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Bariatric surgery glossary

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Term Definition
Self-Funded Plan
A type of health insurance plan in which the employer assumes all risks and costs in providing health care to employees and decides what is and what is not covered, such as bariatric surgery. Self-funded plans are usually administered by an insurance company. This insurance company is often referred to as the third-party administrator (TPA) of the plan. The TPA performs administrative functions only and does not determine coverage. Self-funded plans are exempt from state regulations, including mandated benefits, premium taxes, and consumer protection laws, but they must meet federal regulations.
Sleeve Gastrectomy
A restrictive form of bariatric surgery in which more than half of the patient’s stomach is removed to leave behind a smaller stomach pouch that resembles a thin, vertical sleeve. Also referred to as gastric sleeve surgery.
Surgically sterile staples, similar in look and function to those used to fasten paper, for connecting bodily tissue. Staples are often permanent and are made of stainless steel or titanium.
Summary Plan Description
Employers with self-funded health insurance plans are legally required to provide this document to their beneficiaries. The document provides plan participants with important information about their health benefits. This includes plan rules, financial information, and information on the operation and management of the plan. The information contained in the Summary Plan Description is similar to what is found in the Certificate of Coverage provided by a health insurance company.
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