Glossary A-F

*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***

Glossary A - F

The Health Care Programs Manual glossary contains definitions of many terms related to Minnesota Health Care Programs. These definitions are intended for general reference; for complete policy information, please refer to the relevant section(s) of the manual.

Notification sent to the client at least ten calendar days before the effective date of an agency action. Most adverse actions, such as denial, reduction, or termination of health care benefits, require ten-day notice.

A defined contribution plan whereby employees can elect to defer receiving a portion of their salary, which is instead contributed on their behalf, pre-tax, to the 401(k) plan. Sometimes the employer may match these contributions.

Also referred to as Tax Sheltered Annuities, 403(b) plans are tax-deferred retirement plans available to employees of educational institutions and certain non-profit organizations.

A deferred compensation program made available to employees of state and federal governments and agencies. A 457 plan is similar to a 401(k) plan. Distributions start at retirement age, but participants can also take distributions if they change jobs or in certain emergencies. Participants can choose to take distributions as a lump sum, annual installments or as an annuity.

Provisions of the Social Security Act which allow certain employed people who would otherwise be ineligible to retain SSI status. The Social Security Administration certifies people for 1619(a) and 1619(b) eligibility. People with 1619(a) or 1619(b) status retain their MA eligibility under the SSI-related category if they received MA the month before certification for 1619(a) or 1619(b).

A provision allowing continued SSI and MA eligibility for people who would otherwise lose SSI because of a demonstrated ability to work.

A provision allowing continued MA eligibility for people who become ineligible for SSI benefits under 1619(a) due to excess income.

One of the insurance barriers for MinnesotaCare. The 18-month rule requires that some people cannot have current coverage or access to ESI. It also restricts eligibility for some people who have had access to ESI in the past 18 months if the client stopped the insurance or if the employer chose to drop coverage.

One of the insurance barriers for MinnesotaCare. The four-month rule requires some people to have been uninsured for four months before they can enroll in MinnesotaCare.

The period of coverage that begins the last day of the pregnancy and ends the last day of the month in which a 60-day period, beginning on the last day of the pregnancy, ends.

Obsolete term for non-custodial parent. A parent who does not have physical custody of a child.

Alternative Care. A state-funded program, administered by county social services agencies, which provides home and community-based services for clients age 65 or older in an effort to keep the client in the community and avoid a nursing facility placement.

Transportation and services needed to help clients obtain medically necessary health care. These services may be provided by a health plan, a county agency or MinnesotaCare Operations.

The first phase of a deferred annuity during which the contract accumulates funds from the payments made into the annuity and accrues interest and earnings on investments.

A legal Declaration of Parentage (DOP) or Recognition of Parentage (ROP) signed by both the mother and father of a child born to a woman who was not married to the child's father when the child was conceived nor when the child was born, declaring that they are the biological parents of the child. The DOP is valid only if it was executed before August 1, 1995. For documents executed on or after August 1, 1995, only the ROP is valid.

An annuity is actuarially sound if the cash value as of the date of annuitization is expected to pay out in full within the expected lifetime of the person requesting MA payment of LTC services or his or her spouse.

Receipt of the fair market value, or other compensation equal to the fair market value, in exchange for the transfer or sale of real or personal property.

An adoption assistance grant provided to adoptive parents. It is funded either federally through Title IV-E of the Social Security Act or by the State under Minnesota Statutes, section 259.67.

Annuity-Funded Burial. An annuity contract with an irrevocable designation of the cash surrender value (CSV) to a funeral provider as the primary beneficiary. The value of the contract is to be paid to a funeral provider in exchange for agreed-upon goods and services.

Aid to Families with Dependent Children. The program formerly authorized under Title IV-A of the Social Security Act to provide financial assistance and social services to needy families with dependent children. AFDC was replaced by the Temporary Assistance to Needy Families (TANF) block grant in 1996. Minnesota's TANF program is the Minnesota Family Investment Program (MFIP).

The property located on agricultural land that meets the definition of home and includes the dwelling, the garage, if any, and one acre of land immediately surrounding the dwelling.

A contiguous acreage, of 10 acres or more, used during the preceding year for agricultural purposes, or a contiguous acreage, of less than 10 acres, which is exclusively and intensively used for raising or cultivating agricultural products.

Examples of agricultural products include but are not limited to livestock, dairy animals and products, poultry animals and products, fur-bearing animals, horticultural and nursery stock, fruits, vegetables, forage, grains, bees, and apiary products.

Use of property for the production of products or services offered for sale by the owner.

l Commercial boarding of horses if the boarding is done in conjunction with raising or cultivating agricultural products.

l Fish bred for sale and consumption if the fish breeding occurs on land zoned for agricultural use.

l Property which is owned and operated by nonprofit organizations used for equestrian activities, excluding racing.

l Trees, grown for sale as a crop, and not sold for timber, lumber, wood or wood products.

l Maple syrup taken from trees grown by a person licensed by the Minnesota Department of Agriculture as a food processor.

l Enrollment in the Reinvest in Minnesota program or the federal Conservation Reserve Program.

l Leasing all or a portion of the property to another person for agricultural purposes.

The program formerly authorized under Title IV-A of the Social Security Act to provide financial assistance and social services to needy families with dependent children. AFDC was replaced by the Temporary Assistance to Needy Families (TANF) block grant in 1996. Minnesota's TANF program is the Minnesota Family Investment Program (MFIP).

Obsolete term for spousal maintenance. An allowance for support that a court orders a person to pay to his or her current or former spouse.

A deduction from the income of a long-term care facility resident or a person receiving Elderly Waiver services for the maintenance needs of certain relatives.

A state-funded program, administered by county social services agencies, which provides home and community-based services for clients age 65 or older in an effort to keep the client in the community and avoid a nursing facility placement.

A person who is a member of a federally recognized Indian tribe, considered by the Secretary of the Interior to be an Indian for any purpose, or is determined to be an Indian under regulations promulgated by the U.S. Secretary of Health and Human Services.

A deduction for costs of starting a business that is deducted from the business income over a period of time.

The person(s) upon whose life expectancy annuity payments are based. Multiple annuitants in an annuity contract are commonly referred to as joint annuitants or co-annuitants. Not all annuity payments are based upon a persons life expectancy. See term certain annuity. Annuitant sometimes refers to a person who receives periodic payments from an annuity.

The second phase of a deferred annuity during which the owner chooses a periodic payment option, also called a settlement option. At the time the payment option is chosen, the owner chooses the amount of each payment, how often the payments are to be made, and the length of time over which the payments are to be made. Selecting the settlement option is referred to as annuitization or annuitizing the annuity (also called the Payout Phase).

A purchased contract in which one party (annuity issuer) agrees to pay the purchaser, or the person(s) the purchaser designates (the payee or payees), a return on money deposited with the annuity issuer (either in the form of a single lump sum or several payments deposited over several months or years) according to the terms of the annuity contract.

An annuity contract with an irrevocable designation of the cash surrender value (CSV) to a funeral provider as the primary beneficiary. The value of the contract is to be paid to a funeral provider in exchange for agreed-upon goods and services.

A person or entity (an insurance company) that manages an annuity. The annuity issuer accepts funds from the owner(s) during the accumulation phase and issues payments after the funds have been annuitized. Banks and financial planners often sell annuity arrangements; however, insurance companies issue annuity-based financial arrangements.

Person(s) who may exercise rights provided in the annuity contract. For example, the owner(s) names the payee(s) who can be an owner or other parties, chooses the settlement option, and names the beneficiaries.

A client's or authorized representative's request to the State of Minnesota appeals section for review of the state or a county agencys action or inaction or for review of a managed care health plan's medical service or payment issues. Also known as a Fair Hearing.

A person who has submitted a request for coverage for whom no decision has been made regarding eligibility.

Any of several forms prescribed by the commissioner of DHS which people must complete to apply for health care coverage.

A person chosen by the applicant to assist with the application process. The application assistor performs activities such as helping complete forms and obtain verification, but cannot sign the application unless designated as the authorized representative. Require a signed release form (DHS-3549) to release information to the application assistor.

A secure, web-based application used to apply for Minnesota Health Care Programs (MHCP) including payment of long-term care services, cash assistance, Supplemental Nutrition Assistance Program (SNAP), Child Care Assistance Program (CCAP) and emergency help.

The amount of net countable assets a client may own or have available to them and remain eligible for a health care program.

To transfer legal claim, such as assignment of benefits available through other health coverage or medical support.

A Minnesota Health Care Program household member whose health care expenses are used to meet another household member's medical spenddown.

A person authorized to act on a client's behalf for any of the MHCP. An authorized representative may be designated by the client and may exercise all the rights and responsibilities of a client.

A basis of eligibility for a child who receives automatic MA or MCRE eligibility through the month of his or her first birthday. The child's mother must have been enrolled in a Minnesota Health Care Program during the month of birth and the child must continue to live in Minnesota.

A lump-sum payment scheduled at the end of a series of smaller periodic payments that is selected as part of a payment agreement.

An identifying characteristic of a category of people specified as potentially eligible for Medical Assistance (MA). People without one of the specified characteristics are ineligible for MA but may be eligible for MinnesotaCare.

A noncitizen who is the spouse or child of a U.S. citizen or Lawful Permanent Resident (LPR) and who has been battered or subject to extreme cruelty in the U.S. by a family member residing in the same household.

A public or private nonprofit crisis shelter, housing network or other shelter facility providing services to battered women and their children.

MA coverage for services not related to skilled nursing facility care, nursing facility care in an inpatient medical hospital or intermediate care facility (ICF, ICF/DD), or services covered by home and community-based waiver programs.

Beneficiary Earnings and Exchange Record. A monthly IEVS tape exchange between the Social Security Administration and DHS reporting wages, self-employment, and federal pension earnings from federal tax returns. The original source is the Internal Revenue Service.

A prescription drug coverage plan that has been designated by Medicare to meet certain coverage requirements and which has a monthly premium that is fully subsidized by Extra Help.

The person named to receive benefits or payments (for example, social security payments or payments from a life insurance policy or trust). For annuities, a beneficiary is the individual, trust, or entity named by the annuity owner to receive death benefits from an annuity.

A monthly IEVS tape exchange between the Social Security Administration and DHS. The report provides information on RSDI and Medicare.

A monthly IEVS tape exchange between the Social Security Administration and DHS reporting wages, self-employment, and federal pension earnings from federal tax returns. The original source is the Internal Revenue Service.

A section of DHS which pursues collection of third party payments and determines if health insurance is cost effective.

Burial Fund Exclusion. Allows clients to set aside, or designate, up to $1500 in assets to cover certain burial expenses. Assets designated toward the BFE are not counted in the client's net asset total.

A basis of eligibility for a person without vision, or who meets specific limited-vision conditions.

Beneficiary Data Exchange. A monthly IEVS tape exchange between the Social Security Administration and DHS. The report provides information on RSDI and Medicare.

A facility that serves as an alternative to institutionalization and provides a program of on-site care or supervision to persons who cannot live independently because of age or physical, mental or emotional disability.

A gap of one calendar month or more in receiving MA payment of LTC services because the individual either:

2. Stopped residing in a LTC facility or receiving services through a home and community-based waiver program.

Benefit Recovery Section. A section of DHS which pursues collection of third party payments and determines if health insurance is cost-effective.

Burial Space. Any repository for the remains of the deceased such as cemetery plots, urns, niches, crypts, and caskets.

Burial Space Items. Items which add to or improve burial spaces such as markers, engraving, vaults, opening and closing of the grave, and one time charges for preservation/care of the space (perpetual care).

An arrangement in which funds are deposited with a funeral director to be used for funeral expenses. The agreement may cover funeral and professional services, burial space items, or both. The money is usually held in trust by a bank or other financial institution unless the agreement is funded by an insurance policy or annuity. Burial agreements may be revocable or irrevocable.

The Burial Fund Exclusion (BFE) allows clients to set aside, or designate, up to $1500 in assets to cover certain burial expenses. Assets designated toward the BFE are not counted in the client's net asset total.

Funds paid or designated in advance for funeral expenses, including but not limited to burial agreements. Burial funds provide for preparation of the body, cremation, or burial services.

Any repository for the remains of the deceased such as cemetery plots, urns, niches, crypts, and caskets.

Items which add to or improve burial spaces such as markers, engraving, vaults, opening and closing of the grave, and one-time charges for preservation/care of the space (perpetual care).

The process of having some or all of the clients Medicare costs paid through MA.

Child and Teen Checkups. A component of MA and MinnesotaCare that promotes preventive health care for children from birth to age 21. This program is federally known as the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program.

A corporation in which shareholders receive profits in the form of dividends. Shareholders who perform work for the corporation also receive wages. The corporation must file a corporate tax return.

Community Alternative Care. A federally approved home and community-based services waiver program for chronically ill people under age 65.

Community Alternatives for Disabled Individuals. A federally approved home and community-based waiver program for people under age 65 who would otherwise require the level of care provided in a nursing facility.

Combined Application Form. A form on which people can apply for multiple programs administered by DHS, including but not limited to General Assistance (GA), Supplemental Nutrition Assistance Program (SNAP), Minnesota Family Investment Program (MFIP), Medical Assistance (MA), Minnesota Supplemental Aid (MSA), and Emergency Medical Assistance (EMA).

Cash Advance Items. Items pre-paid in a burial agreement for items above and beyond basic burial services such as flowers, music, obituary notices and motor escort.

Real or personal property used in a trade or business with a useful life of one year or more.

Payment made to purchase or improve property with a useful life of more than one year.

Profit from the sale or exchange of business or personal assets. An asset owned and sold within a year is a short-term capital gain. An asset owned for more than one year is a long-term capital gain.

Loss from the sale or exchange of business or personal assets. An asset owned and sold within a year is a short-term capital loss. An asset owned for more than one year and sold is a long-term capital loss.

A method of payment for health services that involves a monthly per person rate paid on a prospective basis to a managed care organization. Capitation occurs six working days before the end of the month.

A person who provides care and support to a minor child. The person may or may not be covered and may or may not be considered part of the child's household.

A federal tax deduction used when allowable business deductions exceed gross receipts for the tax year. The business loss may be carried over into future years.

1. A method of providing health care in which the managed health care organization (MCO) coordinates the provision of health services to a managed care enrollee. 2. Services not normally covered by MA that may be covered under a waiver for people with severe and persistent mental illness.

Items pre-paid in a burial agreement for items above and beyond basic burial services such as flowers, music, obituary notices and motor escort.

General Assistance (GA), Group Residential Housing (GRH), Minnesota Family Investment Program (MFIP), Minnesota Supplemental Aid (MSA), Refugee Cash Assistance (RCA) and emergency cash programs.

The amount the life insurance policy owner, including an annuity owner, would receive if the policy were cashed in.

Continuing Care Retirement Community. An organization that enters into a written agreement with a client to offer a range of continuing care services while providing flexible accommodations, which may change with the client's needs. A CCRC may also be referred to as a life care community.

Certificate of Deposit. A promissory note issued by a bank entitling the bearer to receive interest. A CD is a time deposit that restricts holders from withdrawing funds on demand. Although it is still possible to withdraw money, this action will often incur a penalty.

A Minnesota-based private, nonprofit, nonpartisan organization founded in 1985. CVT exists to heal the wounds of government-sponsored torture on individuals, their families, and communities and to stop its practice.

Administers the Medicare program and works in partnership with the States to administer Medicaid and other programs. Formerly known as HCFA.

A summary of a health insurance plan's covered services, grievance and appeal processes for the policyholder. Also referred to as member contract or evidence of coverage, provided by the managed care organization.

Documentation of a person's creditable coverage. People can present certificates of creditable coverage to their new health plans to prove that they had previous coverage.

A promissory note issued by a bank entitling the bearer to receive interest. A CD is a time deposit that restricts holders from withdrawing funds on demand. Although it is still possible to withdraw money, this action will often incur a penalty.

The period of time (up to 12 months) for which eligibility is determined. The certification period may include any retroactive months of eligibility. It is also the period of time for which income is calculated to determine income eligibility and premium or spenddown amounts.

A family planning services provider who is approved by DHS to make presumptive eligibility determinations for the Minnesota Family Planning Program.

Former name of TRICARE. A Department of Defense health insurance program providing coverage to active-duty and non-active duty members of the armed forces and their dependents, and certain civilian employees.

A Department of Veterans' Affairs program that provides health care coverage for the spouse and children of certain disabled or deceased veterans. This coverage is provided for these family members if they are not eligible for TRICARE benefits.

A component of MA and MinnesotaCare that promotes preventive health care for children from birth to age 21. This program is federally known as the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program.

Program available to help low- and moderate-income families pursue employment or education leading to economic self-sufficiency by subsidizing their child care.

A voluntary or court-ordered payment by non-custodial parents for the support of their children.

The Centers for Medicare and Medicaid Services (CMS) administers the Children's Health Insurance Program (CHIP). This program provides federal matching funds to help states expand health care coverage for the nation's uninsured children.

The forerunner of the MinnesotaCare program. CHP began in 1988 and provided comprehensive outpatient health care coverage for children ages 1-17. It was discontinued in 1993, and all children covered at that time were converted to MinnesotaCare.

Children's Health Insurance Program. The Centers for Medicare and Medicaid Services (CMS) administers the Children's Health Insurance Program (CHIP). This program provides federal matching funds to help states expand health care coverage for the nation's uninsured children.

Children's Health Plan. The forerunner of the MinnesotaCare program. CHP began in 1988 and provided comprehensive outpatient health care coverage for children ages 1-17. It was discontinued in 1993, and all children covered at that time were converted to MinnesotaCare.

Recovery of an overpayment through the civil judicial process rather than the criminal process.

A list of amounts the State of Minnesota has paid for medical services, whether it be the capitation amount or the actual cost of fee-for-service expenses.

A method for clients to pre-pay a medical spenddown to DHS. Is only available to clients with an automated monthly spenddown.

The amount of monthly income institutionalized clients may keep or receive for their day-to-day expenses.

Centers for Medicare and Medicaid Services. Administers the Medicare program and works in partnership with the States to administer Medicaid and other programs. Formerly known as HCFA.

A provision of the Consolidated Omnibus Budget Reconciliation Act (COBRA) which requires employers to allow former employees to continue coverage through the employer's group plan for 18 months after the employment has ended (29 months if the employee is disabled). In most cases, the former employee must pay the full cost of COBRA coverage.

Certificate of Coverage. A summary of a health insurance plan's covered services, grievance and appeal processes for the policyholder. Also referred to as member contract or evidence of coverage, provided by the managed care organization.

Certificate of Creditable Coverage. Documentation of a person's creditable coverage. People can present certificates of creditable coverage to their new health plans to prove that they had previous coverage.

An insured person's share of the cost of treatment. For example, if an insurance policy covers 80% of the cost, the coinsurance amount is 20%.

A form on which people can apply for multiple programs administered by DHS, including but not limited to General Assistance (GA), Supplemental Nutrition Assistance Program (SNAP), Minnesota Family Investment Program (MFIP), Medical Assistance (MA), Minnesota Supplemental Aid (MSA), and Emergency Medical Assistance (EMA).

The difference between a clients long-term care (LTC) spenddown and the cost of the clients LTC or Elderly Waiver (EW) services. A client must have incurred medical expenses, in addition to the cost of LTC or EW services, in an amount equal to or greater than the combination LTC/medical spenddown to become eligible for MA.

An annuity that is purchased and set up via an insurance company or financial institution licensed or regulated by the Minnesota Department of Commerce or a similar agency of another state.

A federally approved home and community-based services waiver program for chronically ill people under age 65.

A federally approved home and community-based waiver program for people under age 65 who would otherwise require the level of care provided in a nursing facility.

A person who does not reside in a long-term care facility (LTCF) or receive services through a waiver program (EW, CAC, CADI, DD or BI) who is married to a long-term care (LTC) spouse. A community spouse may receive Medical Assistance (MA) or services through the Alternative Care (AC) program.

The calculated amount of income needed by the community spouse. It is an amount up to the maximum monthly income allowance, or the minimum monthly income allowance plus any excess shelter expenses.

A term used by insurance companies to describe a broad range of covered services including the diagnosis and treatment of most illnesses and injuries. Coverage may vary under individual policies.

Data about individuals that even the individuals themselves cannot access, such as information from an investigation about welfare fraud or adoption records.

A person, official, or institution appointed by the court to perform financial functions such as contracting, paying bills and investing assets for a minor or incapacitated person, known as the conservatee or protected person.

An organization that enters into a written contract with a client to offer a range of continuing care services while providing flexible accommodations, which may change with the client's needs. A CCRC may also be referred to as a life care community.

Enrollment in MinnesotaCare or Medical Assistance (MA) without a break in coverage of one month or more.

At least 30 consecutive days of either institutional care in a long-term care facility (LTCF) or receipt of services, based on a documented need of nursing facility level of care that would qualify for payment by the Elderly Waiver (EW) or Alternative Care (AC) programs; or a combination of both a stay in an LTCF and receipt of services that would qualify for payment by the EW or AC programs that is at least 30 consecutive days.

A written obligation by a seller to deliver the deed to the property when certain conditions have been met, such as completion of payments by the purchaser. A contract for deed is a type of mortgage in that it places an encumbrance on the land.

These plans include a network of providers that contract with a Medicare Advantage organization to deliver a federally-approved benefit package.

A fixed amount a person is required to pay for each episode of a particular treatment, medical supply, or equipment. For example, a policy might require a $5 co-payment for each prescription while the insurance pays the remainder.

Income and/or assets that form the main body of a trust. Assets or income in the trust corpus may be available to a person but the person no longer owns them. Also known as the trust principal.

Other health care coverage for which the amount paid for premiums, coinsurance, deductibles, and other costs is likely to be less than the amount paid by MA for equivalent services.

An enrollee's financial responsibility for health care program coverage, such as a co-payment, coinsurance or premium.

An option that allows counties to choose to assume the responsibility for purchasing health services for enrollees who are eligible for PMAP.

The local human services office responsible for determining eligibility for Minnesota Health Care Programs.

Creditable coverage gives people credit for previous health insurance coverage when they move to new health plans to reduce the exclusion period that may be imposed due to pre-existing conditions. A person with creditable coverage must be allowed special enrollment in a health plan at a time other than the employer's open enrollment period.

This type of burial agreement is an agreement in which funds are pre-paid for burial through a cremation society.

Cash Surrender Value. The amount the life insurance policy owner, including an annuity owner, would receive if the policy were cashed in.

The household of a MinnesotaCare applicant in which at least one other household member is eligible for MHCP, SNAP, or a cash assistance program; is being terminated from MHCP or MFIP; or is being denied MHCP coverage.

The date by which information must be entered in the health care eligibility system to effect a change for the following month.

Center for Victims of Torture. A Minnesota-based private, nonprofit, nonpartisan organization founded in 1985. CVT exists to heal the wounds of government-sponsored torture on individuals, their families, and communities and to stop its practice.

1) include supervision, training, assistance, and supported employment, work-related activities, or other community-integrated activities designed and implemented in accordance with the individual service and individual habilitation plans required under Minnesota Rules, parts 9525.0015 to 9525.0165, to help an adult reach and maintain the highest possible level of independence, productivity, and integration into the community; and

2) are provided under contract with the county where the services are delivered by a vendor licensed under sections 245A.01 to 245A.16 and 252.28, subdivision 2, to provide day training and habilitation services.

Developmental Disabilities Waiver. A federally approved home and community-based services program for children and adults with mental retardation or a related condition who need the level of care provided in an Intermediate Care Facility for Persons with Mental Retardation or Related Conditions (ICF/MR).

A form that serves as an acknowledgement of paternity. This form may be signed before or after the child's birth. To be valid it must have been executed before August 1, 1995. Notarized signatures of both parents must be on the form.

The amount of health care expenses an insured person is required to incur before benefits are payable under a health insurance policy. For example, if an insured person has a $1,000 deductible, he or she must incur $1,000 in medical costs before the policy begins paying benefits.

An amount allowed to reduce a person's total net income because its use or intended use is for certain specific expenses.

To count the income or assets of one person when determining the eligibility of another.

A qualified employer plan that maintains a separate account or annuity to receive voluntary employee contributions to facilitate employee retirement savings.

An individual who for MA purposes is considered to be receiving SSI. This includes people eligible under 1619(a) and (b); children eligible under the TEFRA waiver; people eligible for the Pickle disregard; Disabled Adult Children; Disabled Widows and Widowers; and people not receiving SSI payment because of recoupment or one-month suspension due to excess income.

An annuity contract under which periodic payments will begin sometime in the future. A deferred annuity contract provides the purchaser with the opportunity to accumulate savings over an extended period before the contract enters its payout phase. A deferred annuity has two phases: 1) the accumulation phase; and 2) the annuitization phase (also called the payout phase).

The act of disapproving an application, a request to add a person to coverage, or a request for specific medical services.

A child who lives with a parent, legal guardian, relative caretaker or foster parent and is under age 18 or 18 years old, a full-time student, expected to graduate by age 19.

Health insurance coverage offered or provided to the insured's specified dependents.

A federal income tax deduction for the cost of a business asset that gradually loses value through the wear and tear of use.

A method for clients to pay their waiver obligation or medical spenddown to a chosen provider. Clients who receive certain types of services may choose the designated provider option. Clients with long-term care spenddowns must use this option.

A federally approved home and community-based services program for children and adults with mental retardation or a related condition who need the level of care provided in an Intermediate Care Facility for Persons with Mental Retardation or Related Conditions (ICF/MR).

People diagnosed with mental retardation or a related condition who have substantial functional limitations or deficits in adaptive behavior and who manifest these conditions before their 21st birthday.

The DHS Systems Information Resource (SIR) provides system availability information, announcements, and targeted links and content. A login ID and password are required for access.

A basis of eligibility based on the Social Security Administration (SSA) disability standards. Disability may be determined by the SSA or the State Medical Review Team (SMRT).

A policy which pays a fixed amount of income to a person who becomes disabled under the terms of the policy. Disability insurance is intended as an income replacement and is not health insurance.

Any payment from a trust, including, but not limited to, cash and other liquid items, personal property, real property or the right to use and occupy real property.

A trust authorizing the trustee to use full discretion to determine how much is paid out from the trust.

The amount of the profit distribution a shareholder receives or the amount of the surplus distribution a policyholder of a participating insurance policy receives.

Dividends that the policy holder has left in the custody of the insurer to accumulate interest.

Declaration of Parentage. A form that serves as an acknowledgement of paternity. This form may be signed before or after the child's birth. To be valid it must have been executed before August 1, 1995. Notarized signatures of both parents must be on the form.

Day Training and Habilitation. Services for adults with developmental disabilities that:

People enrolled in Medicare Part A or B simultaneously with MA or any of the Medicare savings programs.

Money received from employment or self-employment. This includes but is not limited to salaries, wages, tips, commissions, vacation, and sick pay.

A federal tax credit given to low income people. Household members may receive an EIC once a year as a refund or as an advance payment or tax reduction with each paycheck.

An amount deducted from earned income, as an employment incentive, when determining a client's total net income.

The begin date of a specific action such as an approval, denial, closure or other change in eligibility or coverage.

An MA waiver program providing home and community-based services for clients age 65 or older who need a nursing home level of care to enable them to stay in the community.

The date a client is eligible for coverage under the Minnesota Health Care Programs.

One of four groups assigned to a MinnesotaCare enrollee based on certain factors. The eligibility group determines the eligibility requirements that apply to MinnesotaCare applicants and enrollees.

DHS's system to verify an enrollee's coverage and eligibility dates under the Minnesota Health Care Programs. Providers contact EVS by phone or online to confirm eligibility.

A person under the age of 18 who is or was married, is on active duty in the uniformed services, or has been declared emancipated by a court. In Minnesota, a person is an adult at age 18 and adults are considered ”emancipated” from their parents.

A person has been admitted or held for emergency care and treatment due to mental illness, developmental disability or chemical dependency and is in danger of causing injury to self or others.

A facility that provides shelter when an individual or family loses their housing due to an emergency, such as a fire, flood or condemnation.

A form of defined contribution plan in which the investments are primarily in employer stock.

Insurance coverage offered to employees or dependents for whom the employer or union pays at least 50% of the cost of coverage.

Estimated Market Value. The value assigned to real estate by the county assessor for the purpose of levying property taxes. EMV is found on the annual property tax assessment statement.

A legal claim against real or personal property payable when the property is sold.

A person receiving coverage through a Minnesota Health Care Program or a managed care organization (MCO).

The total amount of payments, and/or the value of property, made or promised as full or partial consideration for acceptance into or maintaining residence in a continuing care retirement community (CCRC).

Explanation of Medical Benefits. A statement from DHS, an insurance company, or a health plan reporting amounts paid, reduced, or denied for the client's health care expenses.

A deed, bond, money, or piece of property held in trust by a third party to be turned over to the grantee only on fulfillment of a condition.

Employer-Subsidized Insurance. Insurance coverage offered to employees or dependents for whom the employer or union pays at least 50% of the cost of coverage.

Employee Stock Ownership Plan. A form of defined contribution plan in which the investments are primarily in employer stock.

On or after August 1, 2003: Estate is defined as the probate estate under Minnesota Statutes, Chapter 524, along with all of the person's interest established on or after August 1, 2003; or proceeds from those interests in real property owned by the person as a life tenant or joint tenant with the right of survivorship at the time of death, and to the extent the following interests become part of the probate estate, all interests or proceeds of those interests in securities owned by the person in beneficiary form and all interests in joint accounts, multiple party accounts, and pay on death accounts or proceeds of those accounts are subject to estate recovery. Prior to August 1, 2003: Estate is defined as described and used in Minnesota Statutes Chapter 524, Uniform Probate Code.

The value assigned to real estate by the county assessor for the purpose of levying property taxes. EMV is found on the annual property tax assessment statement.

Eligibility Verification System. DHS's system to verify an enrollee's coverage and eligibility dates under the Minnesota Health Care Programs. Providers contact EVS by phone or online to confirm eligibility.

Elderly Waiver. An MA waiver program providing home and community-based services for clients age 65 or older who need a nursing home level of care to enable them to stay in the community.

A service or living arrangement which is a factor in determining a client's county of financial responsibility.

A provision in a trust that provides for the suspension, termination, limitation or diversion of the principal, income or beneficial interest of a beneficiary if the beneficiary applies for, and is determined eligible for or receives public assistance.

A statement from DHS, an insurance company, or a health plan reporting amounts paid, reduced, or denied for the client's health care expenses.

A Medicare Part D cost-sharing subsidy program. Full-benefit, dual eligible enrollees are automatically eligible for the full Extra Help subsidy. Others may apply to the Social Security Administration for full or partial Extra Help subsidies.

The policys death benefit (the amount paid out at the death of the insured) at the time a life insurance policy is purchased.

A state-funded program that provides funds to help families provide home care for dependents with mental retardation or related conditions.

Federal Benefit Rate. The maximum federal benefit rate for the Supplemental Security Income (SSI) program. This amount is updated each January and is used to determine the Pickle Disregard and the Special Income Standard (SIS) for the Elderly Waiver (EW) program.

The maximum federal benefit rate for the Supplemental Security Income (SSI) program. This amount is updated each January and is used to determine the Pickle Disregard and the Special Income Standard (SIS) for the Elderly Waiver (EW) program.

Federal reimbursement to DHS for some of the cost of a client's health care services. People must meet certain criteria to be eligible for health care programs with FFP.

The Internal Revenue Service (IRS) forms that people who are not exempt must file annually to establish their federal income tax liability. Federal tax forms usually consist of Form 1040 and various supplemental schedules depending on the taxpayer's circumstances.

The amount of income below which a household of a given size is considered impoverished. The federal government updates the FPG annually. All Minnesota Health Care Programs income standards are based on the FPG.

A method of payment for health services. The medical provider bills the insurer and is paid for specific individual services.

Federal Financial Participation. Federal reimbursement to DHS for some of the cost of a client's health care services. People must meet certain criteria to be eligible for health care programs with FFP.

Social Security payroll taxes that are collected under the authority of the Federal Insurance Contributions Act (FICA).

A managed care enrollee's opportunity to change health plans once during the first year of enrollment in a health plan.

A 12-month accounting period. The DHS fiscal year begins July 1 and ends June 30. The fiscal year is designated by the calendar year in which it ends. For example, fiscal year 2009 is the year that begins July 1, 2008, and ends June 30, 2009.

Employer-established benefit plan that allows employees to be reimbursed for medical expenses. These may be offered in conjunction with other employer-provided benefits. FSAs are usually funded through voluntary salary reduction agreements with an employer. Both employees and employers may make contributions to the FSA. See IRS Publication 969 for more information.

Fair Market Value. The price an item would sell for on the open market in a local geographic area.

Former name of the Federal Supplemental Nutrition Assistance Program (SNAP), a U.S. Department of Agriculture program that issues benefits in the form of electronic benefits to increase food purchasing power.

Former name for the Federal Supplemental Nutrition Assistance Program (SNAP), a U.S. Department of Agriculture programs that issues benefits in the form of electronic benefits to increase food purchasing power.

Care given to a child or adult including emergency, interim, or permanent care that cannot be furnished by a parent or legal guardian in the home.

A child under age 21 whose placement, care, and supervision are the responsibility of a social services agency.

One of the insurance barriers for MinnesotaCare. The four-month rule requires some people to have been uninsured for four months before they can enroll in MinnesotaCare.

Federal Poverty Guidelines. The amount of income below which a household of a given size is considered impoverished. The federal government updates the FPG annually. All Minnesota Health Care Programs income standards are based on the FPG.

People who are enrolled in both federally funded MA and Medicare. People gain full-benefit dual eligible status in the first month they are enrolled in both Medicare and federally funded MA. People enrolled in Medicare and MA with a spenddown gain full-benefit dual eligible status in the first month they meet the MA spenddown. Full benefit dual eligibles automatically qualify for Extra Help through the rest of the calendar year.

Evaluation of the level of care needed by a person who is assessed as being at risk of placement in an intermediate care facility for the developmentally disabled (ICF/MR), nursing facility, or is requesting residential, training and habilitation, or family support services.

A person who is enrolled in a graded or ungraded primary, intermediate, secondary, GED preparatory, trade, technical, vocational, or post-secondary school and who meets the school's standard for full-time attendance. Summer vacations and school holidays do not affect the student's full-time status. Consider people who are enrolled and attending but do not meet the school's standard for full-time attendance to be part-time students.

Face Value. The policy's death benefit (the amount paid out at the death of the insured) at the time a life insurance policy is purchased.

Glossary	Effective: July 1, 2012
Glossary A-F	Archived: June 1, 2016 (Previous Versions)