Calendar Year - The period beginning January 1 of any year through December 31 of the same year.

Case Management - A process whereby a covered person with specific health care needs is identified and a plan which efficiently utilizes health care resources is designed and implemented to achieve the optimum patient outcome in the most cost-effective manner.

Certificate of Coverage - A document given to an insured that describes the benefits, limitations and exclusions of coverage provided by an insurance company.

Claim - Information a medical provider or insured submits to an insurance company to request payment for medical services provided to the insured.

Consolidated Omnibus Budget Reconciliation Act (COBRA) - A federal law that, among other things, requires employers to offer continued health insurance coverage to certain employees and their beneficiaries whose group health insurance has been terminated if they undergo a triggering event.

Coinsurance - The portion of covered health care costs for which the covered person has a financial responsibility, usually a fixed percentage. Coinsurance usually applies after the insured meets his/her deductible.

Consumer Choice plan - A health plan that features payments made by employees into a fund that is then used to pay for health expenses.

Contract Year - The period of time from the effective date of the contract to the expiration date of the contract.

Coordination of Benefits (COB) - A provision in the contract that applies when a person is covered under more than one medical plan. It requires that payment of benefits be coordinated by all plans to eliminate overinsurance or duplication of benefits.

Copayment or copay - A cost-sharing arrangement in which an insured pays a specified charge for a specified service, such as $10 for an office visit. The insured is usually responsible for payment at the time the service is rendered. This charge may be in addition to certain coinsurance and deductible payments.

Covered Person - An individual who meets eligibility requirements and for whom premium payments are paid for specified benefits of the contractual agreement.