Effective Date

The date requested by an employer for insurance coverage to begin.

Elective Surgery and Elective Treatment

Surgery or medial treatment which is not necessitated by a pathological or traumatic change in the function or structure in any part of the body.

Eligible Expenses

Usual and customary expenses that may be used as the basis for a claim under the terms of the insurance.

Eligibility Date

The date that a person is eligible for benefits.

Eligible Dependent

A dependent of an insured person who is eligible for coverage according to the requirements set forth in the contract.

Eligible Expenses

Expenses as defined in the health plan as being eligible for coverage. This could involve specified health services fees or "customary and reasonable charges”.

Elimination Period

A loosely used term, sometimes designating the probationary period, but most often designating the waiting period in a Health Insurance policy.

Emergency

An injury or disease which happens suddenly and requires treatment within 24 hours.

Emergency Accident Benefit

A medical benefit which reimburses the insured for expenses incurred for emergency treatment of accidents.

Emergency Admission

A hospital admission for inpatient hospital confinement for a condition which, unless promptly treated on an inpatient bases, would (1) put the patient’s life in danger; or (2) cause serious damage to a bodily function of the patient.

Emergency Evacuation

Coverage for emergency medical evacuation to the nearest qualified medical facility or the country of residence, as determined by the insurance company; expenses for reasonable travel and accommodations resulting from the evacuation; and the cost of returning to either the country of residence or the country where the evacuation occurred, up to reasonable maximum limit.

Emergency Reunion

Emergency reunion coverage for certain maximum amount, and for certain maximum duration such as 15 days, for the reasonable travel and lodging expenses of a relative or friend during an emergency medical evacuation: generally either the cost of accompanying the insured during the evacuation or traveling from the country of residence to be reunited with the insured.

Endorsement

A written form attached to an insurance policy that alters the policy’s coverage, terms, or conditions. Sometimes called a rider.

Enrollee

An eligible individual who is enrolled in a health plan. Does not include an eligible dependent.

Enrolling Unit

The organization that contracts for participation in a health insurance plan.

Evidence of Insurability

The statement of information needed for the underwriting of an insurance policy.

Examination

The medical examination of an applicant for Life or Health insurance.

Exclusions

Healthcare services not covered by an insured's health insurance policy. This would usually be due to pre-existing conditions or due to the limitation of the insurance plan.

Expense

A policy's share of the company's operating costs, fees for medical examinations and inspection reports, underwriting, printing costs, commissions, advertising, agency expenses, premium taxes, salaries, rent, etc

Explanation of Benefits (EOB)

The statement sent to a participant in a health plan listing services, amounts paid by the plan, and total amount billed to the patient.