This Plan means, in a COB provision, the part of the contract providing the health care benefits to which the COB provision applies and which may be reduced because of the benefits of other plans. Any other part of the contract providing health care benefits is separate from this plan. A contract may apply one COB provision to certain benefits, such as dental benefits, coordinating only with similar benefits, and may apply another COB provision to coordinate other benefits.
This Plan means, in a COB provision, the part of the contract providing the dental benefits to which the COB provision applies and which may be reduced because of the benefits of other Plans. Any other part of the contract providing dental benefits is separate from This Plan. A contract may apply one COB provision to certain benefits, such as dental benefits, coordinating only with similar benefits, and may apply another COB provision to coordinate other benefits.The order of benefit determination rules determine whether This Plan is a Primary Plan or Secondary Plan when you have dental coverage under more than one Plan.When This Plan is primary, it determines payment for its benefits first before those of any other Plan without considering any other Plan’s benefits. When This Plan is secondary, it determines its benefits after those of another Plan and must make payment in an amount so that, when combined with the amount paid by the Primary Plan, the total benefits paid or provided by all Plans for the claim are coordinated up to 100 percent of the total Allowable Expense for that claim. This means that when This Plan is secondary, it must pay the amount which, when combined with what the Primary Plan paid, does not exceed 100 percent of the Allowable Expense. In addition, if This Plan is secondary, it must calculate its savings (its amount paid subtracted from the amount it would have paid had it been the Primary Plan) and record these savings as a benefit reserve for you. This reserve must be used to pay any expenses during that calendar year, whether or not they are an Allowable Expense under This Plan. If This Plan is secondary, it will not be required to pay an amount in excess of its maximum benefit plus any accrued savings.
This Plan means the part of the Plan that provides health care benefits.
Examples of This Plan in a sentence
This Plan will have a 3% Company match, for those employees enrolled in the Plan and making contributions.
This Plan, which is covered by Supplementary Agreement, shall go into effect January 1, 2013 and be continued for the life of this Agreement.
This Plan serves as the mechanism to commit local fire, EMS and special resources to emergencies beyond the scope of their normal mutual aid systems.
This Plan is described more fully in a booklet entitled, "EmblemHealth Preferred Dental Benefit Plan B".
This Plan contains provisions that reduce the Limits of Coverage stated in the Plan by the costs of legal defense.
More Definitions of This Plan
This Plan means this Policy.
This Plan means this Certificate.
This Plan as used in this provision means that portion of the contract by name referred to in this document which provides the benefits that are subject to this provision.
This Plan means the part of the Group’s Benefit Plan and any amendments/endorsements thereto that provides Benefits for health care expenses.
This Plan means the part of this Benefit Plan and any amendments/endorsements thereto that provides Benefits for healthcare expenses.
This Plan means, in a COB provision, the part of the contract providing the health care benefits to which the COB provision applies and which may be reduced because of the benefits of other plans. Any other part of the contract providing health care benefits is separate from this plan. A contract may apply one COB provision to certain benefits, such as dental benefits, coordinating only with like benefits, and may apply other separate COB provisions to coordinate other benefits.The order of benefit determination rules determine whether this plan is a primary plan or secondary plan when the person has health care coverage under more than one plan. When this plan is primary, it determines payment for its benefits first before those of any other plan without considering any other plan’s benefits. When this plan is secondary, it determines its benefits after those of another plan and may reduce the benefits it pays so that all plan benefits equal 100 percent of the total allowable expense