Medical Billing and Coding Certificate Practice Exam

A policyholder is the individual who owns the insurance policy. This person is responsible for paying the premiums and has the rights and responsibilities outlined in the policy. The policyholder may or may not be the same individual who receives healthcare benefits, as benefits can extend to dependents or other covered individuals under the policy. However, it is the policyholder who has the contractual relationship with the insurance provider.

In this context, while anyone covered under an insurance plan may benefit from the services, they do not have ownership of the policy itself, which is why being a policyholder is distinct from simply being a beneficiary of healthcare coverage. An insurance representative, on the other hand, is an individual who sells or manages insurance policies but does not own any policy. Therefore, the emphasis on ownership makes the definition of a policyholder clear and highlights their crucial role in the insurance process.