The insurance world uses lots of industry acronyms, terminology and jargon. From MOOPs to SHOPs to EHBs, it’s no wonder the new health care terms coming out of Washington with the Affordable Care Act (ACA) are confusing.

You likely have many question marks about the changing information on reform—and what all the terms even mean. Need help deciphering the ACA alphabet soup? Here’s a list of the top ACA acronyms, and what they mean, to help keep you up to speed:

EHB:

The ACA requires insurance companies to offer specific Essential Health Benefits or EHBs. EHBs are 10 categories of health services that the legislation deems essential, and includes such services as pediatric dental care, maternity and newborn care, and preventive and wellness services.

MOOP:

Maximum out-of-pocket (MOOP) is the most you pay during a policy period (usually one year) before your health insurance kicks in to pay 100 percent of covered essential health benefits. Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren't covered. The ACA places an annual limit on MOOP.

QDP:

A Qualified Dental Plan (QDP) is one that’s approved by the Centers for Medicare & Medicaid Services (CMS) or states for sale on federal or state exchanges. In 2014, these plans are offered in two categories: high and low.

QHP:

A Qualified Health Plan (QHP) is one that’s approved by CMS or states for sale on federal or state exchanges. They are offered and categorized by four metal levels. QDPs and QHPs can be offered for sale outside of the exchanges as well. So, you might also see these same qualified plans offered on carrier websites and private exchanges. And, brokers can sell these products to their Small Business Health Options Program (SHOP) and individual consumers.

SADP:

A Stand Alone Dental Plan (SADP) is a dental plan that is offered without being bundled with or embedded into a medical plan.

SHOP:

When small businesses (50 or fewer in 2014) offer insurance to their employees, one method of obtaining coverage is through the SHOP. This is a separate portion of the federal and state exchanges where employers can purchase plans for their employees. Depending on the exchange, when an employer offers SHOP products to their employees, they will have the opportunity to select from any carrier offering a QHP or QDP in that exchange. Unlike traditional group benefits, employees can choose any carrier and any plan that best fits their unique needs.

Whew! Now you know the most frequently used ACA terms. Any other ACA “alphabet soup” terms that you’d like cleared up? Post a comment, let us know, and we’ll make sure our next blog post gives you the information you need!

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