Eligible survivor - In LTD plans, a deceased employee's surviving spouse; if no spouse survives, then the employee's children under a certain age (e.g. 25)

Eligibility date - The day on which an employee becomes eligible for insurance, after completing a plan's waiting period.

Elimination period - The number of consecutive days an employee must be disabled before LTD benefits become payable (typically, 90 or 180 days). Also known as benefit waiting period and qualifying period. In some plans, employees are allowed to work during the elimination period; see residual.

Employee - A citizen or permanent resident of the United States or Canada who is in active employment in the United States with the Employer unless an exception is applied for and approved in writing by Sedgwick CMS.

Employee Assistance Program (EAP) - Employer-sponsored program designed to help employees whose job performance is being adversely affected by personal problems. May involve wellness and prevention efforts, counseling, and control of specific conditions (e.g., alcoholism or smoking). Some employers use EAP's to address the psychological aspects of disabling injuries or illnesses.

Employee Retirement Income Security Act (ERISA) - The main purpose of the Employee Retirement Income Security Act is to ensure that employees receive the pension and other benefits promised by their employers. ERISA sets uniform minimum standards to assure that employee benefit plans are established and maintained in a fair and financially sound manner. In addition, employers have an obligation to provide promised benefits and satisfy ERISA's requirements for managing and administering private pension and welfare plans. Title I of ERISA requires persons and entities who manage and control plan funds to: Manage plans for the exclusive benefit of participants and beneficiaries; Carry out their duties in a prudent manner and refrain from conflict-of-interest transactions expressly prohibited by law; Comply with limitations on certain plans' investments in employer securities and properties; Fund benefits in accordance with the law and plan rules; Report and disclose information on the operations and financial condition of plans to the government and participants; Provide documents required in the conduct of investigations to assure compliance with the law. ERISA supersedes almost all state laws that affect employee benefit plans and has thus created a single federal standard for employee benefit.

Employer - The policyholder - which includes any division, subsidiary or affiliated company named in the policy.

Employer's first report of injury - A state-required notice of the details of an industrial accident or occupational disease; must be filed by the employer or its agent with the workers' compensation insurance carrier and, in most cases, also with the state workers' compensation agency.

Enrollment - The process of selecting and signing up as a member of a health or disability plan.

Essential functions - As defined by the Americans with Disabilities Act, the fundamental job duties of the position that an individual with a disability holds or seeks. These are activities that every incumbent in a given job must perform. See also marginal functions

Evidence of insurability - Statement or proof of an individual's medical history, which determines his or her acceptability for coverage.

Examiner - Person responsible for the adjudication of disability claims.

Experience - Experience - The financial status of an insured group's claim activity relative to the insurer or self-funding employer. "Good experience" indicates that claims payments are lower than expected; "bad experience" indicates the opposite.

Experience data - History of premiums, incurred claims, paid claims, open claims, closed claims, plan changes, rates, and changes in number of covered individuals for a group.

Explanation of benefits (EOB) - A statement mailed to a member or covered insured explaining how and why a claim was or was not paid; the Medicare version is called an EOMB.