Common use of Benefit Determinations Clause in Contracts

Benefit Determinations. The Plan, or a person or entity working on behalf of the Plan, will administer your Benefits and determine your Benefits in accordance with the terms of this Agreement. For Claim Denials, your Explanation of Benefits is your Notice of Adverse Benefit Determination. Other Adverse Benefit Determinations are described in section 2.F.4. If you disagree with a determination made by the Plan, you may submit complaints and Appeal the decision as described in section 8.

Benefit Determinations. The Plan, or a person or entity working on behalf of the Plan, will administer your Benefits and determine your Benefits in accordance with the terms of this Agreement. For Claim Denials, your Explanation of Benefits is your Notice of Adverse Benefit DeterminationDete rmination. Other Adverse Benefit Determinations are described in section 2.F.4. If you disagree with a determination made by the Plan, you may submit complaints and Appeal the decision as described in section 8.. SAMPLE

Benefit Determinations. The Plan, or a person or entity working on behalf of the Plan, will administer your Benefits and determine your Benefits in accordance with the terms of this Agreement. For Claim Denials, your Explanation of Benefits is your Notice of Adverse Benefit Determination. Other Adverse Benefit Determinations are described in section 2.F.42.G.4. If you disagree with a determination made by the Plan, you may submit complaints and Appeal the decision as described in section 8.