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| Lapse |
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Termination of insurance for non-payment of Premium
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| Lapsed Policy |
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A Policy that has terminated because of failure to pay the Premium(s).
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| Large Claim Pooling |
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A system designed to help stabilize Premium fluctuations in smaller groups. Large Claims (those over a stated amount) are charged to a pool contributed to by many Small Groups who belong and share in that pool. The smaller the group of groups, the lower the Pooling level. Larger groups will have a larger Pooling level.
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| Large Group |
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A large pool of individuals for which health Coverage is provided by the group sponsor. A Large Group may be defined as more than 250, 500, 1,000, or some other number of members, depending on the MCO.
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| Late Enrollment Fee |
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In an attempt to encourage as many eligible people as possible to enroll in a Part D (Medicare Part D) prescription drug plan before the first Enrollment Period ended in May 2006, or to enroll as soon as they become eligible forMedicare, Congress created a late Enrollment fee. This fee is equal to about one percent of the Medicare Part D Premium for each month's delay in enrolling. This is an unlimited percentage, lasting as long as you are enrolled in a Part D (Medicare Part D) prescription drug plan.
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| Leading Producers Round Table (LPRT) |
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An organization of agents who qualify for membership annually or on a lifetime basis by producing certain high levels of Health Insurance (HI) Premium volume in a year. It is sponsored by the International Association of Health Underwriters.
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| Legend Drug |
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A drug which has on its label "caution: federal law prohibits dispensing without a prescription."
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| Length of Stay (LOS) |
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The total number of days a Participant stays in a facility such as a Hospital.
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| Lifetime Maximum |
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A cap on the Benefits paid for the duration of a Health Insurance (HI) Policy. Many policies have a lifetime limit of $5 million, which means that the insurer agrees to cover up to $5 million in covered services over the life of the policy. Once the $5 million maximum is reached, no additional Benefits are payable.
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| Lifetime Maximum Benefit Amount |
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The maximum dollar amount set by an MCO that limits the total amount the plan must pay for all healthcare services provided to a Subscriber in the Subscriber's lifetime.
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| Limitations |
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The conditions or circumstances for which Benefits are limited or are not payable.
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| Limited Policy |
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A Policy that covers only specified accidents or Sicknesses (e.g. a cancer policy)
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| Line Slip |
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A document (most commonly used at Lloyd's) which describes a risk to be insured. It is circulated by Brokers, and underwriters subscribe to it by indicating what percentage of the risk they are willing to take.
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| Living Benefits Rider |
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A Rider attached to a life insurance Policy which provides LTC Benefits or Benefits for the Terminally Ill. The Benefits provided are derived from the available life insurance Benefits.
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| Living Need Benefits |
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A combination of life insurance and Long Term Care (LTC) insurance which allows life insurance Benefits to generate Long Term Care (LTC) Benefits. Up to a certain percentage of the life insurance Policy's death Benefit may be used in advance to offset Nursing Home or medical expenses, reducing the face amount of the life policy.
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| Long Term Care (LTC) |
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Care which is provided for persons with chronic diseases or disabilities. The term includes a wide range of health and social services provided under the supervision of medical professionals.
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| Long Term Care Facility |
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Usually a state licensed facility which provides skilled nursing services, Intermediate Care and Custodial Care.
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| Long-Term Care Policy |
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Insurance policies that cover specified services for a specified period of time. Long Term Care (LTC) policies (and their prices) vary significantly. Covered services often include nursing care, Home Health Care services, and Custodial Care.
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| Long-Term Disability Insurance |
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A group or individual Policy which provides Coverage for longer than a short term, often until the Insured reaches age 65 in the case of illness and for the remainder of his lifetime in the case of accident. See also Short-Term Disability Insurance.
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| Loss |
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The basis for a Claim under an insurance Policy.
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| Loss of Income Insurance |
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Insurance paying loss of income Benefits.
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| Loss of Time Benefits |
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See Loss of Income Insurance.
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| Loss of Time Insurance |
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See Loss of Income Insurance.
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| Loss Rate |
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The number and timing of losses that will occur in a given group of insureds while the Coverage is in force.
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| Loss-Of-Income Benefits |
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Benefits paid for inability to work for remuneration because of disability resulting from accidental bodily Injury or Sickness. The loss of income may be real or presumptive.
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| Low-Income Assistance |
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Low-Income Assistance helps people whose incomes are limited. For the Medicare Prescription Drug Program (Part D), if your income is below 135 percent of the federal poverty level and your Assets are also limited, you'll pay no monthly Premium, no Deductible and have no gap in Coverage. |
| LPRT |
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See Leading Producers Round Table (LPRT).
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