ACRONYMS

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  • Employee Assistance Programs (EAPs) are free, confidential, employer-sponsored services designed to help employees and their families manage personal or work-related issues. They provide short-term counseling, assessments, and referrals for issues like stress, mental health, addiction, legal, and financial problems. EAPs aim to improve employee well-being and productivity.
  • Electronic Data Interchange (EDI) in insurance is the computer-to-computer exchange of standardized documents—such as claims, eligibility checks, and billing—between insurers, providers, and employers. It eliminates paper-based processes and manual data entry, enabling faster, more accurate, and secure transactions while reducing administrative costs.
  • The EEO-1 report stands for Employer Information Report, a mandatory annual survey required by the U.S. Equal Employment Opportunity Commission (EEOC). It mandates that private employers with 100+ employees and federal contractors with 50+ employees submit workforce data categorized by race, ethnicity, sex, and job category.
  • The U.S. Equal Employment Opportunity Commission (EEOC) is a federal agency that enforces laws prohibiting workplace discrimination, harassment, and retaliation based on race, color, religion, sex, national origin, age (40+), disability, or genetic information. It covers most employers with 15+ employees, handling complaints via investigation, mediation, and, if needed, lawsuits.
  • Employer Group Waiver Plans (EGWPs), often pronounced "egg-whips," are Medicare Advantage (Part C) or Prescription Drug Plans (Part D) sponsored by employers or unions for their retirees. These plans allow employers to customize coverage and provide benefits, often more generous than traditional Medicare, using "800 series" plan numbers.
  • Essential Health Benefits (EHBs) are a set of 10 core categories of services that HealthCare.gov Marketplace, individual, and small group health insurance plans must cover under the Affordable Care Act (ACA). They ensure comprehensive coverage, including emergency services, prescription drugs, maternity care, and mental health services.
  • lectronic Health Records (EHRs) are digital, patient-centered, real-time records that securely store comprehensive, longitudinal health information—such as histories, diagnoses, medications, and test results—across different healthcare settings. They enable authorized providers to access data instantly, enhancing care coordination, reducing errors, and improving patient safety, though they can introduce usability challenges.
  • The Earned Income Tax Credit (EITC or EIC) is a refundable federal tax credit for low-to-moderate-income working individuals and families, designed to reduce taxes owed or provide a larger refund. It is specifically for people who work, including self-employed individuals. The maximum credit for the 2025 tax year is up to , depending on income and children.
  • An Employer Identification Number (EIN) is a unique nine-digit number assigned by the IRS to businesses, partnerships, corporations, and non-profits for tax filing. You can obtain an EIN for free by applying online at the IRS website, which provides immediate results. It is necessary for hiring employees, opening business bank accounts, and establishing business credit.

  • q

  • The Qualified Medicare Beneficiary (QMB) program is a Medicaid-sponsored Medicare Savings Program that helps low-income beneficiaries pay for Medicare Part A and B premiums, deductibles, coinsurance, and copayments. It acts as a form of secondary coverage, often eliminating out-of-pocket costs for Medicare-covered services.

  • e

  • The Employer of Record is the organization that serves as the employer for tax and legal purposes. The Employer of Record takes on the responsibility of employment tasks such as completing and storing personal files including Form I-9, processing and funding payroll, depositing and filing state and federal taxes, handling unemployment claims, providing workers’ compensation coverage, issuing a year end W-2.
  • An Experience Modification Rate (EMR) is a numerical multiplier used by insurance companies to calculate workers' compensation premiums, acting as a "credit score" for workplace safety. An EMR of 1.0 is industry average; lower than 1.0 (e.g., 0.8) lowers premiums, while higher than 1.0 (e.g., 1.2) increases them.
  • Evidence of Coverage: An Evidence of Coverage (EOC) is a comprehensive, legally binding document—often 200+ pages—outlining your specific health plan's benefits, costs (copays, deductibles), exclusions, and rules for receiving care. It acts as a contract between you and your insurer, sent annually in the fall, particularly for Medicare.
  • An Exclusive Provider Organization (EPO) is a managed care health insurance plan that covers services only when you use doctors, specialists, or hospitals in the plan's network, except for emergencies. EPOs generally offer lower premiums and no need for referrals to see specialists, but they do not pay for out-of-network care.
  • The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for voluntarily established pension and health plans in private industry to protect participants. It mandates accountability for plan fiduciaries, enforces reporting and disclosure requirements, and guarantees payment for certain terminated defined benefit plans.