Category: I

A letter from the Bureau of Health Insurance to the intermediaries in the Medicare program which provides them with administrative direction or policy. These letters form a numbered series in which the Social Security Administration has made much of the policy for the Medicare program over the last decade.  

A public or private agency or organization selected by providers of health care which enters into an agreement with the Secretary of HEW under the Hospital Insurance Program (Part A) of Medicare, to pay claims and perform other functions for the Secretary with respect to such providers. Usually, but not necessarily, a Blue Cross plan…

The quantities of services provided to patients in a hospital or some other identifiable setting. Intensity can be expressed in terms of a weighted index of services provided, or in terms of a set of statistics indicating the average number of laboratory tests, surgical procedures, X-rays, etc., provided per patient or per patient day. Intensity…

The party to an insurance policy who contracts to pay losses or render services.  

The individual or organization protected in case of loss under the terms of an insurance policy. The insured is not necessarily the risk, the person whose risk of loss from accident or sickness is protected against. In group insurance the employer is the insured, the employees are the risks.      

An organization of insurers or reinsurers through which particular types of risks are shared or pooled. The risk of high loss by any particular insurance company is transferred to the group as a whole (the insurance pool) with premiums, losses, and expenses shared in agreed amounts. The advantage of a pool is that the size…

A written contract of insurance.  

The State official charged with the enforcement of laws pertaining to insurance in the respective States. The commissioner’s title, status in government and responsibilities differ somewhat from State to State but all States have an official having such responsibilities regardless of his title. Sometimes called superintendent or director.  

A risk which has the following attributes: it is one of a large homogeneous group of similar risks; the loss produced by the risk is definable and quantifiable; the occurrence of loss is large enough to cause hardship; the cost of insuring is economically feasible; the chance of loss is calculable; and it is sufficiently…

A proposed licensure system (not presently in use in any State) under which medical care institutions would be generally licensed by the State and would then be free to hire and use personnel as each saw fit, whether or not they met usual, individual licensure requirements. Using this system, formal education would become only one…