maintenance expenses
The costs of
keeping a policy in force. Maintenance expenses include the cost of
processing premium payments and making policy dividend payments and the time that agents and
customer service personnel spend in servicing and conserving policies that are
in force.
major medical insurance
A type of medical expense
insurance that provides broad coverage for most of the expenses
associated with treating a covered illness or injury. See also
comprehensive major medical insurance and supplemental major medical
insurance.
major services
In dental insurance, dental services,
such as inlays, crowns, prosthodontics, and orthodontics, which are
often covered at 50 percent of their reasonable and customary
charges.
managed care
An organized way to manage costs, use, and
quality of the health-care system. The major types of managed care
plans are health maintenance organizations (HMOs), point-of-service
(POS) plans, and preferred provider organizations (PPOs).
managing general agent (MGA)
An independent
contractor who is authorized to appoint PPGAs on a company's behalf
and who may represent more than one company.
mandatary
In Quebec, a party who is authorized by
another party, the mandator, to act on the mandator's behalf in
contractual dealings with third parties.
mandated benefit
A benefit required by state law to be
included in a health insurance policy.
mandator
In Quebec, a party who authorizes another
party, the mandatary, to act on the mandator's behalf in contractual
dealings with third parties.
mandatory securities valuation reserve (MSVR)
In the
United States, a liability account that is designed to absorb,
within certain specified limits, realized and unrealized capital
gains and losses resulting from an insurer's investments.
manual rates
Premium rates that are established for
broad classes of groups. Manual rates are often used to establish
premium rates for small groups with no credible loss experience, and
to establish initial premium rates for large groups. See also
blended rates and experience rating.
master contract
The legal contract
between an insurance company and a group insurance policyholder. The
master contract insures a number of people under a single contract.
Also called the master policy. See also certificate of insurance.
master plan
A standardized form of pension or other
employee-benefit plan developed by a financial institution to
simplify plan drafting for plan sponsors. Although similar to a
prototype plan, a master plan usually refers to a plan document
developed by a financial institution (like an insurer) that can be
adopted only by plan sponsors who use that financial institution to
fund the plan.
matching contributions
In the United States,
contributions made by an employer to an employee's Section 401(k)
plan (cash or deferred arrangement) and designed to equal the
employee's contributions up to a certain amount or percentage of
compensation. See also elective contributions and nonelective
contributions.
material fact
A fact that is relevant to an insurance
company's underwriting decision regarding issuing or rating a
policy.
material misrepresentation
In insurance, a misstatement
by an applicant that is relevant to the insurer's acceptance of the
risk, because, if the truth had been known, the insurer would not
have issued the policy or would have issued the policy on a
different basis.
matured endowment
An endowment insurance policy that
has reached the end of its term during the lifetime of the insured
and is therefore payable.
maximum benefit
The largest benefit amount that a
defined benefit pension plan is legally permitted to provide to a
plan participant. In the United States, the maximum benefit is
determined under Section 415 of the Internal Revenue Code. The
maximum benefit is subject to legislative change and is generally
indexed to inflation so that it increases as price levels increase.
In Canada, a maximum pension benefit is also established under
taxation rules. See also contribution limit and section 415 limits.
maximum benefit period
The maximum length of time for
which disability income payments will continue.
maximum benefits for related confinements provision
A
provision included in basic hospital and surgical policies that
limits the maximum benefits for all hospital confinements and for
all surgery performed during one period of sickness or for any
single injury.
Medicaid
A joint federal-state health insurance program
that is run by the states and covers certain low-income people
(especially children and pregnant women) and disabled people.
medical application
An application for insurance in
which the proposed insured is required to undergo some type of
medical examination. The results of the medical examination are then
reported to the insurance company.
medical expense insurance
Any of several types of
health insurance designed to pay for part or all of an insured's
health care expenses, such as hospital room and board, surgeon's
fees, visits to doctors' offices, prescribed drugs, treatments, and
nursing care. See also hospital confinement insurance,
hospital-surgical expense insurance, major medical insurance, and
specified expense coverage.
medical necessity provision
A condition included in
most major medical expense plans, stating that medical services that
are educational or experimental in nature are not eligible for
coverage.
medical report
A report on a proposed insured's health
that is completed by a physician and is based on a physical
examination and questioning of the proposed insured. Such a medical
report serves as part of a medical application.
medical savings accounts (MSAs)
Health
insurance plans which provide incentives for individuals to replace
high-premium, low-deductible policies with lower-cost,
high-deductible catastrophic coverage. Premiums for this coverage
are lower, and the savings may be used to fund a tax-preferred
medical savings account from which you can pay for qualified medical
care and expenses, including annual deductibles and copayments on a
pre-tax basis.
Medicare
The federally sponsored health insurance
program of hospital and medical insurance primarily for people aged
65 and older.
Medicare carve-out
Medical expense coverage offered by
employers to retired employees that reduces medical expense benefits
to the extent that those benefits are provided by Medicare.
Medicare supplement
Medical expense coverage that
provides benefits for certain expenses not covered under Medicare.
This coverage is available only to individuals who are covered by
Medicare and can be purchased by individuals or by employers to
cover retired employees.
MIB, Inc. (Medical Information Bureau)
MIB is organized
as a non-stock, not-for-profit membership association of life
insurance companies of the United States and Canada. MIB conducts a
confidential interchange of information of underwriting significance
among its member life insurance companies. The interchange enables
MIB member companies to protect the interests of prospective
insurance consumers, policyholders and life insurance companies from
consumers who omit or misrepresent material facts on their
applications for life, health or disability insurance. If in the
underwriting of an application for insurance, an MIB member company
develops information which is significant to health or longevity, a
brief, coded resume of such information will be submitted to MIB. If
the consumer applies to another MIB member insurance company, that
company may request a copy of the report from MIB provided it has
obtained from the consumer a written authorization naming MIB as an
informational source. Under the general rules of the association, an
insurance company may not base its underwriting decision solely on
information provided by MIB. Each member company must conduct its
own underwriting investigation. Access to MIB information is
restricted to each member company's authorized medical, underwriting
and claims personnel. Consumers may request disclosure of or
correction to their MIB record by contacting the MIB Information
Office, P.O. Box 105, Essex Station, Boston, MA 02112, (617)
426-3660.
minimum age requirement
In pension planning, a
requirement that an employee attain a certain age before being
permitted to participate in the employer's pension plan. In the
United States, a private employer's qualified pension plan cannot
have a minimum age requirement greater than age 21. See also minimum
service requirement.
minimum deposit arrangement
An arrangement whereby a
policyowner can apply the first-year cash value of a policy to the
initial premium amount.
minimum deposit business
The use of policy loans to pay
premiums. In minimum deposit business, a policyowner instructs the
insurance company to pay the premium out of the policy's cash value
and to bill the policyowner for a premium only if the cash value is
insufficient to pay the premium. Also called leveraged business.
minimum funding standards
In the United States,
standards established under Section 412 of the Internal Revenue Code
relating to the advance funding of qualified pension plans. The
standards are designed to ensure that contributions to a qualified
plan are adequate to meet the plan's current and future obligations.
Failure to satisfy minimum funding standards can lead to penalty
taxes and enforcement actions. See also funding standard
account.
M: Part
Two
