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Lagged Claims: Refers to the time a service is incurred to when it is submitted for payment processing.
Lapse: Refers to the period when insurance coverage is terminated due to non-payment of the premium.
Late Entrant: Refers to any member who applies for coverage post-expiration date. Some late entrants are governed by HIPAA.
Large Claim Pooling: Refers to the practice of experience rating where claim amounts are isolated and charged to a pool the groups that share a similar pool level.
Legend Drug: Refers to a drug that may only be obtained via a prescription. Such drugs also bear contain the label: "Caution: federal law prohibits dispensing without a prescription."
Length-of-Stay (LOS): Refers to the number of days that an insured member may remain in an inpatient facility per each of their admissions.
Life Event: The IRS defines a life event as any of the following: · A change in marital status · A change in an individual's tax dependents · Birth of a child / date a child is adopted · Death of a dependent · Change in a dependent's eligibility · Changes in child or elder care providers including the cost · Change in work status · A dependent experiences a qualifying life experience
Long-Term Care: Provides assistance for individuals living with chronic illness or disability. Long-term care providers seek to allow their charges to live as independent a life as is possible. In most cases, the goal of long-term care is to provide care rather than a cure.
Loss Ratio: Refers to the cost ratio of health insurance benefits that have been used as compared to the premium revenue that has been received by the insurer.