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THE SMALL BUSINESS BENEFITS GLOSSARY:Clear, Friendly, and ShareableBenefits can be confusing. This glossary helps HR managers and small business leaders explain Open Enrollment termsin a way real people understand. Whether sharing it with your team or reviewing it yourself, each definition is clear andjargon-free. This is the cheat sheet every small business needs during benefits season.What it means: A federal law that lets you keep youremployer's health insurance for a limited time after leaving, butyou pay full cost.Think of it like: Paying the full mortgage on a house afterpreviously sharing it with a roommate. HR Tip: Include COBRA info in exit materials to ease transitions.COBRAWhat it means: A request to your insurance to pay for amedical service.Think of it like: Submitting a receipt to get reimbursed.HR Tip: Employees usually don’t need to file claims. Providershandle this.CLAIMWhat it means: The percentage you pay for care after yourdeductible is met; insurance pays the rest.Think of it like: Sharing project costs; you pay part, insurancepays most.HR Tip: Clarify coinsurance differs from copays and varies byservice.COINSURANCEWhat it means: A fixed fee you pay for specific services, like $25for a doctor's appointment.Think of it like: Paying an entry fee. It will be the same cost nomatter how long you stay.HR Tip: Highlight copays so employees can plan expenses.COPAY (COPAYMENT)What it means: A spouse or family member covered in your plan.Think of it like: Adding family members to a phone plan.HR Tip: Remind employees to collect needed info beforeenrollment.DEPENDENTWhat it means: The amount you pay before insurance coversmore costs.Think of it like: Paying for pizza crust before toppings.HR Tip: Higher deductibles often pair with HSAs to help withcosts.DEDUCTIBLEWhat it means: A summary showing what insurance paid andwhy, after care.Think of it like: A receipt, not a bill.HR Tip: Many confuse it with a bill. Make its purpose clear.EOB (EXPLANATION OF BENEFITS)What it means: A personal, pre-tax savings account forhealthcare, paired with high deductibles.Think of it like: A special savings jar for medical costs whereyour money grows tax-free.HR Tip: Great for healthy or long-term planners.HSA (HEALTH SAVINGS ACCOUNT)What it means: A low-cost plan requiring you to use in-networkdoctors and get referrals.Think of it like: Shopping at one store with a membership.HR Tip: Best for simple plans with lower premiums.HMO (HEALTH MAINTENANCE ORGANIZATION)What it means: A list of covered prescription drugs, sortedby cost.Think of it like: A menu with prices and options.HR Tip: Share the formulary link during enrollment.FORMULARYWhat it means: A less expensive version of a brand-namemedication with the same ingredients.Think of it like: Store-brand cereal that tastes the same.HR Tip: Encourage asking for generics to save money.GENERIC DRUGWhat it means: Pre-tax money set aside for healthcare orchildcare that must be used by year-end.Think of it like: A gift card with an expiration date.HR Tip: Stress deadlines and suitable expenses.FSA (FLEXIBLE SPENDING ACCOUNT)Page 1

THE SMALL BUSINESS BENEFITS GLOSSARY:Clear, Friendly, and ShareableWhat it means: In-network providers cost less due toagreements; out-of-network may cost more or not be covered.Think of it like: Wi-Fi versus data roaming.HR Tip: Encourage employees to confirm if providers are in-network to avoid surprise bills and reduce costs.IN-NETWORK VS. OUT-OF-NETWORKWhat it means: A flexible plan allowing out-of-network carewithout referrals, usually at a higher cost.Think of it like: A travel pass with extra fees.HR Tip: Good for families needing choice or traveling.PPO (PREFERRED PROVIDER ORGANIZATION)What it means: The yearly period to enroll, change, or dropbenefits.Think of it like: Picking your plan for the year, like choosingyour phone or internet package.HR Tip: Send frequent reminders.No HR team? No problem. Read this article for helpful tips. OPEN ENROLLMENT (OE)What it means: The most you pay annually before insurancepays 100%.Think of it like: A spending limit that protects you from big bills.HR Tip: Emphasize as protection for big expenses.OUT-OF-POCKET MAXIMUMWhat it means: The monthly cost to keep insurance active,regardless of use.Think of it like: A subscription box you pay for every month.HR Tip: Clarify premiums do not count toward deductibles.PREMIUMWhat it means: Services like checkups and vaccines oftencovered 100%.Think of it like: A tune-up to avoid future breakdowns.HR Tip: Remind employees it is free when in-network.PREVENTIVE CARENeed Help Making Benefits Make Sense?For employees: This glossary is yours. Bookmark it, share it, and keep it handy during Open Enrollment. Clearanswers = confident choices.For small business leaders: Whether you’re already working with us or just found this resource, we’re here to helpyour team feel confident about their benefits. Not a OneDigital client yet? Let’s talk. Our Small Business Essentials team can help you streamline OpenEnrollment and simplify the entire benefits process.Page 2