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https://aptia365.com/horacemann 25 Copyright 2024 Aptia Insurance Services Group, LLC. All rights reserved.Medical Insurance%u2022 Coinsurance: Percentage of the charge that your plan pays, typically after you have met the deductible%u2022 Copay: An amount you pay for a covered service each time you use that service, which usually does not apply toward the deductible%u2022 Deductible: The amount you pay before the plan begins to pay%u2022 Out-of-Pocket Costs: Expenses you pay, such as deductibles, copays and the remaining amounts after plan coinsurance is paid%u2022 Out-of-Pocket Maximum: The maximum amount you pay for covered services in a year (you may need to pay additional amounts if you receive care from an out-of-network provider)Dental InsuranceThe service examples below are not guarantees of coverage; refer to Plan Documents to confirm covered services.%u2022 Annual Maximum Benefit: Maximum total amount the plan will pay during the plan year%u2022 Basic Services: Restorations, some oral surgery, endodontics and periodontics%u2022 Deductible: The amount you pay before the plan begins to pay%u2022 Major Services: Crowns, dentures, implants and some oral surgery%u2022 Orthodontia: Straightening or moving misaligned teeth and/or jaws with braces and/or surgery%u2022 Preventive Services: Designed to prevent or diagnose dental conditions, including oral evaluations, routine cleanings, X-rays, fluoride treatments and sealantsVision Insurance%u2022 Copay: An amount you pay for a covered service each time you use that service%u2022 Retail Allowance: Maximum allowance paid toward the cost of vision materials; you are required to pay any amounts in excess of the retail allowanceLife Insurance%u2022 Accidental Death & Dismemberment Insurance: Pays a benefit upon the accidental death of an insured person; also provides benefits for certain covered accidental dismemberments%u2022 Beneficiary: Person or legal entity designated as the recipient of benefits from life or AD&D insurance%u2022 Evidence of Insurability (EOI): Statement of health proving a person%u2019s eligibility for certain amounts of coverage%u2022 Guaranteed Issue: An amount of insurance that does not require evidence of insurability%u2022 Imputed Income: The value of certain benefits that you receive from your employer that are considered a form of compensation or income. For life insurance, it refers to the value of the coverage provided by your employer that exceeds a threshold of $50,000, set by the IRS. %u2022 Life Insurance: Pays a benefit upon the death of an insured personDisability Insurance%u2022 Actively at work: You are considered to be actively at work if you are performing all of the usual and customary duties of your job at your employer%u2019s place of business (or an alternate place approved by your employer). Use of normal time off provided by your employer does not impact your actively at work status. If you are not working due to an illness, injury or leave of absence, you are not considered to be actively at work. If you are not actively at work you cannot enroll in or increase life, disability or Supplemental Health coverage. %u2022 Short Term Disability: When you are unable to work for a period of time due to a disabling illness or injury, short term disability insurance can replace a percentage of your lost income (up to a maximum weekly benefit) for a period of time as defined by the policy.%u2022 Long Term Disability: When you are unable to work for an extended period of time due to a disabling illness or injury, long term disability insurance can replace a percentage of your lost income (up to a maximum monthly benefit) for a period of time as defined by the policy.Key Words to Know