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Key Terms

ACA Out-of-Pocket Maximum

ACA Out-of-Pocket Maximum is $9100 per person and $18,200 per family in 2023. Except as otherwise specified, unreimbursed in-network covered services that are medical or prescription drug expenses (except for chiropractic services, refractive eye surgery, and all services that are covered under the SHARP DVH Option other than under age 19 pediatric preventive dental, pediatric annual eye examination, and pediatric eyeglasses) are applied to the ACA out-of-pocket maximum includes any co-payments, co-insurances, and deductibles, but does not include the member share contribution costs. Amounts in excess of usual, reasonable, and customary do not apply to the ACA out-of-pocket maximum.

Adverse Benefit Determination

An adverse benefit determination is any of the following (i) a denial, reduction, or termination of a Plan benefit, (ii) a failure to provide or make payment (in whole or in part) for a Plan benefit, or (iii) a rescission of coverage (whether or not the rescission has an adverse effect on any particular Plan benefit at the time of the rescission).

Adventist Retirement Board

Adventist Retirement Board means the board established by the NAD to maintain and amend from time to time SHARP and the various other NAD programs available to NAD retirees.

Adventist Retirement Plan

Adventist Retirement Plan means the Seventh-day Adventist Retirement Plan of the North American Division and Auxiliary Benefits and the Adventist Retirement Plan.

Affordable Care Act

Affordable Care Act means The Patient Protection and Affordable Care Act (PPACA) – also known as the Affordable Care Act or ACA.

Ambulatory Services

Ambulatory Services means medical care provided on an outpatient basis. Ambulatory care is given to persons who are not confined to a hospital.

Beneficiary

The person you designate to receive death benefits payable in the event of your death (typically your spouse).

Benefit Rate Factor

The average of your 10 highest Yearly Rate Factors.

Break in Service

A break in service occurs during a calendar year in which you are either not employed by a participating Church Plan organization, or are denominationally employed by a Church Plan organization but are not paid for more than 500 hours or more than three months on a full time salary basis.

Defined Benefit (DB) Plan

The retirement plan in the form of a pension that applies to denominational service up through the year 1999.

Defined Contribution (DC) Plan

The retirement plan that applies to denominational service after the year 1999.

DVH

The SHARP dental, vision and hearing coverage option.

Eligible Retiree

A retiree of a participating employer organization within the North American Division (NAD) of the Seventh-day Adventist church who satisfies the eligibility requirements for receiving retirement plan benefits.

Eligible Spouse

The spouse of an employee or participant who qualifies for benefits under the Joint and Survivor provision.

Empower Retirement

The retirement brand name of Great West, the company currently contracted to provide DC Plan administration for Adventist Retirement Plan.

Health Reimbursement Account (HRA)

A tax-free account opened for eligible retirees and/or spouses. The account receives annual contributions from SHARP to reimburse the retiree for qualifying healthcare expenses.

International Service Employee (ISE)

An employee who is formally assigned by the General Conference to serve in a division other than his or her home division under the General Conference ISE policies. Previously known as interdivision employees, these employees retain a link to their home division.

Joint and Survivor Annuity

The form of retirement benefit that provides benefits to the participant and spouse while both are living, and to the spouse who survives the participant.

Joint and Survivor Benefit

A benefit option for a married retiree. A reduction from the Single Life Benefit nominally pays for survivor benefits and healthcare provisions for the spouse.

Non-Medicare SHARP

The health care plan offered to a child of an Eligible Retiree who is under age 26.

Participant

An employee of a participating employer who is eligible to earn service credit in the plan, or a former employee who is receiving benefits from the plan.

Pension Factor

A dollar amount voted each year by the North American Division (NAD) to calculate the retirement benefit for the Defined Benefit Plan. This provides for the annual Cost of Living Adjustment.

Pre-Medicare SHARP

The health care plan offered to retirees and their spouses who are not currently entitled to enroll for Medicare benefits, but who otherwise meet eligibility requirements.

Retirement Allowance

The one-time lump-sum benefit, based on years of pre-2000 service credit, granted at the time of admission to the Plan for those who go directly from active service on to retirement.

Rx Option

The SHARP option for prescription drug coverage.

Service Credit

A measure of time, expressed in years and percentage of years up to a maximum of 40, used in determining the amount of a participant’s retirement benefit.

SHARP

A healthcare plan provided by Adventist Retirement for retirees, J&S spouse, and children. SHARP-Ex is the specific portion of SHARP dealing with retirees and spouses age 65 and over.

Single Life Benefit

A benefit for the retiree only, providing no benefits for the retiree’s spouse. It is also the foundational calculation for all retirees.

Vesting Employee

A vesting employee has reached a service requirement which grants unconditional entitlement to future retirement benefits.

Yearly Rate Factor

The Yearly Rate Factor is a percentage of your remuneration factor assigned at the end of each calendar year prior to January 1, 2000 in which you earned service credit.