Glossary

This glossary defines key terms and terminology used throughout the MonarkHQ platform. Terms are designed to reflect how brokers, carriers, and employers actually think about employee benefits.

A

Account

Deprecated term.

Previously used to describe an employer client. MonarkHQ no longer uses “Account” in the user experience. See Employer.

AD&D (Accidental Death & Dismemberment)

A type of insurance that pays benefits if the insured dies or loses a limb, sight, hearing, or speech due to an accident. Often bundled with life insurance.

Age-Banded Rates

A rating methodology where premiums vary based on the insured member’s age. Common for life insurance and some medical plans.

Annual Maximum

The maximum amount a dental or vision plan will pay for covered services in a plan year. Once reached, the member pays 100% of additional costs.

Attachment

A document uploaded to a Census, RFP, or Proposal, such as benefit summaries, current enrollment files, or supporting materials.

B

Base Plan Pricing

An employer contribution strategy where the employer’s contribution is calculated based on the premium of a designated “base” plan. Employees choosing more expensive plans pay the difference.

Benefits Summary

A document outlining the key benefits and coverage details of an insurance plan.

Broker

An insurance professional who helps employers evaluate, select, and manage employee benefits. Brokers are the primary users of MonarkHQ.

Buy-Up

When an employee chooses a more expensive plan than the employer-subsidized base plan and pays the additional cost themselves.

C

Carrier

An insurance company that underwrites and provides insurance coverage. Examples include Aetna, Blue Cross Blue Shield, Cigna, and UnitedHealthcare.

Carrier Representative (Rep)

An employee of an insurance carrier who responds to RFPs and provides quotes to brokers. Carrier reps access MonarkHQ via secure magic links.

Census

A structured list of benefit-eligible employees and dependents for a specific Group and plan year.

Includes demographic data such as date of birth, ZIP code, relationship, coverage tier, and employment status. Census data is the primary input for underwriting and quoting.

COBRA

Consolidated Omnibus Budget Reconciliation Act. A federal law allowing employees to continue group health coverage after leaving employment. Census data may flag COBRA participants.

Commission

The compensation a broker receives from a carrier for placing business. May be structured as a percentage, PEPM (Per Employee Per Month), or PPPM (Per Participant Per Month).

Composite Rate

A single premium rate that applies to all employees regardless of age or family status. Contrasts with age-banded or tiered rates.

Contribution

The portion of the insurance premium paid by the employer. See Employer Contribution.

Copay (Copayment)

A fixed dollar amount the insured pays for a covered service (e.g., $25 for a doctor visit). The insurance pays the remainder.

Coverage Type

A category of insurance benefit. MonarkHQ supports Medical, Dental, Vision, Life & AD&D, Disability, Accident, Hospital Indemnity, Critical Illness, and Pet Insurance.

Critical Illness Insurance

Coverage that pays a lump-sum benefit upon diagnosis of specified serious illnesses such as cancer, heart attack, or stroke.

D

Deductible

The amount the insured must pay out-of-pocket before insurance begins paying.

Dependent

A family member covered under an employee’s insurance plan, typically a spouse, domestic partner, or child.

Disability Insurance

Coverage that replaces a portion of income if the insured becomes unable to work due to illness or injury. Includes STD and LTD.

DPPO (Dental PPO)

A dental plan that provides reduced costs when using in-network providers and still covers out-of-network care at lower benefit levels.

E

Effective Date

The date when insurance coverage begins. All quotes and premiums are calculated relative to this date.

Elimination Period

The waiting period between when a disability begins and when benefits start paying.

Employee Contribution

The portion of the insurance premium paid by the employee, typically via payroll deduction.

Employer

The legal company entity offering benefits to its employees.

Employers are long-lived entities that persist across plan years and renewals. An Employer can have multiple Groups over time.

Employer Contribution

The portion of the insurance premium paid by the employer on behalf of employees.

Enrollment

The process by which employees select and activate benefits coverage after plans are finalized.

EPO (Exclusive Provider Organization)

A medical plan that only covers in-network care except in emergencies.

F

Family ID

A unique identifier in census data that groups an employee with their dependents.

FIPS Code

A geographic identifier used for rating and compliance purposes.

Flat Contribution

An employer contribution strategy where the employer pays a fixed dollar amount toward premiums regardless of plan cost.

Fully Insured

A funding arrangement where the carrier assumes all financial risk and pays claims in exchange for fixed premiums.

G

Group

A benefit-eligible population tied to an Employer and a specific plan year.

Groups change over time (e.g., annually at renewal) and are the unit to which Census data, Quotes, and Proposals apply.

Group Size

The number of eligible employees in a Group. Affects rating rules and carrier eligibility.

H

HDHP (High Deductible Health Plan)

A medical plan with higher deductibles and lower premiums, often paired with an HSA.

Heaped Commission

A commission structure with higher first-year compensation and lower renewal commissions.

HMO (Health Maintenance Organization)

A medical plan requiring members to use in-network providers and obtain referrals for specialists.

Hospital Indemnity

Insurance that pays a fixed cash benefit for hospital stays, regardless of actual costs incurred.

HSA (Health Savings Account)

A tax-advantaged savings account available to members enrolled in qualifying HDHPs.

I

Ideon

A third-party API provider used by MonarkHQ to retrieve instant medical quotes.

Instant Quote

A quote generated immediately using available off-the-shelf rates, without manual underwriting.

J

Job Class

A classification of employees (e.g., Executive, Hourly, Union) used to apply different contribution or eligibility rules.

L

Levelized Commission

A commission structure with consistent compensation across policy years.

Level Funded

A hybrid funding arrangement combining features of fully insured and self-funded plans.

LTD (Long-Term Disability)

Disability insurance providing income replacement for extended periods.

M

MAC (Maximum Allowable Charge)

A method for determining out-of-network dental reimbursement.

Magic Link

A secure, passwordless login method used by MonarkHQ.

Medical

Comprehensive health insurance covering physician care, hospitalization, prescriptions, and preventive services.

Member

An individual covered under a plan, including employees and dependents.

Member Breakdown

A detailed view of premiums and contributions calculated at the individual member level.

N

Network

The group of providers contracted with a carrier to deliver services at negotiated rates.

New Business

Coverage quoted for a Group without existing carrier coverage.

O

Offer

A carrier representative’s response to an RFP, including rates and plan terms.

Onboarding

The initial setup process for new brokers and carrier representatives.

Organization

A brokerage or company within MonarkHQ that contains users and shared access to Employers, Groups, and Proposals.

P

PEPM (Per Employee Per Month)

A commission or fee structure based on each eligible employee.

Percentage Contribution

An employer contribution strategy where a fixed percentage of premium is paid by the employer.

Premium

The cost of insurance coverage before employer and employee contributions are applied.

Proposal

A curated collection of Quotes assembled by a broker for a specific Group.

Proposals are presented to the Employer for review and selection.

Proposal Item

An individual plan option included within a Proposal.

R

Rate Tier

The premium category based on coverage level (Employee Only, Employee + Spouse, etc.).

Rating Area

A geographic zone used to determine insurance pricing.

Recommendation

A broker-designated indicator that highlights preferred plans within a Proposal.

Renewal

Coverage quoted for an existing Group at the annual renewal date.

RFP (Request for Proposal)

A formal request sent to carriers for underwritten quotes based on Census and plan specifications.

S

SBC (Summary of Benefits and Coverage)

A standardized document required by law that explains plan coverage in plain language.

Selection

The Employer’s final choice of plans from a Proposal.

Self-Funded

A funding arrangement where the employer assumes claims risk and pays claims directly.

STD (Short-Term Disability)

Disability insurance providing income replacement for a limited duration.

Supplemental Insurance

Voluntary coverage that supplements primary insurance.

T

Tier

See Rate Tier.

Tobacco User

An individual whose tobacco use may affect insurance rates.

Total Premium

The full premium amount before contributions are applied.

U

UCR (Usual, Customary, and Reasonable)

A reimbursement method for out-of-network services.

Underwriting

The carrier’s process for evaluating risk and determining pricing and eligibility.

V

Vision Insurance

Coverage for eye exams, glasses, and contact lenses.

Voluntary Benefits

Employee-paid benefits elected at the individual level.

W

Waiting Period

The period before benefits eligibility begins for new hires or certain services.