Glossary: F

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Face amount See “Death benefit.”
Facility-of-payment provision This can be part of a life insurance policy. It lets insurers pay out some of the benefit before the final claim is settled. The money can go to a beneficiary. It can also go to a friend or relative. The money is often used to pay for funeral costs or other related costs.
Family and Medical Leave Act (FMLA) This is a law for employers with 50 or more workers. It applies to workers who need to take time off from work for:
  • Birth and care of a newborn child up to 12 months old
  • Adoption or foster care of a child
  • Care of an immediate family member (spouse, child or parent) with a serious health condition
  • Medical leave because of a serious health condition that leaves a worker unable to do his or her job

Workers can get up to 12 workweeks of unpaid leave per year if they qualify. This law also provides certain rights for members of the military and their families.

Federal Employees Health Benefits Program (FEHBP) This is a type of health plan. Most federal government workers are covered under it.
Fee for service This is a process used by some health plans. It lets plans pay doctors and other providers a fee for each service they provide.
FEHBP See “Federal Employees Health Benefits Program.”
First dollar plan This can be a health plan without a deductible. It can also be a health plan with a high deductible. This plan pays for some services before the member has to pay money on his or her own. Covered services are paid out of a special fund first. Once the fund is used up, the member must satisfy the deductible before receiving coverage under the plan. Funds for this plan do not roll over from year to year.
Flexible spending account (FSA) This is a way workers can set aside money to help pay for health care. It is used with a health benefits plan. The worker asks for money to be taken from his or her pay each pay period. This money is not taxed in most states. The money goes into a fund the worker can use to pay for different health expenses. All money must be used by the end of the stated year or it will be lost. This money cannot be transferred to another job or account.
FMLA See “Family and Medical Leave Act.”
Formulary This is a list of prescription drugs the health plan covers. It can include drugs that are brand name and generic. Drugs on this list may cost less than drugs not on the list. How much a plan covers may vary from drug to drug. An open formulary provides a greater choice of covered drugs. It is also called a “preferred drug list.”
Formulary exclusion list This is a list of prescription drugs not covered by a health plan. It applies to closed formulary plans. If a member needs a drug on this list, the doctor must ask the plan to cover it as an exception. The plan will only do so if use is medically necessary.
FSA See “Flexible spending account.”
Fully insured employers These employers pay the health plan provider to administer and manage the benefits they've chosen. The insurer pays the claims. This means the insurer is the one taking the risk.
Functional capacity evaluation This exam is done by occupational or physical therapists. It tests people who have been injured or sick to see if they can return to work. It might test how well a person can lift, bend, stand, climb or carry. It can also focus on a specific function, like use of the hands. The tests used show if the worker can resume normal job activities.

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