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Word
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Definition
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Waiver
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Waiver: The intentional or voluntary relinquishment, abandonment or surrender of a claim, right or privilege. An exception to the usual requirements of Medicaid granted to a state by HCFA. See Section 1115 Medicaid Waiver and Section 1915(b) Medicaid Waiver.
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Waiver of Premium
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Waiver of Premium: Exemption of an employee from responsibility for LTD premium
payments during any period in which a disability benefit is payable.
Wellness program - Any of a range of employer-sponsored activities designed to increase
employees' overall quality of life, prevent accidents and ill health, and reduce the associated
costs. May include programs for fitness, smoking cessation, nutrition and weight
management, stress management, blood pressure screening, health risk appraisals, etc.
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Waiver of Premium Provision
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Waiver of Premium Provision: A provision in a life insurance policy stating that, upon the total disability of the insured, the payment of premiums shall be waived.
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Welfare Benefit Plan
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Welfare Benefit Plan: The terms "employee welfare benefit plan" and "welfare plan" mean any plan, fund, or program established or maintained by an employer or by an employee organization, or by both, to the extent that such plan, fund, or program was established or is maintained for the purpose of providing for its participants or their beneficiaries, through the purchase of insurance or otherwise, (A) medical, surgical, or hospital care or benefits, or benefits in the event of sickness, accident, disability, death or unemployment, or vacation benefits, apprenticeship or other training programs, or day care centers, scholarship funds, or prepaid legal services, or (B) any benefit described in section 186(c) of this title [Title 29] (other than pensions on retirement or death, and insurance to provide such pensions).
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Well-Pleaded Complaint Rule
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Well-Pleaded Complaint Rule: As a general rule, determining whether a particular case arises under federal law turns on the " 'well-pleaded complaint' " rule. Under this rule, determining whether federal question jurisdiction exists, permitting a removal to federal court, must be determined from what appears from the plaintiffs statement of claims, "unaided by anything alleged in anticipation of avoidance of defenses which it is thought the defendant may interpose." Thus, the existence of a federal defense normally does not create statutory "arising under" jurisdiction and "a defendant may not [generally] remove a case to federal court unless the plaintiffs complaint establishes that the case 'arises under' federal law.
On the other hand, when a federal statute wholly displaces the state-law cause of action through complete pre-emption, the state claim can be removed. In other words, when the federal statute completely pre-empts the state-law cause of action, the plaintiffs claims, even if pleaded in terms of state law, are treated as if based upon federal law. Applying this exception to the well-pleaded complaint rule, the U.S. Supreme Court has held that "any state-law cause of action that duplicates, supplements, or supplants the ERISA civil enforcement remedy conflicts with the clear congressional intent to make the ERISA remedy exclusive and is therefore pre-empted." AETNA Health, Inc. V. Davila (02-1845) 542 U.S. 200 (2004). (holding that ERISA's civil remedies provisions preempt the Texas Health Care Liability Act (THCLA), Tex. Civ. Prac. & Rem. Code Aim. §§88.001-88.003 (2004 Supp. Pamphlet).
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Whole Life Insurance
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Whole Life Insurance: Permanent life insurance offering guaranteed death benefits and guaranteed cash values.
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Willful Misconduct
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Willful Misconduct: An intentional action with knowledge of its potential to cause serious injury or with reckless disregard for the consequences of such act.
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Wind-up Annuity
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Wind-up Annuity: An annuity sold by an insurer to satisfy liabilities under terminated pension plans.
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Wishful Thinking
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Wishful Thinking: The Dingell Committee's latest report and a 1994 sequel to Failed Promises (1990). The report describes the inadequacies of state insurance regulation in either anticipating illegal or inappropriate insurance company behavior or stopping it before it occurs. The report also claims that state regulators and the NAIC lack the authority to regulate the insurance marketplace effectively. See Dingell.
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Work Incentive Improvement Act of 1999
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Work Incentive Improvement Act of 1999: Federal law that provides for continuation of
Medicare benefits when SSDI recipients return to work. Also provides for state
demonstration projects for Medicaid continuation/buy-in arrangements for disabled
employees and rehabilitation vouchers.
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Workers' Compensation
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Workers' Compensation: A system of providing for the cost of medical care and weekly
payment to employees injured on the job or to dependents of those killed in industry in
which no-fault liability is imposed on the employers. In return, employees are generally
prohibited from using employers, even if the disabling event was due to employer
negligence. US government employees, harbor works, and railroad workers are not covered
by state workers' compensation laws, but instead by other federally administered laws.
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Workers' Compensation Insurance
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Workers' Compensation Insurance: A statutory no-fault form of insurance purchased by employers to provide benefits to employees for injuries sustained during employment.
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Working Layer
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Working Layer: A layer of an excess-of-loss reinsurance treaty just above the cedant's retention layer, in which frequent losses are expected.
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Writing
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Writing: See Underwriting.
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Written Premiums
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Written Premiums: See Premium.
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