insurance

Defined Contribution

A retirement plan where the employer, employee, or both make regular contributions and the final benefit depends on investment performance. 401k plans are the most common type.

Retirement

Defined Benefit

A retirement plan that promises a specific monthly benefit at retirement, calculated by a formula based on salary and years of service. Also called a pension.

Retirement

Direct Rollover

A rollover where funds are transferred directly from one retirement plan to another without the employee taking possession. No taxes or penalties apply.

Retirement

DOL

Department of Labor. The federal agency that enforces ERISA and oversees employee benefit plan compliance.

Compliance & Law

Department of Labor

The full name for DOL. Responsible for protecting employee benefit rights and ensuring plan sponsors meet their fiduciary obligations.

Compliance & Law

Dental Insurance

Coverage for preventive, basic, and major dental services. Most plans have an annual maximum benefit and may have separate deductibles from medical coverage.

Insurance

Dependent Care Credit

A federal tax credit available to employees who pay for dependent care expenses. Cannot be claimed for the same expenses reimbursed through a DCFSA.

Tax-Advantaged

E

Employee Benefits

Non-wage compensation provided to employees in addition to their salary, including health insurance, retirement plans, paid time off, and other perks.

Health Benefits

Eligible Employee

An employee who meets the requirements for participation in employer-sponsored benefits, typically based on hours worked, employment status, and waiting period.

Compliance & Law

Election Period

The time frame during which a person can choose to enroll in COBRA coverage. Generally 60 days from the date of the qualifying event notice.

Health Benefits

EPO

Exclusive provider organization. A type of health plan that covers only in-network providers except in emergencies, but does not require referrals.

Insurance

Essential Health Benefits

Ten categories of services that ACA-compliant plans must cover, including hospitalization, prescription drugs, maternity care, and mental health services.

Compliance & Law

Employer Mandate

An ACA requirement that applicable large employers offer affordable, minimum value health coverage to full-time employees or face penalties.

Compliance & Law

Employer Match

The employer's contribution to an employee's retirement account, usually expressed as a percentage of the employee's contribution up to a limit.

Retirement

ERISA

Employee Retirement Income Security Act. A federal law that sets standards for retirement and health plans in private industry, including fiduciary duties and reporting.

Compliance & Law

Employee Retirement Income Security Act

The full name for ERISA. Protects employee benefits by establishing rules for plan management, funding, vesting, and disclosure.

Compliance & Law

Elimination Period

The waiting period between the onset of disability and when benefits begin. For STD, it is typically 0 to 14 days. For LTD, it is usually 90 to 180 days.

Insurance

EAP

Employee assistance program. A confidential benefit that provides employees with short-term counseling, referrals, and support for personal and work-related issues.

Health Benefits

Employee Assistance Program

The full term for EAP. Services typically include counseling for stress, substance abuse, financial concerns, and family issues at no cost to the employee.

Health Benefits

Evidence of Insurability

Health information required by an insurer to approve coverage amounts above the guaranteed issue level. Also called proof of good health.

Insurance

Essential Job Function

The fundamental duties of a position that the employee must be able to perform, with or without reasonable accommodation.

Compliance & Law

Ergonomics

The science of designing workstations, tools, and tasks to fit the worker's physical needs, reducing strain and injury risk.

Health Benefits

Equity Compensation

Compensation in the form of company stock or options, including restricted stock units (RSUs), stock options, and employee stock purchase plans.

Health Benefits

Employee Stock Purchase Plan

A program that allows employees to purchase company stock at a discount, often through payroll deductions. Abbreviated ESPP.

Health Benefits

Explanation of Benefits

A statement from the health insurer detailing what was billed, what the plan paid, and what the member owes for a medical service. Abbreviated EOB.

Insurance

F

FSA

Flexible spending account. A tax-advantaged account that allows employees to set aside pre-tax dollars for qualified medical or dependent care expenses.

Tax-Advantaged

Flexible Spending Account

The full term for FSA. Unlike an HSA, funds typically must be used within the plan year or be forfeited.

Tax-Advantaged

Formulary

A list of prescription drugs covered by a health insurance plan, organized by tiers with different cost-sharing levels.

Insurance

Fiduciary

A person or entity with a legal obligation to act in the best interest of plan participants when managing benefit plans. Includes plan administrators and trustees.

Compliance & Law

Form 5500

An annual report filed with the DOL and IRS by employee benefit plans. Provides financial and operational information about the plan.

Compliance & Law

FMLA

Family and Medical Leave Act. A federal law that provides eligible employees with up to 12 weeks of unpaid, job-protected leave per year for qualifying reasons.

Leave & Time Off

Family and Medical Leave Act

The full name for FMLA. Applies to employers with 50 or more employees within a 75-mile radius.

Leave & Time Off

Fiduciary Liability

The legal exposure of individuals who manage employee benefit plans. Fiduciaries can be held personally liable for losses resulting from a breach of their duties.

Compliance & Law

Fringe Benefit

Any form of compensation provided to an employee in addition to regular wages, including benefits, perks, and non-cash compensation. Some fringe benefits are taxable.

Tax-Advantaged

Fully Insured Plan

A health plan where the employer pays fixed premiums to an insurance carrier, which then assumes the risk of paying claims.

Insurance

G

H

HIPAA

Health Insurance Portability and Accountability Act. A federal law that protects health information privacy and ensures portability of health coverage between jobs.

Compliance & Law

HMO

Health maintenance organization. A type of health plan that requires members to use a network of providers and get referrals from a primary care physician for specialist visits.

Insurance

HDHP

High deductible health plan. A health plan with a higher deductible than traditional plans, paired with lower premiums and eligibility to contribute to an HSA.

Insurance

High Deductible Health Plan

The full term for HDHP. IRS sets the minimum deductible and maximum out-of-pocket amounts that qualify a plan as an HDHP each year.

Insurance

HSA

Health savings account. A tax-advantaged account available to employees enrolled in an HDHP, used to pay for qualified medical expenses.

Tax-Advantaged

Health Savings Account

The full term for HSA. Contributions are tax-deductible, growth is tax-free, and withdrawals for qualified medical expenses are tax-free.

Tax-Advantaged

HRA

Health reimbursement arrangement. An employer-funded account that reimburses employees for qualified medical expenses and sometimes health insurance premiums.

Insurance

Health Reimbursement Arrangement

The full term for HRA. Unlike HSAs and FSAs, HRAs are funded entirely by the employer.

Insurance

Hardship Withdrawal

A withdrawal from a 401k plan to meet an immediate and heavy financial need. Subject to income tax and may incur a 10% early withdrawal penalty.

Retirement

Highly Compensated Employee

An employee who earns above a threshold set by the IRS or owns more than 5% of the business. HCEs are subject to nondiscrimination testing limits.

Compliance & Law

Health Risk Assessment

A questionnaire or screening tool used to evaluate an employee's health status and identify risk factors. Often part of a wellness program.

Health Benefits

Health Plan

An organization or arrangement that provides or pays for health care services for its members. Includes employer-sponsored plans, marketplace plans, and government programs.

Insurance

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L

M

N

O

P

PPO

Preferred provider organization. A type of health plan that offers a network of providers at lower cost but allows out-of-network visits at higher cost without referrals.

Insurance

POS

Point of service. A type of health plan that combines features of HMO and PPO plans, requiring referrals for specialists but offering some out-of-network coverage.

Insurance

Premium

The amount paid periodically (usually monthly) for health insurance coverage. Employers typically pay a portion and employees pay the remainder through payroll deduction.

Insurance

Prior Authorization

A requirement that the health plan approve certain services, procedures, or medications before they are provided. Ensures the treatment is medically necessary.

Insurance

Pension

A defined benefit retirement plan funded by the employer that provides a guaranteed monthly income in retirement based on a formula.

Retirement

Plan Administrator

The person or entity responsible for the day-to-day operation and management of an employee benefit plan.

Compliance & Law

Plan Sponsor

The employer or organization that establishes and maintains an employee benefit plan. The plan sponsor has overall responsibility for the plan.

Compliance & Law

Payroll Deduction

The method of collecting an employee's share of benefit premiums and contributions directly from their paycheck, either pre-tax or after-tax.

Tax-Advantaged

Pre-Tax

Contributions or deductions taken from an employee's paycheck before income taxes are calculated, reducing taxable income. Applies to many health and retirement contributions.

Tax-Advantaged

Plan Year

The 12-month period designated for benefit plan administration, reporting, and enrollment. May follow the calendar year or a different fiscal year.

Compliance & Law

Paid Time Off

A bank of days employees can use for vacation, personal time, or sick leave. PTO combines traditional separate leave categories into one flexible pool.

Leave & Time Off

PTO

Abbreviation for paid time off. Offers employees flexibility in how they use their allotted days away from work.

Leave & Time Off

Parental Leave

Leave granted to parents following the birth, adoption, or foster placement of a child. May be paid or unpaid depending on employer policy and state law.

Leave & Time Off

Pension Survivor Benefit

A provision in a defined benefit plan that provides ongoing payments to the surviving spouse or designated beneficiary after the participant's death.

Retirement

Premium Conversion

A Section 125 plan feature that allows employees to pay their share of health insurance premiums with pre-tax dollars.

Tax-Advantaged

Prohibited Transaction

A transaction between a benefit plan and a disqualified person (such as the plan sponsor or fiduciary) that is forbidden under ERISA and the tax code.

Compliance & Law

PCORI Fee

A fee assessed on health plan sponsors to fund the Patient-Centered Outcomes Research Institute. Reported and paid annually on IRS Form 720.

Compliance & Law

Primary Care Physician

A doctor who provides general medical care and coordinates referrals to specialists. Required as a first point of contact in HMO plans. Abbreviated PCP.

Insurance

Preventive Care

Health services aimed at preventing illness or detecting conditions early, such as annual physicals, immunizations, and screenings. Covered at no cost under ACA plans.

Insurance

Prescription Drug Coverage

The portion of a health plan that covers medication costs. Drugs are typically organized into tiers on a formulary with different cost-sharing levels.

Insurance

Q

R

S

Special Enrollment Period

A time outside of open enrollment when employees can change their benefits due to a qualifying life event such as marriage, birth of a child, or loss of coverage.

Health Benefits

Safe Harbor

A type of 401k plan design that automatically satisfies nondiscrimination testing by meeting specific employer contribution or matching requirements.

Retirement

Summary Plan Description

A document that explains the key features of an employee benefit plan in plain language, including eligibility, benefits, costs, and procedures. Abbreviated SPD.

Compliance & Law

SPD

Abbreviation for summary plan description. Employers are legally required to provide an SPD to plan participants.

Compliance & Law

Summary of Material Modifications

A document that describes significant changes to a benefit plan. Must be distributed to participants within a specified time after the change.

Compliance & Law

Serious Health Condition

Under FMLA, an illness, injury, impairment, or physical or mental condition involving inpatient care or continuing treatment by a health care provider.

Leave & Time Off

Short-Term Disability

Insurance that replaces a portion of an employee's income when they are unable to work due to a non-work-related illness or injury. Abbreviated STD.

Insurance

STD

Abbreviation for short-term disability insurance. Typically covers 60 to 70% of salary for up to 13 to 26 weeks.

Insurance

Supplemental Life

Additional life insurance coverage an employee can purchase beyond the employer-provided basic life benefit, often at group rates.

Insurance

Section 125 Plan

An IRS provision that allows employees to pay for certain benefits with pre-tax dollars, reducing their taxable income. Also called a cafeteria plan.

Tax-Advantaged

Sabbatical

An extended period of leave, often several weeks or months, granted to employees after a specified period of service. Usually used for rest, education, or personal projects.

Leave & Time Off

Summary of Benefits and Coverage

A standardized document required by the ACA that helps employees compare health plan options by presenting key features in a uniform format. Abbreviated SBC.

Compliance & Law

Student Loan Repayment

An employer benefit where the company makes payments toward an employee's student loan debt. A growing benefit used to attract and retain talent.

Health Benefits

Stipend

A fixed allowance provided by the employer for a specific purpose, such as wellness, home office setup, or professional development. May be taxable income.

Health Benefits

Stock Options

The right to purchase company stock at a predetermined price (exercise price) within a specified time period. Part of equity compensation.

Health Benefits

Salary Continuation

An arrangement where the employer continues paying an employee's salary during a period of disability, sometimes in lieu of or in addition to disability insurance.

Insurance

Sick Leave

Time off from work due to illness or medical appointments. May be a separate bank of days or included within a broader PTO policy.

Leave & Time Off

Specialty Drug

A high-cost medication used to treat complex or chronic conditions. Often requires prior authorization and may have separate cost-sharing rules.

Insurance

Self-Funded Plan

A health plan where the employer pays claims directly from its own funds rather than purchasing insurance from a carrier. Also called self-insured.

Insurance

Stop-Loss Insurance

Insurance purchased by self-funded employers to limit their financial exposure from very high claims. Includes specific (per person) and aggregate (total) coverage.

Insurance

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