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Anniversary Year

An anniversary year is a 12-month benefit period that begins on the date your insurance coverage takes effect rather than on a standard calendar year. This means your plan’s annual maximums, deductibles, and claim resets follow your personal enrollment date instead of January 1 to December 31.

For example, if your coverage starts on April 1, your anniversary year runs from April 1 of one year to March 31 of the next. This system ensures that benefits renew exactly one year after your policy begins, regardless of when you joined.

Anniversary years are common in individual and family health or dental plans because they provide flexibility for policyholders who start coverage at different times of the year. They are less common in large group benefit plans, which typically align with the employer’s fiscal or calendar year for administrative simplicity.

Example:

If your policy starts on July 01, your first benefit year runs from July 01 to the following June 30. Any annual maximums, deductibles, or frequency-based benefits reset on that date each year.

What to Watch For:

Keep track of your anniversary date so you know when benefits renew. Submitting large claims just before the anniversary reset may exhaust your current year’s maximums, leaving little available until the next benefit period begins.

Related Terms

Accident

An accident is an unexpected, sudden, and external event that causes bodily injury, occurring independently of any illness or pre-existing condition. In the context of health and dental insurance, an accident typically refers to physical harm resulting from an unforeseen incident such as a fall, collision, or blow to the body. Accidents are distinct from sickness or degenerative conditions because they are caused by an identifiable event rather than a gradual process.

Accidental Death and Dismemberment Insurance (AD&D)

Accidental Death and Dismemberment Insurance (AD&D) provides a tax-free lump-sum payment if you die or suffer a severe injury as the direct result of an accident. It is designed to offer financial protection for you and your family in the event of an unexpected, accidental injury or loss that causes death, dismemberment, or permanent disability.

Accidental Dental

Accidental dental coverage pays for the repair or replacement of natural teeth damaged due to an accidental blow to the mouth or jaw. This benefit is distinct from routine dental coverage because it applies to emergencies caused by external physical impact, not decay or normal wear.

Actuary

An actuary is a professional who specializes in analyzing financial risk and uncertainty, particularly in the fields of insurance, pensions, and investments. Actuaries use mathematics, statistics, and financial theory to calculate premiums, reserves, and probabilities of future events such as illness, disability, or death. Their work ensures that insurance plans remain financially stable and that companies can meet future claim obligations while staying competitively priced.

Advisor/Agent

An advisor or agent is a licensed professional who helps individuals and businesses understand, choose, and manage insurance and financial products. In the context of health, dental, life, and disability insurance, an advisor’s role is to assess a client’s needs, explain plan options, and recommend solutions that provide appropriate protection within their budget.

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