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   Refers to the main decision-making body of a health micro-insurance scheme when the latter is managed in a participatory fashion. In the case of a mutual organization, cooperative or association, the general assembly brings together members or their representatives; in the case of a joint stock company, it brings together shareholders. The general assembly determines the scheme's objectives and overall policy. [ILO-STEP, 144]

   Contributions by the government in order to finance the cost of goods and services provided by the government to protected persons in the form of means-tested benefits, as well as payments to social security institutions to cover deficits and to support expenditure related to guaranteeing minimum benefit levels. [ILO,694]

   Government financing from sources other than ear-marked taxes. [ILO,694]

   A medicine designated by the name of its main active ingredient and not by its commercial name. In general, the International Non-proprietary Name (INN) established by WHO corresponds to the generic name. Generic drugs are less expensive than brand-name drugs.

   A method of payment according to which health care providers are paid a fixed, comprehensive fee. It may consist of:
1. A global fee per cluster of related health services.
Example: A fixed daily rate per hospital day may include charges for accommodation, consultations and examinations performed during the hospital stay.
2. A global fee per episode of illness that includes all health services utilized in connection with a single episode of illness or maternity case.
Example: A global maternity fee may include all health services utilized before delivery, during delivery (complicated or uncomplicated) and after delivery (follow-up).
3. A global fee per "head", called a capitation payment. This is a comprehensive fee paid for each person covered and for a specified period – often one year – granting entitlement to unlimited utilization of all or some of the health services of a health facility. [ILO-STEP, 144]
See also: methods of payment

   See: group insurance

   An insurance contract concluded between an insurer and a group of beneficiaries, such as the employees of an enterprise or the members of an association, cooperative, trade union, etc. Such contracts usually provide insurance coverage in the following areas: health care, retirement pensions, temporary or permanent disability, and death of the breadwinner. [ILO-STEP, 144]
Synonym: group contract

   A fund that a health micro-insurance scheme can call upon in the event of financial difficulty. Generally speaking, the assistance provided by the guarantee fund takes the form of a loan to the requesting scheme. The circumstances in which the guarantee fund may be used are usually specified in detail. The fund's assistance may be made conditional upon changes in the operation of the health micro-insurance scheme. Guarantee funds may be financed by member schemes, the State, financing institutions or support organizations. [ILO-STEP, 144]

   A document proving that a patient is covered by a health micro-insurance scheme; that is, that he or she is enrolled as a member or dependent, is up to date with his or her premiums and has completed the required waiting period. The guarantee letter also indicates the level of coverage to which the patient is entitled. In certain schemes, the person protected by the scheme must obtain a guarantee letter before receiving treatment if he or she wishes to benefit from third-party payment. The guarantee letter helps to eliminate attempts at fraud, limit over-consumption and guarantee health providers that expenses relating to patients' treatment will be paid by the health micro-insurance scheme (third-party payment principle). [ILO-STEP, 144]