benefit trigger


Also found in: Dictionary, Thesaurus, Legal, Financial, Encyclopedia.

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 ?
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.
For qualified contracts, the benefit triggers are specified in the governing section of the Internal Revenue Code.
Benefit triggers require specific, chronic conditions.
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.
Note that these revised standards provide the option for an insurance company to include benefit triggers for temporary claims, but the standards do not require a company to do so.
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.
Benefit triggers (such as inability to perform specified activities of daily living) had not been met.