Glossary

Family and Medical Leave Act

A law that requires your employer to give you up to 12 work weeks of unpaid leave per year for the following reasons:

• Birth and care of a newborn baby
• Adoption or foster care placement
• Care for an immediate family member (spouse, child, or parent) with a serious health condition
• Medical leave when you are unable to work because of a serious health condition

Only companies with 50 or more staff members are required to comply with this law, so check with your human resource department about their medical leave policy if you work for a smaller company. Also, to qualify you must have worked at your company for at least 1,250 hours in the last 12 months before you begin your leave.

Federal Employees Health Benefits Program (FEHBP)

The health benefits program under which most Federal government employees are covered.

Fee for Service

A reimbursement system that pays physicians or other providers a fee for each service they perform, often based on a schedule of fees.

First Dollar Plan

This term is applied generically to a health benefits plan that does not have a deductible. More recently, it is also used to describe a plan that does have a deductible but also incorporates a benefits "fund" or account that can be used to pay for medical services before the deductible is met. Unlike an HRA or HSA, the fund benefit incorporated in these first dollar plans generally does not roll over from one year to the next.

Flexible Spending Account (FSA)

A FSA is an account tied to an employer-sponsored health plan. It can be used to pay for medical expenses. Contributions to the account are typically made by the employee. The contributions are free of federal, Social Security and most state taxes. You must use the funds before the end of the year or you lose them. Funds do not accrue interest.

Formulary

A list of covered prescription drugs established by a health plan with the assistance of their Pharmacy and Therapeutics Committee. Generally includes both brand-name and generic prescription drugs. Most health benefits plans that cover prescription drugs use a formulary and, within each category of covered drugs, may provide different levels of coverage based on the drug's cost, efficacy or other considerations. Formularies are subject to periodic review and modification by a health plan.

Fully Insured

An employer who pays a premium to a health plan provider to provide and administer benefits plans for its employees is said to be "fully insured." This means the insurer, not the employer, is liable for the cost of medical claims.