Annualized Premium:
The total amount of premiums paid within 12 policy months. For example, if the monthly premium is $10, the annualized premium is $120 ($10 x 12 months).

Assignment:
The transfer of ownership rights in a life insurance policy or other type of contract from one party to another, or the document that causes the transfer of ownership rights to go into effect.

Beneficiary:
The person to receive the death benefits payable at the insured's death.

Benefit Period:
The maximum number of days for which benefits can be paid for any one or successive periods of confinement or disability.

Cafeteria Plan:
A benefit plan maintained by an employer for its employees, under which all participants have the opportunity to select benefits that are suitable for their lifestyles, and for which premiums can be deducted from their paychecks on a pre-tax basis.

Canceled:
Policy terminated by request.

Claim:
Written proof of financial loss.

Claims History:
History of claims previously processed.

Compliance (or Conformity With State and Federal Statutes):
To abide by the statutory requirements established at the federal, state, and industry levels.

Continuous Coverage:
May occur when a person is deleted from a policy and issued a new policy under one of the following conditions: policy upgrade, divorce of a husband and wife who hold a family policy, dependent child has reached the age limit or marries, a husband and wife decide they want separate policies. Your policy will govern the specific requirements for continuous coverage.

Conversion:
The process of exchanging benefits for the purpose of increasing or decreasing coverage.

Decline:
An applicant is denied coverage for specified reasons.

Denial:
The process of reviewing a claim and deciding that, due to the terms of the policy contract, no benefits are due for the claim.

Dependent Children:
Usually refers to the children covered under a parent's family policy. Please see your policy for a specific definition.

Direct Billing:
A mode of premium payment in which policies are billed on an individual basis to the policyholder at home.

Due Date:
Date to which premiums have been paid and when the next premium payment is due.

Each Subsequent Year:
Every 12-month period after the policy year.

Effective Date:
Date the policy goes into effect for a specified person.

Elimination Period:
Time period after the onset of an injury or illness during which disability benefits may not be payable. Please see your disability policy for a specific definition.

Employer Statement:
Part of the claim form that is to be completed by the employer.

Endorsement:
An endorsement adds or deletes a person or benefit to/from an existing policy. The endorsement is mailed to the policyholder or attached to the original policy.

Entire Contract Clause:
A provision in the insurance contract stating that the entire agreement between the insured and the insurer is contained in the contract, which includes the policy, the application and any attachments and riders.

Excessive Coverage:
A policyholder is covered by two or more like policies which, when combined, provide more coverage than NTA Life guidelines allow.

Exclusion:
An exclusion refers to a person(s) or a condition(s) not covered by the policy due to policy provisions or underwriting requirements.

Exclusions & Limitations Clause:
Section of the contract that explains exclusions and limitations regarding policy provisions and benefits.

Grace Period:
A period of time beyond the due date for premium payment (usually 31 days) during which time a policyholder may still remit the premium payment without losing coverage.

Guaranteed Renewable:
Certain policy coverages are guaranteed renewable for life if the premiums are paid when due or within the Grace Period. If the premiums are paid on time, the policy cannot be terminated by the insurer.

Inactive:
Term used to describe a policy that is lapsed, terminated, or canceled.

Indemnity:
Term used to describe a benefit that pays a specific dollar amount rather than the actual charges or a percentage of the charges.

Individual:
Coverage for only the insured person listed in the policy.

Injury:
Usually a term used in an accident or disability policy which means accidental bodily injury which is direct cause of loss, independent of disease, bodily infirmity or any other cause.

Insured:
The person named as the insured on the schedule page.

Insurer:
The party to an insurance arrangement who undertakes payment for losses, provides benefits, or renders services.

Issue Date:
The effective date of the policy shown on the schedule page.

Issue State:
State in which the policy was issued.

Line of Business:
Refers to the various types of insurance policies sold by an insurer, for instance, life insurance, cancer insurance, etc.

NTA:
Refers to National Teacher Associates, Inc. and its affiliated licensed insurance agencies. NTA Life's products are sold by NTA, not NTA Life.

NTA Life:
Refers to National Teachers Associates Life Insurance Company, which is the company that underwrites, issues, and pays claims for our policies. NTA Life's products are sold by NTA, not NTA Life.

Occupational Group:
The job-type classification used for determining premium rates as indicated on the schedule page.

Occurrence Date:
Initial date of loss for a specified claim.

Paid-To Date:
The day, month, and year through which a policy is paid.

Participating Employee:
Status of an employee who chooses to participate in a Section 125 Cafeteria Plan.

Pending:
A claim that cannot be processed completely until additional information requested by the claims specialist is received.

Pending Issue:
A policy that cannot be issued until additional information is received or requested by the underwriter.

Physician Statement:
The part of the claim form that is to be completed by the physician.

Policy Effective Date:
Beginning date of coverage for a current policy.

Policyholder:
Person listed as the owner of the policy and who is responsible for premium payment.

Premium:
The amount of money required at specified intervals to keep a policy contract in force.

Pre-existing Condition:
A condition which existed prior to the effective date of coverage which prevents certain benefits from being payable. Please see your policy for a specific definition.

Pre-tax:
Premiums that are deducted from the employee's paycheck before taxes are calculated and deducted.

 

Primary Policyholder:
The person to whom the policy was issued.

Proof of Loss:
Written proof that is required to be furnished to the insurer about a loss to help determine the extent of insurer liability.

Provider:
A facility, licensed as such, that provides health services for an individual.

Reinstatement:
The act of putting a lapsed policy back in force.

Reinstatement Date:
Date the lapsed or terminated policy was put back in force.

Replacement Policy:
A policy that has replaced a similar product from another company.

Rider:
A supplementary section or page that is attached to and made a part of the insurance contract to modify or add to the coverage the contract provides.

Supplemental Insurance:
Insurance policies designed to supplement other basic coverage.

Term:
Period of time the policy is in force.

Terminated:
A term used to describe a policy or account that is no longer active.

Termination Date:
The actual date the coverage ceased.

Unearned Premium:
The portion of a paid premium which is attributed to a period of time for which coverage was not in force.

Waiver of Premium:
The provision of the policy that relieves payment responsibility for the policyholder as defined in the policy.

Written Request:
A request in writing signed by the policyowner and acceptable to us.