maintenance expenses
The costs of keeping a policy in force. Maintenance expenses include
the cost of processing premium payments and making policy dividend payments
and the time that agents and customer service personnel spend in servicing
and conserving policies that are in force.
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major medical insurance
A type of medical expense insurance that provides broad coverage for
most of the expenses associated with treating a covered illness or injury.
See also comprehensive major medical insurance and supplemental major
medical insurance.
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major services
In dental insurance, dental services, such as inlays, crowns, prosthodontics,
and orthodontics, which are often covered at 50 percent of their reasonable
and customary charges.
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managed care
An organized way to manage costs, use, and quality of the health-care
system. The major types of managed care plans are health maintenance
organizations (HMOs), point-of-service (POS) plans, and preferred provider
organizations (PPOs).
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managing general agent (MGA)
An independent contractor who is authorized to appoint PPGAs on a company's
behalf and who may represent more than one company.
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mandatary
In Quebec, a party who is authorized by another party, the mandator,
to act on the mandator's behalf in contractual dealings with third parties.
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mandated benefit
A benefit required by state law to be included in a health insurance
policy.
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mandator
In Quebec, a party who authorizes another party, the mandatary, to act
on the mandator's behalf in contractual dealings with third parties.
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mandatory securities valuation reserve (MSVR)
In the United States, a liability account that is designed to absorb,
within certain specified limits, realized and unrealized capital gains
and losses resulting from an insurer's investments.
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manual rates
Premium rates that are established for broad classes of groups. Manual
rates are often used to establish premium rates for small groups with
no credible loss experience, and to establish initial premium rates
for large groups. See also blended rates and experience rating.
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master contract
The legal contract between an insurance company and a group insurance
policyholder. The master contract insures a number of people under a
single contract. Also called the master policy. See also certificate
of insurance.
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master plan
A standardized form of pension or other employee-benefit plan developed
by a financial institution to simplify plan drafting for plan sponsors.
Although similar to a prototype plan, a master plan usually refers to
a plan document developed by a financial institution (like an insurer)
that can be adopted only by plan sponsors who use that financial institution
to fund the plan.
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master policy
See master contract.
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matching contributions
In the United States, contributions made by an employer to an employee's
Section 401(k) plan (cash or deferred arrangement) and designed to equal
the employee's contributions up to a certain amount or percentage of
compensation. See also elective contributions and nonelective contributions.
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material fact
A fact that is relevant to an insurance company's underwriting decision
regarding issuing or rating a policy.
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material misrepresentation
In insurance, a misstatement by an applicant that is relevant to the
insurer's acceptance of the risk, because, if the truth had been known,
the insurer would not have issued the policy or would have issued the
policy on a different basis.
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matured endowment
An endowment insurance policy that has reached the end of its term during
the lifetime of the insured and is therefore payable.
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maximum benefit
The largest benefit amount that a defined benefit pension plan is legally
permitted to provide to a plan participant. In the United States, the
maximum benefit is determined under Section 415 of the Internal Revenue
Code. The maximum benefit is subject to legislative change and is generally
indexed to inflation so that it increases as price levels increase.
In Canada, a maximum pension benefit is also established under taxation
rules. See also contribution limit and section 415 limits.
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maximum benefit period
The maximum length of time for which disability income payments will
continue.
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maximum benefits for related confinements provision
A provision included in basic hospital and surgical policies that limits
the maximum benefits for all hospital confinements and for all surgery
performed during one period of sickness or for any single injury.
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Medicaid
A joint federal-state health insurance program that is run by the states
and covers certain low-income people (especially children and pregnant
women) and disabled people.
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medical application
An application for insurance in which the proposed insured is required
to undergo some type of medical examination. The results of the medical
examination are then reported to the insurance company.
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medical expense insurance
Any of several types of health insurance designed to pay for part or
all of an insured's health care expenses, such as hospital room and
board, surgeon's fees, visits to doctors' offices, prescribed drugs,
treatments, and nursing care. See also hospital confinement insurance,
hospital-surgical expense insurance, major medical insurance, and specified
expense coverage.
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medical necessity provision
A condition included in most major medical expense plans, stating that
medical services that are educational or experimental in nature are
not eligible for coverage.
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medical report
A report on a proposed insured's health that is completed by a physician
and is based on a physical examination and questioning of the proposed
insured. Such a medical report serves as part of a medical application.
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medical savings accounts (MSAs)
Health insurance plans which provide incentives for individuals to replace
high-premium, low-deductible policies with lower-cost, high-deductible
catastrophic coverage. Premiums for this coverage are lower, and the
savings may be used to fund a tax-preferred medical savings account
from which you can pay for qualified medical care and expenses, including
annual deductibles and copayments on a pre-tax basis.
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Medicare
The federally sponsored health insurance program of hospital and medical
insurance primarily for people aged 65 and older.
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Medicare carve-out
Medical expense coverage offered by employers to retired employees that
reduces medical expense benefits to the extent that those benefits are
provided by Medicare.
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Medicare supplement
Medical expense coverage that provides benefits for certain expenses
not covered under Medicare. This coverage is available only to individuals
who are covered by Medicare and can be purchased by individuals or by
employers to cover retired employees.
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MIB, Inc. (Medical Information Bureau)
MIB is organized as a non-stock, not-for-profit membership association
of life insurance companies of the United States and Canada. MIB conducts
a confidential interchange of information of underwriting significance
among its member life insurance companies. The interchange enables MIB
member companies to protect the interests of prospective insurance consumers,
policyholders and life insurance companies from consumers who omit or
misrepresent material facts on their applications for life, health or
disability insurance. If in the underwriting of an application for insurance,
an MIB member company develops information which is significant to health
or longevity, a brief, coded resume of such information will be submitted
to MIB. If the consumer applies to another MIB member insurance company,
that company may request a copy of the report from MIB provided it has
obtained from the consumer a written authorization naming MIB as an
informational source. Under the general rules of the association, an
insurance company may not base its underwriting decision solely on information
provided by MIB. Each member company must conduct its own underwriting
investigation. Access to MIB information is restricted to each member
company's authorized medical, underwriting and claims personnel. Consumers
may request disclosure of or correction to their MIB record by contacting
the MIB Information Office, P.O. Box 105, Essex Station, Boston, MA
02112, (617) 426-3660.
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minimum age requirement
In pension planning, a requirement that an employee attain a certain
age before being permitted to participate in the employer's pension
plan. In the United States, a private employer's qualified pension plan
cannot have a minimum age requirement greater than age 21. See also
minimum service requirement.
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minimum deposit arrangement
An arrangement whereby a policyowner can apply the first-year cash value
of a policy to the initial premium amount.
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minimum deposit business
The use of policy loans to pay premiums. In minimum deposit business,
a policyowner instructs the insurance company to pay the premium out
of the policy's cash value and to bill the policyowner for a premium
only if the cash value is insufficient to pay the premium. Also called
leveraged business.
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minimum funding standards
In the United States, standards established under Section 412 of the
Internal Revenue Code relating to the advance funding of qualified pension
plans. The standards are designed to ensure that contributions to a
qualified plan are adequate to meet the plan's current and future obligations.
Failure to satisfy minimum funding standards can lead to penalty taxes
and enforcement actions. See also funding standard account.
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minimum premium plan (MPP)
A group health insurance plan that is partially self-insured by the
group policyholder but fully administered by an insurance company. The
premium is small because the group policyholder pays most of the claims
itself. See also administrative services only (ASO) contract and self-insured
group.
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minimum service requirement
In pension planning, a requirement that an employee complete a certain
period of employment (often known as a probationary or waiting period)
before being permitted to participate in the employer's pension plan.
In the United States, an employee who meets minimum age requirements
generally cannot be subject to a waiting period of more than one year,
although a plan with full and immediate vesting of benefits can require
a two-year waiting period. In Canada, a two-year waiting period is permissible.
See also minimum age requirement.
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misrepresentation
(1) A false or misleading statement made to induce a prospect to purchase
insurance. Misrepresentation is a prohibited insurance sales practice.
(2) A false or misleading statement made by an applicant for insurance.
Certain misrepresentations provide a basis for the insurer to avoid
the policy.
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misstatement of age provision
Life insurance policy wording that specifies the action the insurer
will take if, at the insured's death, the insurer discovers that the
insured's age was misstated in the application and the misstatement
has resulted in an incorrect premium for the amount of insurance purchased.
In an individual life insurance policy, this provision specifies that
the policy's benefit amount will be adjusted. In a group insurance policy,
this provision generally specifies that the policy's premium amount
will be adjusted.
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mode of premium payment
The frequency with which premiums are paid (for example, annually, quarterly,
monthly).
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model bill
Sample legislation developed by the National Association of Insurance
Commissioners (NAIC) in the United States or the Canadian Council of
Insurance Regulators (CCIR) in Canada. States and provinces may adopt
this sample legislation exactly as written or use it as the basis for
developing their own laws.
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Model Life Insurance Solicitation Regulation
In the United States, a regulation adopted by the NAIC in 1976 that
requires insurers to give life insurance consumers (1) information that
will improve their ability to select the most appropriate plan of life
insurance to meet their needs, (2) an understanding of the basic features
of the policy that has been purchased or that is under consideration,
and (3) the ability to evaluate the relative costs of similar plans
of life insurance.
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Model Rules Governing the Advertisement of Life Insurance
In the United States, an NAIC model law which provides a set of comprehensive
guidelines covering nearly all aspects of advertisements for life insurance
policies and annuity contracts.
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Model Unfair Trade Practices Act
In the United States, an NAIC model law that prohibits unfair trade
practices, such as defamation, rebating, unfair discrimination, and
unfair claim settlement practices; the law contains a general prohibition
agahnst any form of insurance advertising that is "untrue, deceptive,
or misleading."
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modified net premiums
Net premiums that are other than level, generally being lower for the
first year than for subsequent years.
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modified-premium whole life insurance
A type of whole life insurance in which the policyowner pays a lower
than normal premium for a specified initial period, such as five years.
After the initial period, the premium increases to a stated amount that
is somewhat higher than usual. This higher premium is then payable for
the life of the policy.
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money market fund
A low-risk mutual fund that achieves great liquidity by investing primarily
in short-term securities.
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money-purchase pension plan
A type of defined contribution plan that specifies a rate of contribution
to each participant's account (for example, 8% of annual compensation)
and results in a benefit that is equal to the amount in the participant's
account (including investment gains and losses) at retirement. Upon
retirement, the money that the employer has contributed, plus investment
earnings, is often used to purchase an annuity which will provide a
regular pension benefit.
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monthly debit ordinary (MDO) insurance
Ordinary life insurance that is marketed under the home service system
and paid for by monthly premium payments, usually made to an agent.
See also home service distribution system.
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monthly outstanding balance method
In group creditor insurance, a premium-paying arrangement for contributory
plans whereby, every month, the lender adds to the outstanding balance
of the loan an amount sufficient to insure that balance for one month.
Contrast with single-premium method.
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moral hazard
The danger that a proposed insured might deliberately attempt to conceal
or misrepresent information. Moral hazard is a risk factor that affects
the underwriting decision.
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morbidity
Sickness, disability, or failure of health.
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morbidity rate
The likelihood that a person of a given age will suffer an illness or
disability. The premium that a person pays for health insurance is based
in part on the morbidity rate for that person's age group.
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morbidity table
A chart that shows the rates of sickness and injury occurring among
given groups of people categorized by age.
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mortality charge
The cost of the insurance protection element of a universal life policy.
This cost is based on the net amount at risk under the policy, the insured's
risk classification at the time of policy purchase, and the insured's
current age.
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mortality curve
A line graph that represents the mortality rates as they change from
age to age.
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mortality experience
The actual number of deaths occurring in a given group of people.
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mortality rate
The frequency with which death occurs among a defined group of people.
The premium that a person pays for life insurance is based in part on
the mortality rate for that person's age group.
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mortality table
A chart that displays the rates of death among a given group of people
categorized by age. See also aggregate mortality table, annuity mortality
table, basic mortality table, select and ultimate mortality table, select
mortality table, and ultimate mortality table.
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mortgage redemption insurance
A form of decreasing term insurance that covers the life of a person
who takes out a mortgage. If the person dies during the term of insurance,
the policy proceeds will approximate the remaining amount of the mortgage
loan.
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multi-company representation
In Canada, an arrangement by which a life and health insurance agent
is allowed to represent more than one insurance company.
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multi-employer plan
A pension or other employee-benefit plan involving more than one employer
and established by collective bargaining (negotiation between a union
and employers). Coverage under the plan is portable within the group,
which means that an employee who leaves one employer who is a member
of the group and goes to work for another member of the group may continue
coverage under the plan.
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multiple-employer trust (MET)
(1) An arrangement whereby several employers (often in the same industry)
cooperate to procure group insurance for their employees. (2) An arrangement
made by an insurance company to cover several employers under one master
policy, usually with specific benefit packages and limitations.
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multiple-line agency (MLA) system
A personal selling distribution system that uses full-time career agents
to distribute both life and health and property/casualty insurance products
for groups of financially interrelated or commonly managed insurance
companies. Also known as the multiple-line exclusive agency system or
all-lines exclusive agency system.
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mutual benefit method
An early method of funding life insurance, formerly used by fraternal
orders or guilds. Under the mutual benefit method, the promised death
benefit was provided by charging participating members an equal amount
after the death of an insured member. Also called the post-death assessment
method. See also assessment method.
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mutual insurance company
An insurance company owned by policyowners rather than stockholders.
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mutualization
The process of converting a stock insurance company to a mutual insurance
company.