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Word
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Definition
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DAC
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DAC: See Deferred Acquisition Costs.
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DAC Tax
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DAC Tax: A form of federal alternative minimum tax imposed upon life insurers.
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Daily Report
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Daily Report: A copy of an insurance policy used as the insurer's record of issuance.
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Date of Last Insured
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Date of Last Insured: Some people have what is known as a “Date of Last Insured” with regard to SSD. This means
they may have not filed a timely application for benefits, didn’t pay into the system long enough, etc. In this
case, the SSA would send you a letter stating, “We did not find that you became disabled on or before X date, the
date in which you were last insured for purposes of receiving SSDI benefits.” This means that your conditions have to have been disabling on or before X date in order to recover.
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DB
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DB: See Defined Benefit Plan.
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DC
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DC: See Defined Contribution Plan.
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Death Benefit
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Death Benefit: See Face Amount.
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Debit Insurance
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Debit Insurance: See Industrial Life Insurance.
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Declarations
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Declarations: The portion of an insurance policy that sets forth pertinent information regarding the insured and the coverage provided.
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Declination
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Declination: The rejection of an application for insurance.
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Decreasing Term Insurance
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Decreasing Term Insurance: A form of term life insurance in which benefits are reduced over the term of the policy.
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Deductible
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Deductible: The up-front amount of a loss for which the insured is responsible before benefits are paid; also known as a self-insured retention. The insurer's liability begins when or if the deductible is exhausted.
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Deductible
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Deductible: The portion of a loss for which the policy-holder is responsible. In workers'
compensation, the injured individual is generally not liable for a deductible.
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Deductible Clause
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Deductible Clause: A provision in an insurance policy setting forth the amount of liability being retained by an insured and the sharing of losses once the deductible is exhausted.
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Deductible Sources of Income
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Deductible Sources of Income: Income from deductible sources listed in the plan which
you receive or are entitled to receive while you are disabled. This income will be subtracted
from your gross disability payment.
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Defendant
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Defendant: The party against whom a legal action has been brought.
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Deferred Acquisition Costs (DAC)
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Deferred Acquisition Costs (DAC): Commissions and other selling expenses that vary with, and are directly related to, the production of business by an insurer. These acquisition costs are deferred and amortized to achieve a matching of revenues and expenses when reported in financial statements prepared in accordance with generally accepted accounting principles.
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Deferred Annuity
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Deferred Annuity: An annuity that can be paid either with a single premium or with a series of installments and includes a schedule of periodic income benefit payments to commence after an accumulation period (more than one year). Because the inside build-up on life insurance products is tax-deferred, deferred annuities have become a very popular vehicle for retirement savings and tax planning. Deferred annuities can either be sold on a single-premium (SPDA) or flexible-premium (FPDA) basis.
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Defined Benefit (DB) Plan
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Defined Benefit (DB) Plan: A retirement pension plan that provides a specified level of benefits upon an employee's retirement, with the employer being responsible for funding the plan. Benefits usually are expressed as a function of an employee's years of service and average salary over the last few years of employment. Plan participants have no responsibility for the investment strategy, which is borne by the sponsor, who has sole discretion over the investment of plan assets. If asset values decline, it is the obligation of the sponsor to make additional contributions to the plan.
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Defined Contribution (DC) Plan
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Defined Contribution (DC) Plan: A retirement pension plan that allows an employee to make annual contributions to the plan, based on a percentage of compensation, with some of it usually (but not always) matched by the plan sponsor. Contributions and earnings thereon are tax-deferred. There is no guarantee as to the eventual level of benefits to be provided by this plan. The participant selects the desired investment options, which may be changed at regular intervals. The plan sponsor periodically reports to the participant on the amount that is in his or her account. The level of benefits ultimately payable out of plan assets is variable, and depends on the investment performance of the participant's selected asset mix.
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Demutualization
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Demutualization: The process of converting a mutual company into a stock company.
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Department of Health and Human Services
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Department of Health and Human Services: The federal department that is responsible for health-related programs and issues. Its Health Care Financing Administration (HCFA) agency administers the Medicare and Medicaid programs.
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Dependent
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Dependent: A spouse or unmarried child under age 19 (if a child is a full-time student in
an accredited school, age 23 or 25 depending upon the provisions of the contract). Children
can include biological, adopted, foster and step who are supported by the insured.
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Deposit Administration Plan
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Deposit Administration Plan: A type of defined benefit plan that sets up a single fund for all eligible employees, into which deposits are accumulated and money is withdrawn at employees' retirement to purchase an annuity for the employee.
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Deposit Term Insurance
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Deposit Term Insurance: A form of term life insurance in which the first year's premium is greater than those in successive years. See Term Life Insurance.
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Deposit Term Insurance
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Deposit Term Insurance: A form of term life insurance in which the first year's premium is greater than those in successive years. See Term Life Insurance.
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Deposit Term Insurance
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Deposit Term Insurance: A form of term life insurance in which the first year's premium is greater than those in successive years. See Term Life Insurance.
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Deposits
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Deposits: Payments received by an insurer not included as revenue but included as a policyholder account balance.
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Development
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Development: The change in loss estimates between reports.
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Deviation
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Deviation: A change from the standard form or published rates of an insurer.
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Diagnosis-Related Groups (DRG)
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Diagnosis-Related Groups (DRG): A reimbursement system used by Medicare and other insurers to classify illnesses according to diagnosis and treatment. It clusters patients into 468 categories on the basis of their illnesses, diseases and medical problems. All Medicare inpatient hospital operating costs are determined in advance and paid on a per-case basis, according to fixed amount or weight established for each DRG.
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Diagnostic and Statistical Manual of Mental Disorders [Fourth Edition] (DSM-4)
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Diagnostic and Statistical Manual of Mental Disorders [Fourth Edition] (DSM-4): A
tool used by the medical and psychological communities to identify and classify behavioral,
cognitive, and emotional problems according to a standard numerical coding system of
mental disorders.
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Dictionary of Occupational Titles (DOT)
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Dictionary of Occupational Titles (DOT): A book of job classifications that specifies the
duties of each job listed; maintained and updated by the U.S. Department of Labor as new
jobs are created and technologies change.
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Difference in Conditions (DIC) Insurance
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Difference in Conditions (DIC) Insurance: An "all-risks" property insurance policy that covers risks not covered by a basic property policy. It is a separate, supplementary policy designed to fill gaps in coverage.
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Dingell, John
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Dingell, John: A member of the U.S. House of Representatives (D-Mich.) and former chairman of the Subcommittee on Oversight and Investigations of the House Committee on Energy and Commerce. He is the principal author of Failed Promises (1990), the Federal Insurance Solvency Act of 1992 and Wishful Thinking (1994), a sequel to Failed Promises. He also is the leading proponent of an increased federal regulatory role over the insurance industry.
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Direct Billing
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Direct Billing: A system in which the insurer, not the independent agent, sends invoices directly to the policyholder.
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Direct Premiums Written (DPW)
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Direct Premiums Written (DPW): Premiums written by an insurer before any ceding.
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Direct Response Marketing
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Direct Response Marketing: A form of marketing insurance products through the media, Internet and the mail.
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Direct Writer
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Direct Writer: An insurer whose products are sold directly to the public by a sales force consisting of employees or exclusive agents of the insurer; it also refers to a reinsurer that provides reinsurance directly to primary companies without using a reinsurance broker.
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Directors' and Officers' Liability Insurance (D&O Insurance)
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Directors' and Officers' Liability Insurance (D&O Insurance): A form of insurance that indemnifies directors and officers for their wrongful acts.
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Disability
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Disability: Physical or mental condition resulting from illness, injury or disease.
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Disability
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Disability: A physical or mental impairment that prevents or restricts normal achievement.
Something that hinders or incapacitates.
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Disability Benefit
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Disability Benefit: 1) Amount payable under a group disability (STD or LTD) plan
to a covered employee who meets eligibility criteria typically between 50% and 70%
of pre-disability income. Salary continuation plans often provide 100% of pre-
disability income prior to eligibility for STD/LTD. 2) A provision added to a life
insurance policy providing for a waiver of premium and sometimes payment of
monthly income if the insured becomes totally and permanently disabled.
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Disability Income Insurance
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Disability Income Insurance: A form of health insurance that provides payments to a disabled insured to replace lost income during periods of disability.
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Disability Management
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Disability Management: Programs that seek to prevent disability, reduce the cost impact
of disability, and provide mechanisms to promote maximum functional recovery and return-
to-work. Integrated disability management refers to those programs that are implemented
across all disability plans (e.g., STD, LTD, WC, and salary continuation) in addition to,
increasingly, group health plans.
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Disability Premium Waiver
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Disability Premium Waiver: See Waiver of Premium Provision.
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Disability, Duration Guidelines
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Disability, Duration Guidelines: Guidelines that describe the duration of different
types of disabilities according to diagnosis, symptoms, severity, and occupational
factors. Duration guidelines may be used to evaluate disabilities and forecast an
expected return-to-work time frame, such as in duration control guidelines.
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Disability, Earnings
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Disability, Earnings: The earnings you receive while you are disabled and working,
plus the earnings you could receive if you were working to your maximum capability.
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Disability, Employer-Sponsored Plans
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Disability, Employer-Sponsored Plans: A functional limitation that impedes the
performance of material duties of an employee's customary work. Disabilities are
usually classified as total (permanent total / temporary total) or partial (permanent
partial / temporary partial).
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Disability, Full Maternity
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Disability, Full Maternity: If an insured employee becomes disabled as a result of
a pregnancy or complications, the disability will be covered on the same basis as any
other illness.
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Disability, Individual with
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Disability, Individual with: Under the ADA, a person who has a physical or mental
impairment that substantially limits one or more of that person's major life activities,
has a record of such impairment, or who is regarded as having such an impairment.
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Disability, Maximum Benefit
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Disability, Maximum Benefit: For disability benefits, the maximum dollar amount
an insured will receive while disabled. For health benefits, the total dollar amount the
insurer will pay on any given individual.
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Disability, Maximum Benefit Duration
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Disability, Maximum Benefit Duration: The longest period for which employer-
sponsored disability benefits will be paid, provided that the employee remains
continuously disabled. Typically, the lesser of the number of years until Social
Security normal retirement age or the age specified in the plan.
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Disability, Maximum Monthly Benefit
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Disability, Maximum Monthly Benefit: The highest dollar amount that an
employee who has been disabled will receive each month from the employer's LTD
plan.
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Disability, Pension
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Disability, Pension: An annuity payable from a qualified pension plan to an eligible
employee who becomes disabled before normal retirement age. May be paid as a
supplement to another employer-sponsored disability benefit plan or as a reduced
pension.
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Disability, Permanent Partial
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Disability, Permanent Partial: A disability in which some portion of earning power
is lost, and the loss is expected to last for the individual's lifetime.
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Disability, Permanent Total
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Disability, Permanent Total: A disability in which all earning power is lost, and the
loss is expected to last for the individual's lifetime. In many states, workers'
compensation laws specify certain injuries as permanent total disabilities even if the
injured person is able to do some work. Compensation may be limited by time or
amount, or it may run for life.
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Disability, Social Security
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Disability, Social Security: The inability to engage in any substantial gainful
activity because of a medically determinable physical or mental impairment that can
be expected to result in death or that lasts or can be expected to last for 12 months
or more.
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Disability, Temporary Partial
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Disability, Temporary Partial: A disability in which some portion of earning power
is lost for a period of time, but from which complete recovery is expected. Benefits
are generally based on a percentage of the difference between the person's pre-
disability wage and what he or she can earn during disability.
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Disability, Temporary Total
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Disability, Temporary Total: A disability in which all earning power is lost for a
period of time, but from which complete recovery is expected. Benefits are payable
until the individual returns to employment at some level of pre-disability earnings.
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Disability, Workers' Compensation
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Disability, Workers' Compensation: A physical or psychological condition that
occurs in or results from the workplace and that actually or presumptively results in a
loss of earning power. Disabilities may be total (permanent total / temporary total)
or partial (permanent partial / temporary partial).
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Discharge Planning
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Discharge Planning: A component of utilization management, wherein medical personnel of the health plan work with the attending physician and hospital staff to assess alternatives to hospitalization, evaluate appropriate settings for care and arrange for the discharge of a patient, including planning for subsequent care at home or in a skilled nursing facility. The goal is to determine when patients are ready to go home and to provide a more comfortable, cost-efficient setting for continued treatment.
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Discounting of Reserves
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Discounting of Reserves: The process of setting the present value of a full value reserve, calculated at a selected interest rate.
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Discovery Period
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Discovery Period: The period of time in which claims must be reported under the terms of an insurance policy.
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Disease Management
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Disease Management: A coordinated care approach focused on prevention, early
identification, and intervention in the chronic disease process. Services are typically
provided by employer-sponsored health plans, contracted or "carve out" provider groups, or
through the employer's occupational health facility. By controlling factors that determine the
early course of a chronic condition, disease management proponents attempt to show that
such programs improve individual health status, control medical costs, and reduce the
incidence of work limiting disability.
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Disease Management Programs
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Disease Management Programs: Programs aimed at preventing or identifying disease earlier, thus improving quality of care and reducing its costs. These programs emphasize preventive medicine for common diseases, such as asthma and diabetes, certain effects of which may be prevented. Databases are used to help flag patients who need prescription refills or monitoring, or to notify physicians when their patients need special disease-related preventive care (e.g., eye exams for diabetics).
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Disproportionate Share Hospital
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Disproportionate Share Hospital: A hospital designated by a state as disproportionately serving Medicaid beneficiaries and other indigent patients. Medicaid allows states to make special payments to disproportionate share hospitals, and they are eligible for federal matching funds.
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Dividend
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Dividend: An amount payable by an insurer from earnings to policyholders by mutual, reciprocal and stock insurers, and to stockholders by stock insurers.
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Dividend Options
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Dividend Options: The various methods available to an insured electing to receive dividends under a life insurance policy.
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Dividend Scales
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Dividend Scales: The actuarial formulae used by life insurers to determine amounts payable as dividends on participating policies based on a variety of experience factors, including investment results, mortality, lapse rates, expenses, premium taxes, policy loan interest and utilization rates.
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Domestic Insurer
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Domestic Insurer: An insurer transacting business in the jurisdiction in which it is domiciled.
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Double Indemnity
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Double Indemnity: A benefit available as an endorsement to certain life insurance policies. It provides that twice the face amount of the policy shall be payable if death is accidental; also known as accidental death benefit.
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Downstream Holding Company
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Downstream Holding Company: A stock subsidiary of a mutual insurer, which is itself not an insurance company, but which may own insurance companies. Frequently, mutual insurers raise capital by the sale of shares in a downstream holding company.
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DPW
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DPW: See Direct Premiums Written.
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DRG
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DRG: See Diagnosis-Related Groups.
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Drop Down
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Drop Down: An insurance policy that covers a loss either because an underlying policy's limits are exhausted or because an underlying insurer is unable, by reason of insolvency or otherwise, to provide coverage.
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Dual Regulation
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Dual Regulation: The prospect of divided and possibly conflicting regulation of insurers cited by opponents of federal regulation as a reason for maintaining the current state-based regulatory system.
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Duty to Defend
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Duty to Defend: Under the terms of an insurance policy, an insurer has a "duty to defend" its insured in a court action, even in those instances where a suit may be groundless or false.
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