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effective date
The specified date of when the health insurance policy is to begin.
emergency care
Most plans cover emergency care in a hospital emergency room if it is an extremely urgent medical emergency, even if the hospital you are taken to is not in the plan's network. It is possible, however, that after your condition has been stabilized, you would be transferred to a participating plan hospital.
emergency-room visit
A visit to a hospital for treatment of an accidental injury or for emergency medical care. To qualify as an emergency, the symptoms must be sudden, severe and require immediate medical attention. Some states judge emergencies by the "prudent layperson" law, meaning that the health plan must cover a trip to the emergency room "if a prudent layperson, acting reasonably, would have believed that an emergency medical condition existed." Keep in mind that some plans won't cover a trip to the emergency room if the symptoms appeared more than 24 hours earlier.
employee contribution
The amount of premium the employer requires the employee to pay for his or her health insurance.
enrollment or eligibility period
The time during which a new group member may first enroll for group insurance coverage.
exclusions and limitations
Conditions, situations and services not covered by the health plan.
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