Benefit plan design definition

Benefit plan design means a specific health coverage product issued by a carrier to small employers, to trustees of associations that include small employers, or to individuals if the coverage is offered through employment or sponsored by an employer. It includes services covered and the levels of copayment and deductibles, and it may include the professional providers who are to provide those services and the sites where those services are to be provided. A benefit plan design may also be an integrated system for the financing and delivery of quality health care services which has significant incentives for the covered individuals to use the system.
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Benefit plan design. Suite of drug benefits established by and/or for a Plan Sponsor, to contain but not limited to coverage inclusions/exclusions, limitations, pricing, DUR, DAW Codes, Network and formulary rules.
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Benefit plan design means the terms, scope and conditions for Prescription Drug or device benefits under a Plan, including Formularies, exclusions, days or supply limitations, prior authorization or similar requirements, applicable Cost Share, benefit maximums and any other features or specifications as may be included in Plan documents, as communicated by the Customer to Aetna in accordance with any implementation procedures described herein. The Customer shall disclose to Plan Participants any and all matters relating to the Benefit Plan Design that are required by law to be disclosed, including information relating to the calculation of Cost Share or any other amounts that are payable by a Plan Participant in connection with the Benefit Plan Design.
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Examples of Benefit plan design in a sentence

  • Benefit plan design, including point of service employee cost-sharing arrangements.

  • Benefit plan design data was analyzed and a process was built to compare the actuarial value of the various book of business plan designs to the value of a$0 base plan (100% coverage of all services with no member cost sharing).

  • We then go on to outline how a Target Benefit plan design could be used to redefine the “pension deal” and result in a method of sharing risk that may be more appealing to some employers and employee groups.

  • For the candidate seeking appointment as a regular faculty/secondary appointment, the Dean is empowered to make the appointment at the Assistant Professor rank.

  • Absentee ballots totaling 108,947 were issued by municipalities within Milwaukee County and an additional 61,193 absentee ballots were issued by municipalities in Dane County during the “in-person absentee voting” period pursuant to Wis.

  • Provide examples: • Benefit plan design, cost, trends and benchmarking, ongoing financial reporting • Assistance with retiree healthcare lawsuits • Federal compliance education and recommendations • Michigan Public Act compliance and education (PA 54, 106, 152, and Public Act 202).

  • Benefit plan design, cost, trends and benchmarking, including ongoing reporting.

  • HKAS 39 & HKFRS 7(Amendments)Reclassification of Financial AssetsHK(IFRIC) – Int 12 Service Concession ArrangementsHK(IFRIC) – Int 14 HKAS 19 – The Limit on a Defined Benefit Asset, Minimum Funding Requirements and their Interaction The adoption of the new HKFRSs had no material effect on how the results and financial position for the current or prior accounting periods have been prepared and presented.


More Definitions of Benefit plan design

Benefit plan design means a specific health coverage product offered for sale and includes services covered and the levels of copayments, deductibles, and annual out-of-pocket expenses, and may include the professional providers who are to provide those services and the sites where those services are to be provided. A benefit plan design may also be an integrated system for the financing and delivery of quality health care services that has significant incentives for the covered individuals to use the system.
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Benefit plan design or “BPD” means a description of the essential elements of the Pharmacy Benefit Plan, provided by Participating Program to Contractor for the initial program Implementation and ongoing program management.
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Related to Benefit plan design

  • Company Benefit Plan has the meaning specified in Section 4.13(a).

  • Non-U.S. Benefit Plan has the meaning set forth in Section 3.20(a).

  • Health benefit plan means a policy, contract, certificate or agreement offered or issued by a health carrier to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services.

  • Parent Benefit Plan means any Employee Benefit Plan maintained by, sponsored by or contributed to by, or obligated to be contributed to by any Parent Group Entity.

  • Company Benefit Plans has the meaning set forth in Section 3.16(a).

  • Seller Benefit Plan means each Employee Benefit Plan sponsored, maintained or contributed to by a Seller or any of its Affiliates or with respect to which a Seller or any of its Affiliates has, or could reasonably be expected to have, any direct or indirect Liability.

  • Welfare Benefit Plan means each welfare benefit plan maintained or contributed to by the Company, including, but not limited to a plan that provides health (including medical and dental), life, accident or disability benefits or insurance, or similar coverage, in which Executive was participating at the time of the Change in Control.

  • Benefit Plan means any of (a) an “employee benefit plan” (as defined in ERISA) that is subject to Title I of ERISA, (b) a “plan” as defined in and subject to Section 4975 of the Code or (c) any Person whose assets include (for purposes of ERISA Section 3(42) or otherwise for purposes of Title I of ERISA or Section 4975 of the Code) the assets of any such “employee benefit plan” or “plan”.

  • Basic health benefit plan means any plan offered to an individual, a small group,

  • Benefit Plan Entity shall have the meaning assigned to such term in Section 3.9.

  • Foreign Benefit Plan means any Employee Benefit Plan established, maintained or contributed to outside of the United States of America or which covers any employee working or residing outside of the United States.

  • Qualified Benefit Plan has the meaning set forth in Section 3.20(c).

  • Company Plan means all Plans of which the Company or an ERISA Affiliate of the Company is or was a Plan Sponsor, or to which the Company or an ERISA Affiliate of the Company otherwise contributes or has contributed, or in which the Company or an ERISA Affiliate of the Company otherwise participates or has participated. All references to Plans are to Company Plans unless the context requires otherwise.

  • Parent Benefit Plans has the meaning set forth in Section 5.07(b).

  • EHC plan means an Education, Health and Care plan made under sections 37(2) of the Children and Families Act 2014.

  • Company Employee Benefit Plan means each Employee Benefit Plan that is maintained, sponsored or contributed to (or required to be contributed to) by any of the Group Companies or under or with respect to which any of the Group Companies has any Liability.

  • Employee Welfare Benefit Plan has the meaning set forth in ERISA Section 3(1).

  • Buyer Benefit Plans has the meaning set forth in Section 6.10(f).

  • Company Employee Plan means any plan, program, policy, practice, contract, agreement or other arrangement providing for compensation, severance, termination pay, deferred compensation, performance awards, stock or stock-related awards, fringe benefits or other employee benefits or remuneration of any kind, whether written or unwritten or otherwise, funded or unfunded, including without limitation, each "employee benefit plan," within the meaning of Section 3(3) of ERISA which is or has been maintained, contributed to, or required to be contributed to, by the Company or any Affiliate for the benefit of any Employee, or with respect to which the Company or any Affiliate has or may have any liability or obligation;

  • Seller Benefit Plans has the meaning set forth in Section 4.10(a).

  • Pension Benefit Plan means at any time any employee pension benefit plan (including a Multiple Employer Plan, but not a Multiemployer Plan) which is covered by Title IV of ERISA or is subject to the minimum funding standards under Section 412 of the Code and either (i) is maintained by any member of the Controlled Group for employees of any member of the Controlled Group; or (ii) has at any time within the preceding five years been maintained by any entity which was at such time a member of the Controlled Group for employees of any entity which was at such time a member of the Controlled Group.

  • Parent Employee Plan means any plan, program, policy, practice, contract, agreement or other arrangement providing for compensation, severance, termination pay, performance awards, stock or stock-related awards, fringe benefits or other employee benefits or remuneration of any kind, whether written or unwritten or otherwise, funded or unfunded, including without limitation, each "EMPLOYEE BENEFIT PLAN," within the meaning of Section 3(3) of ERISA which is maintained, contributed to, or required to be contributed to, by Parent or any Affiliate for the benefit of any Parent Employee;

  • Employee Plan means each "employee benefit plan," as such term is defined in Section 3(3) of ERISA, that (A)(i) is subject to any provision of ERISA and (ii) is maintained or contributed to by the Company, or (B)(i) is subject to any provision of Title IV of ERISA and (ii) is maintained or contributed to by any of the Company's ERISA Affiliates.

  • Purchaser Benefit Plans has the meaning set forth in Section 8.7(d).

  • Separation Plan means the Company’s Separation Plan Amended and Restated Effective August 13, 2006, as may be amended from time to time or any successor plan, program, arrangement or agreement thereto.

  • Supplemental Plan means a written plan for a child outlining the agency's plan to locate a permanent placement for the child and which may be developed concurrently with the case plan.