What is an "explanation of benefits" (EOB)?

An "explanation of benefits" (EOB) is a document provided by an insurance company that outlines and clarifies how a specific claim was processed. It details the amount that the health insurer has paid for a service, the total cost incurred, and what the insured individual is responsible for paying out-of-pocket. This includes deductibles, copayments, or any coinsurance amounts that may be applicable. The purpose of the EOB is to help policyholders understand their financial responsibilities related to a healthcare service, ensuring transparency in claims processing and the allocation of costs.

The other choices represent different aspects of health insurance operations. A summary of premiums due pertains to the upcoming costs for maintaining a policy, a provider list is related to network availability for policyholders, and a chart of covered services relates to what is included in a health plan. While all are relevant to the overall insurance experience, they do not convey the same meaning or function as the explanation of benefits, which specifically addresses the breakdown of claim processing.