benefit trigger

(redirected from Benefit Triggers)
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benefit trigger

A term used in health insurance policies which describe when and how payments for benefits begin.

benefit trigger

, trigger
A set of conditions or self-care deficits used by a health insurer as criteria for the initiation of insurance payouts. In the care of elderly patients, benefits for certain residential services may be linked to the documentation of new deficits in self-care, e.g., the inability to perform two or more activities of daily living.
References in periodicals archive ?
Under the federal CLASS Act (Community Living Assistance Services and Support Act), benefit triggers will parallel private sector triggers, although it has yet to be determined whether the law will require meeting two or three activities.
Benefit triggers require specific, chronic conditions.
Adult day care is paid for by the policy if one of the benefit triggers is activated and a dependent adult is taken to a center that typically provides intermediate or custodial type care.
The 1996 Federal Health Insurance Portability and Accountability Act (HIPAA) covers all tax-qualified LTCI policies that have the two standard benefit triggers for an insured to qualify for benefits.
In addition to an insurer's financial strength, and the benefits, costs and benefit triggers, etc.
This perception, however, does not mean that a non-tax-qualified plan will automatically have more liberal benefit triggers than tax-qualified plans.
Exhibit 2: Eligibility Requirements Tax-Qualified LTC Plans Non-tax-Qualified LTC Plans Common Benefit Triggers Common Benefit Triggers * Activities of daily living: * Activities of daily living: HIPAA requires that a policy LTC professionals generally acknowledge only five ADLs.
Benefit Triggers Nonqualified "Triple- Trigger * Trigger" Contracts Activities Of Daily Inability to perform 2 of Living (ADLs).
The House has passed a broad TPIA bill that would include protection for group life insurers and a variety of other provisions, such as a reduction in benefit triggers and protection against attacks involving weapons of mass destruction.
If a long-term care insurance policy is a "qualified" policy, the benefit triggers are dictated in the Internal Revenue Code.
The benefit triggers are the same as LTCi -- 2 of 6 activities of daily living (ADL's) or severe cognitive impairment.
Benefit triggers (such as inability to perform specified activities of daily living) had not been met.