Health Insurance Terms G

GAMC
See General Agents and Managers Conference.

Gatekeeper Model
Under this model of HMO and PPO organizations, the primary care physician (the gatekeeper) is the initial contact for the patient for medical care and for referrals. This is also called a closed access or closed panel.

General Agent (GA)
An individual appointed by a Life or Health insurer to administer its business in a given territory. He is responsible for building his own agency and service force and is compensated on a commission basis, although he possibly has some additional expense allowances. (LI,H)

General Agents and Managers Conference
An association of insurance general agents and managers affiliated with the National Association of Life Underwriters.

General LTC Rider
A LTC rider which is attached to a life insurance policy but stands alone or is independent of the life policy. Any LTC benefits paid do not reduce any of the life insurance benefits. (H)

Generic Drug
A drug which is exactly the same as a brand name drug and which is allowed to be produced after the brand name drug's patent has expired. It is also called a "generic equivalent." (H)

Generic Equivalence
See Generic Drug.

Grievance Procedure
A procedure which allows a member of a health plan or a provider of benefits to express complaints and seek remedies.

Group
Coverage of a number of individuals under one contract. The most common "group" is employees of the same employer.

Group Certificate
The document provided to each member of a group plan. It shows the benefits provided under the group contract issued to the employer or other insured. (LI,H)***

Group Contract
A contract of insurance made with an employer or other entity that covers a group of persons identified by reference to their relationship to the entity buying the contract. The group contractual arrangement is generally used to cover employees of a common employer, members of a trade association or trusteeship, members of a welfare or employee benefit association, members of a labor union, or members of a professional or other association not formed only for the purpose of obtaining insurance.

Group Credit Insurance
Insurance on the Life or Health of debtors of a creditor, payable for reduction or extinguishment of the debts in case of the disability or death of the debtor. (LI,H)***

Group Disability Insurance
Coverage provided for a group of individuals for loss of compensation due to accident or sickness.

Group Health Insurance
The same definition as Life Insurance but with the application to Health Insurance coverages. See Group Life Insurance. (H)

Group Model HMO
A health plan where a group of physicians is reimbursed for services they provide at a negotiated rate. The HMO also contracts with hospitals for the care of the patients of the physicians who belong to the group. (H)

Guaranteed Standard Issue (GSI)
An underwriting term used to describe the fact that a group insurance contract was issued without reference to any medical underwriting. All group participants are covered regardless of health history.