Health Insurance Terms F

FASB
The Financial Accounting Standards Board.

Family Dependent
A person entitled to coverage because he or she is: 1. The enrollee's spouse, or 2. A single dependent child of either the enrollee or the enrollee's spouse (including stepchildren or legally adopted children), and 3. A resident of the enrollee's home.

Family Expense Policy
A policy which insures the medical expenses of all members of a family.
Federal Qualification
Approval of any HMO made by the HCFA after conducting their evaluation of methods of doing business, documents, contracts, facilities, and systems.
Fee-for-Service Equivalency
The difference between the amount a provider receives from a reimbursement system such as capitation (a flat charge per month, for instance) compared to fee-for-service reimbursement.

Fee-for-Service Reimbursement
A health care system where physicians and other providers receive payment based on their billed charge for each service provided.

Fee Maximum
The maximum amount available to a provider for specific health care services under a contract.

Fee Schedule
A list of maximum fees for providers who are on a fee-for-service basis.

Field Underwriting
The initial screening of prospective buyers of health insurance, performed by sales personnel "in the field." May also include quoting of premium rates.

Financial Accounting Standards Board (FASB)
A non-governmental group that sets standards for generally accepted accounting principles. (H)

Fiscal Intermediary
A commercial insurer contracted by the Department of Health and Human Services for the purpose of processing and administering Part A Medicare claims.

Flat Maternity Benefit
A stipulated benefit in a Hospital Reimbursement policy that is paid for maternity confinement, regardless of the actual cost of the confinement.

Flexible Benefit Plan
A type of program where employees can tailor their benefits to meet their own specific needs. (H)

Formulary
See Drug Formulary.

Franchise Insurance
A plan for covering groups of persons with individual policies having uniform provisions, although they may differ in benefits. Individual contracts are issued to each person with individual underwriting. It is usually applied to groups too small to qualify for true group coverage, and the solicitation of cases usually takes place among an employer's work force with his consent. In Life Insurance, it is sometimes called Wholesale Insurance. Contrast with True Group Insurance. (LI,H)***

Fraternal Insurance
Insurance offered a special group of people, namely, members of a lodge or a fraternal order. Such insurance may be written on an assessment basis or on a legal reserve basis. (LI,H)***

Free-Standing Emergency Medical Service Center
A facility whose primary purpose is the provision of care for emergency medical conditions. Also called emergi-center or urgi-center.

Free-Standing Outpatient Surgical Center
A facility which only provides outpatient surgical services. Also called surgi-center. (H)

Frequency
The number of times a service is provided over a given time period. (H)

Fringe Benefits
See Employee Benefit Program.

Funding Level
The dollar amount required to purchase a particular medical care program. Usually measured by the premium rate for an insured program, or an amount assessed for expected claim loss and related fees under a self-funded program.

Funding Methods
The agreed means by which an employer pays for health coverage. Future Increase Option. An option which allows the insured to increase disability income benefits at predetermined times, specified in the policy, without evidence of insurability.