Glossary of Terms

Family and Medical Leave Act (FMLA)

A federal law that guarantees up to 12 weeks of job-protected leave for certain employees when they need to take time off due to serious illness or disability, to have or adopt a child, or to care for another family member. When on leave under FMLA, you can continue coverage…

Federal Poverty Level (FPL)

A measure of income level issued annually by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility for certain programs and benefits, including Washington Apple Health (Medicaid), Health Insurance Premium Tax Credits, and cost-sharing reduction subsidies.

Federally Qualified Health Centers (FQHC)

Federally funded nonprofit health centers or clinics that serve medically underserved areas and populations. Federally Qualified Health Centers provide primary care services regardless of your ability to pay. Services are provided on a sliding scale fee, based on your ability to pay.

Fee (Penalty)

If someone does not have a health insurance plan that qualifies as minimum essential coverage, he or she may have to pay a fee. The fee increases every year: from 1% of income (or $95 per adult, whichever is higher) in 2014 to 2.5% of income (or $695 per adult)…

Fee For Service (FFS)

A method by which doctors and other health care providers are paid for each service performed. Examples of services include tests, office visits, or procedures. The fee for service method is often compared to the managed care model in which beneficiaries pay a set premium in return for care from…

Flexible Benefits Plan

A benefit program that offers employees a choice of various benefits including cash, life insurance, health insurance, vacations, retirement plans, and child care. Although a common set of core benefits may be required, you can choose how your remaining benefit dollars are allocated to each type of benefit from the…

Flexible Spending Account (FSA)

An arrangement you set up through your employer to pay for many of your out-of-pocket medical expenses with tax-free dollars. These expenses include insurance co-payments and deductibles, and qualified prescription drugs, insulin and medical devices. You decide how much of your pre-tax wages you want taken out of your paycheck…

Formulary

A list of the prescription drugs your insurance plan will pay for, fully or partially. Depending on your plan, you may pay a co-pay for these drugs.