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• Co-insurance- the percentage of covered expenses an insured individual shares with the carrier. (For example, for an 80/20 plan, the health plan member's co-insurance is 20%.) If applicable, co-insurance applies after the insured pays the deductible and is only required up to the plan's stop loss amount. (see "stop loss.")

• Co-pay/co-payment- the amount an insured individual must pay toward the cost of a particular benefit. i.e. a plan might require a $30 co-pay for a physician visit.

• Deductible- the dollar amount an insured individual is required to pay for covered expenses during a calendar year before the plan begins paying co-insurance benefits.

• Lifetime maximum benefit- the maximum amount a health plan will pay in benefits to an insured.

• Out-of-pocket maximum- the total of an insured individual's co-insurance payments and co-payments. (Usually measured in an annual amount- i.e. $1500/year.)

• Stop-loss- the dollar amount of claims filed for eligible expenses at which the insurance begins to pay at 100% per insured individual. Stop-loss is reached when an insured individual has paid the annual deductible and reached the out-of-pocket maxiumum amount of co-insurance.