PEO GLOSSARY

Human resources definitions that any human can understand

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P/E -  Price/earnings
Paperless -  A paperless office is a work environment in which the use of paper is eliminated or greatly reduced. This is done by converting documents and other papers into digital form. Proponents claim that "going paperless" can save money, boost productivity, save space, make documentation and information sharing easier, keep personal information more secure, and help the environment.
Participant -  A participant is a member of an employer-sponsored benefit plan. The participant could be an active employee, former employee and/or dependents or beneficiaries of such employees, based on the eligibility circumstances of the participant.
PBGC -  Pension Benefit Guaranty Corporation
PBM -  Pharmacy Benefit Manager
PIN -  Personal identification number
Plan Administrator -  A Plan Administrator is responsible for the structuring, management and compliance of certain company group benefits such as Health and/or Retirement plans. The Plan Sponsor typically refers to the employer or employment services organization offering the plan or benefit and the Plan Administrator is usually determined by the terms of the plan.
Plan Sponsor -  Generally, the employer, the employee organization (such as a union), or both, that establishes or maintains an employee benefit plan, including a group health plan.
POS -  Point of Service health plan
PPACA -  Patient Protection and Affordable Care Act (2010)
PPO -  Preferred Provider Organization
PPS -  Professional practices section
Pre-existing Condition -  An illness or condition that was present before an individual's first day of coverage under a group health plan.
Pre-existing Condition Exclusion -  A limitation or exclusion of benefits for a condition based on the fact that you had the condition before your enrollment date in the group health plan. A pre-existing condition exclusion may be applied to your condition only if the condition is one for which medical advice, diagnosis, care or treatment was recommended or received within the 6 months before your enrollment date in the plan. A pre-existing condition exclusion cannot be applied to pregnancy (regardless of whether the woman had previous coverage), or to genetic information in the absence of a diagnosis. A pre-existing condition exclusion also cannot be applied to a newborn or a child who is adopted or placed for adoption if the child has health coverage within 30 days of birth, adoption or placement for adoption and does not later have a significant break in coverage. If a plan provides coverage to you through an HMO that has an affiliation period, the plan cannot apply a pre-existing condition exclusion. A pre-existing condition exclusion can not be longer than 12 months from your enrollment date (18 months for a late enrollee). A pre-existing condition exclusion that is applied to you must be reduced by the prior creditable coverage you have that was not interrupted by a significant break in coverage. You may show creditable coverage through a certificate of creditable coverage given to you by your prior plan or insurer (including an HMO) or by other proof. The plan can apply a pre-existing condition exclusion to you only if it has first given you written notice. If your plan has both a waiting period and a pre-existing condition exclusion, the exclusion begins when the waiting period begins. In some states, if plan coverage is provided through an insurance policy or HMO, you may have more protections with respect to pre-existing condition exclusions. The Department has developed a model general notice of pre-existing condition exclusion and a model individual notice of pre-existing condition exclusion that can be used by a group health plan or a health insurance issuer. Correct use of the model notices will general assure compliance with regulatory requirements.
Pre-existing Condition Exclusion Period -  The period of time that a group health plan can legally limit your access to the health benefits offered by that plan because of a pre-existing condition. Under HIPAA, the maximum pre-existing condition exclusion period that can be applied to an individual is 12 months (18 months for late enrollees).
Premium -  The amount paid or to be paid by the policyholder for coverage under the contract, usually in periodic installments.
PWBA -  Pension and Welfare Benefits Administration
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