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79 11/2005
FEP:
The “Federal Employee Program” is a group contract to provide health care benefits to
federal employees, underwritten by Blue Cross and Blue Shield Plans. The official
name of the program is the Government-Wide Service Benefit Plan.
Guest Member:
Members of an Affiliate of BCBSGa temporarily residing in a Service Area. Guest
Member(s) will be treated as BCBSGa Members while present in a Service Area.
Group Health Coverage:
A health benefits plan that covers a group of people as permitted by state and federal
law.
Health Maintenance Organization (HMO):
An organized system of health care that assures the delivery of a comprehensive
range of health services to members who enroll voluntarily and pay a fixed, prepaid
fee. Such services include a wide variety of medical treatments and counsel, inpatient
and outpatient hospitalization, home health service, ambulance service, and
sometimes dental and pharmacy services.
HEDIS (Health Plan and Employer Data Information Set):
HEDIS is a standard set of more than 100 indicators developed to assist
purchasers/employers in evaluating health plans. HEDIS has become a standard of
measurement for the Health care Financing Administration (HCFA), for some state
insurance departments and for many large companies. HEDIS has also become a
component of the NCQA accreditation process.
Home Health Agency:
A facility or program licensed, certified or otherwise authorized pursuant to state and
federal laws to provide home health care services.
Hospice:
A facility or program licensed or certified under law to provide palliative and
supportive care for the terminally ill.