Glossary of Insurance Terms
- Health Employer Data and Information Se
HEDIS enables purchasers and consumers to readily compare the performance of managed care plans. HEDIS is a standardized set of performance measures that assesses plans’ performance on a number of elements, including such things as financial stability, access and quality of care. It has been used extensively by private sector purchasers to judge the quality of care provided by plans to their employees. It is sponsored, supported and maintained by the National Committee for Quality Assurance (NCQA).
- Health insurance
A general term for insurance against loss by sickness or bodily injury. This usually includes coverage for medical expenses such as doctor visits and hospital stays and can cover normal and preventive care such as check-ups, prenatal care, and well-baby care.
- Health Insurance Risk Sharing Plan (HIR
Wisconsin’s high risk health insurance pool. HIRSP offers health insurance to Wisconsin residents who either are unable to find adequate health insurance coverage in the private market due to their medical conditions or who have lost their employer-sponsored group health insurance. Applicants are required to meet HIRSP eligibility criteria to qualify.
- Health maintenance organization (HMO)
A health care financing and delivery system that provides comprehensive health care services for enrollees in a particular geographic area. HMOs require the use of specific plan providers.
- High Risk Health Insurance Pool
(See Health Insurance Risk Sharing Plan)
- Home health care
A wide variety of skilled nursing care and supportive services for individuals who do not need institutional care. The services are available through intermittent visits and may include nursing care, physical therapy, speech and hearing therapy, occupational therapy, social services, and other support services.