Glossary

Quick reference for abbreviations and terms used throughout AskFlorence documentation.

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Subsidies & Pricing

Term	Full Name	What It Means
APTC	Advance Premium Tax Credit	Monthly subsidy that reduces your health insurance premium. Calculated from income, household size, and the SLCSP.
SLCSP	Second Lowest Cost Silver Plan	The benchmark Silver plan used to calculate APTC. Not necessarily the plan you enroll in.
CSR	Cost Sharing Reduction	Reduces deductibles, copays, and max out-of-pocket on Silver plans for people under 250% FPL.
FPL	Federal Poverty Level	Income threshold set by HHS. All subsidy eligibility is measured as a percentage of FPL.
IRA	Inflation Reduction Act	Extended enhanced premium tax credits through 2025. Standard (less generous) table applies in 2026.
AV	Actuarial Value	The percentage of total costs a plan covers. Silver = 70%, Gold = 87%, etc. CSR increases Silver's AV.
MOOP	Maximum Out-of-Pocket	The most you pay in a year for covered services. After hitting MOOP, the plan pays 100%.

Plans & Metal Levels

Term	Full Name	What It Means
QHP	Qualified Health Plan	An ACA-compliant health plan sold through a marketplace. What most people mean by "Obamacare plan."
HMO	Health Maintenance Organization	Plan type requiring in-network providers and usually a primary care referral for specialists.
PPO	Preferred Provider Organization	Plan type allowing out-of-network providers at higher cost, no referral needed.
EPO	Exclusive Provider Organization	Like an HMO but usually no referral needed. Still in-network only.
HIOS	Health Insurance Oversight System	CMS system that assigns unique plan IDs. HIOS ID = the plan's federal identifier (e.g., 25303NY0630001).
SBC	Summary of Benefits and Coverage	Standardized document every plan must publish showing deductibles, copays, and covered services.
EHB	Essential Health Benefits	The 10 categories of services all ACA plans must cover (hospitalization, Rx, maternity, mental health, etc.).
SADP	Stand-Alone Dental Plan	Dental-only plan sold separately from medical QHPs on the marketplace.
HSA	Health Savings Account	Tax-advantaged account paired with high-deductible plans. Not all plans are HSA-eligible.

Marketplaces

Term	Full Name	What It Means
FFM	Federally Facilitated Marketplace	Healthcare.gov. Serves 30 states that don't run their own exchange.
SBE	State-Based Exchange	A state that runs its own marketplace (NY, CA, CO, etc.) instead of using Healthcare.gov.
SBE-FP	State-Based Exchange on Federal Platform	A state exchange that uses Healthcare.gov's technology but manages its own program (AR, OR).
NYSOH	NY State of Health	New York's state-based marketplace at nystateofhealth.ny.gov.
CMS	Centers for Medicare & Medicaid Services	Federal agency that runs Healthcare.gov and publishes marketplace data.
EDE	Enhanced Direct Enrollment	Allows third-party sites (like AskFlorence, eventually) to enroll consumers directly without redirecting to Healthcare.gov.

New York Specific

Term	Full Name	What It Means
EP	Essential Plan	NY's Basic Health Program. $0 premium, $0 deductible coverage for people under 200-250% FPL.
BHP	Basic Health Program	ACA Section 1331 authority that lets states create programs like NY's Essential Plan. Only NY and MN use it.
DFS	Department of Financial Services	NY's insurance regulator. Approves health plan rates annually.
1332 Waiver	Section 1332 State Innovation Waiver	Federal waiver NY used to expand Essential Plan to 250% FPL. Terminates July 1, 2026.
PRUCOL	Permanently Residing Under Color of Law	Immigration status category eligible for state-funded coverage in NY (includes DACA).
CHP	Child Health Plus	NY's separate health program for children under 19. Free up to 222% FPL.

California Specific

Term	Full Name	What It Means
CAPS	California Additional Premium Subsidy	State-funded premium subsidy on top of federal APTC for low-income Californians.
CAPC	California Additional Premium Credit	$1/member/month state credit. Small but stacks with APTC + CAPS.

Data Sources

Term	Full Name	What It Means
PUF	Public Use File	CMS-published CSV datasets with plan rates, benefits, and service areas. Published annually.
MR-PUF	Machine-Readable PUF	Contains carrier URLs for drug formulary and provider directory JSON files.
Exhibit 23	DFS Rate Filing Exhibit 23	The specific Excel workbook in NY DFS filings that contains approved plan-level premiums by rating region.

Infrastructure & Compliance

Term	Full Name	What It Means
SOC 2	System and Organization Controls 2	Audit standard for service organizations covering security, availability, and confidentiality.
BAA	Business Associate Agreement	HIPAA-required agreement between covered entities and their service providers (e.g., MongoDB Atlas, AWS).
HIPAA	Health Insurance Portability and Accountability Act	Federal law requiring protection of personal health information (PHI).
PHI	Protected Health Information	Health data linked to an individual (SSN + health plan = PHI).
PII	Personally Identifiable Information	Any data that can identify a person (name, email, SSN, address).
CSFLE	Client-Side Field Level Encryption	MongoDB feature that encrypts individual fields before they leave the application.
KMS	Key Management Service	AWS service that manages encryption keys used for CSFLE.
IAM	Identity and Access Management	AWS service for managing users, roles, and permissions.
MFA	Multi-Factor Authentication	Requiring two forms of verification (password + code) to log in.
NPN	National Producer Number	Unique ID assigned to licensed insurance brokers/agents.

ACA Formula Reference

APTC = SLCSP_household - (applicable_percentage x income / 12)

Where:
  SLCSP_household = SLCSP_individual x number_of_adults  (NY: community rated)
  SLCSP_household = sum of age-rated SLCSP per member    (federal states)
  applicable_percentage = from IRS Rev. Proc. table based on income as % of FPL
  
If APTC < 0, APTC = 0
If income > 400% FPL, APTC = 0 (cliff in 2026, post-IRA expiry)