Named peril or specified peril
This is a peril indicated or identified in the contract as a cause of loss for which insurance is being provided. Under such contracts if a peril is not named or specified it is not covered.
National Committee for Quality Assurance (NCQA)
NCQA is a non-profit organization that evaluates and accredits managed care plans. It is also responsible for implementing the Health Employer Data and Information Set (HEDIS) data reporting system that provides standardized performance measures for managed care plans.
A group of doctors, nurses and hospitals that work for a managed care plan to provide health care services to its members. To get the most benefits for the lowest cost to you, you generally have to use the plan's network.
Nonparticipating physician
A doctor or supplier who does not accept assignment on all Medicare claims. A doctor or supplier who does not have a network agreement with a managed care plan.

Next Page