Glossary of Terms

Balance Billing

A balance billing is the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. An in-network provider may not “balance bill” you for covered services.

Benefit Year

A year of benefits coverage under an individual health insurance plan. The benefit year for plans bought inside or outside Washington Healthplanfinder begins January 1 and ends December 31 of the same year. Your coverage ends December 31, even if your coverage started after January 1. Any changes to a…

Benefits

The health care items or services covered under a health insurance plan. Covered benefits and excluded services are defined in the health insurance plan’s coverage documents. In Medicaid or CHIP, covered benefits and excluded services are defined in state program rules.

Brand Name (Drug)

A drug sold by a drug company under a specific name or trademark and protected by a patent. Brand name drugs may be available by prescription or over the counter.

Broker

A broker is a person or business who can help you enroll in a Qualified Health Plan through Washington Healthplanfinder. They can recommend which plan you should enroll in. They are also licensed and regulated by Washington state and typically get payments, or commissions, from health insurers for enrolling a…

Bronze Health Plan

Plans in Washington Healthplanfinder are available in 4 categories – Bronze, Silver, Gold and Platinum. The category you choose impacts how much of the overall costs of services your insurer pays per year. On average, a Bronze plan pays 60% of the costs, a Silver plan pays 70%, a Gold…