Benefits Available from Other Sources Sample Clauses

Benefits Available from Other Sources. This agreement does NOT cover the cost of covered health care services provided to you when there is no charge to you or there would have been no charge to you absent this agreement. This agreement does NOT cover health care services when you can recover all or a portion of the cost of such services through a federal, state, county, or municipal law or through legal action. This is true even if you choose not to assert your rights under these laws or if you fail to assert your rights under these laws. This agreement does NOT cover health care services if another entity or agency is responsible for such services under state or federal laws which provide service for the health of school children or children with disabilities. (See generally, Title 16, Chapters 21, 24, 25, and 26 of the Rhode Island General Laws. See also applicable regulations about the health of school children and the special education of children with disabilities or similar rules set forth by federal law or state law of applicable jurisdiction.)
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Benefits Available from Other Sources. This agreement does NOT cover:  the portion of costs for dental services you receive when there is no charge to you or would have been no charge to you absent this agreement;  dental services when you can recover all or a portion of the cost of such services through a federal, state, county, or municipal law or through legal action. This is true even if you choose not to assert your rights under these laws or if you fail to assert your rights under these laws; or  services received from a dental department maintained or on behalf of an employer, mutual benefit association, labor union, trustee, or similar group or person.
Benefits Available from Other Sources. This agreement does NOT cover the portion of costs for health care services you receive when there is no charge to you or would have been no charge to you absent this agreement. This agreement does NOT cover health care services when you can recover all or a portion of the cost of such services through a federal, state, county, or municipal law or through legal action. This is true even if you choose not to assert your rights under these laws or if you fail to assert your rights under these laws.

Related to Benefits Available from Other Sources

  • Services Available or Provided from Other Sources Services for any condition, illness, or disease which should be covered by the United States government or any of its agencies, Medicare, any state or municipal government or any of its agencies except emergency care when there is a legal responsibility to provide it. • Services or supplies for military-related conditions, such as war, or any military action, which takes place after your coverage becomes effective. • Services received in a facility mainly meant to care for students, faculty, or employees of a college or other institution of learning. • Covered healthcare services provided to you when there is no charge to you or there would have been no charge to you absent this health plan. • Services if another entity or agency is responsible under state or federal laws, which are provided for the health of schoolchildren or children with disabilities. See Title 16, Chapters 21, 24, 25, and 26 of the R.I. General Laws. See also applicable regulations about the health of schoolchildren and the special education of children with disabilities or similar rules set forth by federal law or state law of applicable jurisdiction. • Services and supplies which are required under the laws of a state, other than Rhode Island, and are not provided under this health plan. All Other Exclusions • Services not approved by the FDA or other governing body. • Services we have not reviewed or we have not determined are eligible for coverage. • Services obtained through fraud or intentional misrepresentation. • Administrative service charges for: o missed appointments; o completion of claim forms; o additional fees, sometimes referred to as access fees, associated with concierge, boutique, or retainer practices; and o any other administrative charges. • Blood services for drawing, processing, or storage of your own blood, including any penalty fees related to blood services. • Continuation of a covered healthcare service or benefit as a result of a clerical error. • Custodial care, rest care, day care, or non-skilled care services. • Convalescent homes, nursing homes including non-skilled care, assisted living facilities, or other residential facilities. • Educational classes, unless listed as covered, and training services. • Exams or services that are required for or related to employment, education, marriage, adoption, insurance purposes, court order, or similar third parties when not medically necessary or when the benefit limit for the exam or service has been met. • Routine foot care, including the treatment of corns, bunions except capsular or bone surgery, calluses, the trimming of nails, the treatment of simple ingrown nails and other preventive hygienic procedures, except when performed to treat diabetic related nerve and circulation disorders of the feet. • Treatment of flat feet unless the treatment is a covered surgical service. • Telephone consultations, telephone services, or medication monitoring by phone, except for clinically appropriate telemedicine services as described in Section 3. • Healthcare services for work-related illnesses or injuries for which benefits are available under Workers’ Compensation , whether or not you are entitled to such benefits, unless: o you are self-employed, a sole stockholder of a corporation, or a member of a partnership; and o your illnesses or injuries were incurred in the course of your self-employment, sole stockholder, or partnership activities; and o you are not enrolled as an employee under a group health plan sponsored by another employer. • Services and supplies used for your personal appearance and/or comfort, whether or not prescribed by a physician and regardless of your condition. These services and supplies include, but are not limited to: o batteries, unless indicated as covered;

  • EPP service availability Refers to the ability of the TLD EPP servers as a group, to respond to commands from the Registry accredited Registrars, who already have credentials to the servers. The response shall include appropriate data from the Registry System. An EPP command with “EPP command RTT” 5 times higher than the corresponding SLR will be considered as unanswered. If 51% or more of the EPP testing probes see the EPP service as unavailable during a given time, the EPP service will be considered unavailable.

  • Transfers From Other Plans We can receive amounts transferred to this Xxxx XXX from the trustee or custodian of another Xxxx XXX as permitted by the Code. In addition, we can accept rollovers of eligible rollover distributions from employer-sponsored retirement plans as permitted by the Code. We reserve the right not to accept any transfer.

  • Employee Availability (a) An Employee designated for standby duty shall be available during her period of standby duty at a known telephone number or pager number and be able to report for duty as quickly as possible if called.

  • COMPENSATION FOR LOSS OF OTHER REVENUES To the extent not included in the amounts calculated pursuant to Section 4.2 above, Applicant shall also pay to or on behalf of the District on an annual basis all M&O Revenue losses, and other costs as they are incurred by the District that arise from entering this Agreement (the “Additional Loss”), including without limitation to: (a) any loss incurred by the District resulting from a judicial challenge to this Agreement; (b) any reasonable attorneys’ fees or other costs incurred by the District due to any amendment, audit, legal defense or enforcement of this Agreement brought by or against either party or person or entity, irrespective of whether or not this Agreement or any interpretation thereof by the District is ultimately determined to be valid; and (c) any non-reimbursed reasonable costs or fees incurred by the District and reasonably necessary to administer or maintain this Agreement, either directly or indirectly, including costs paid to the Appraisal District based on the values of the Qualified Property used for the District’s debt service (interest and sinking fund) that exceeds the Tax Limitation Amount provided in Section 2.4 herein. Notwithstanding anything to the contrary in Section 4.8, payment for such Additional Loss shall be made by Applicant no later than 30 days following written notice that such Additional Loss is due and owing, together with supporting calculations by the Third Party Consultant and copies of invoices (redacted as needed) for any such non-reimbursed costs and fees paid.

  • RDDS availability Refers to the ability of all the RDDS services for the TLD, to respond to queries from an Internet user with appropriate data from the relevant Registry System. If 51% or more of the RDDS testing probes see any of the RDDS services as unavailable during a given time, the RDDS will be considered unavailable.

  • Service Availability You understand that Service availability is at all times conditioned upon the corresponding operation and availability of the communication systems used in communicating your instructions and requests to the Credit Union. We will not be liable or have any responsibility of any kind for any loss or damage thereby incurred by you in the event of any failure or interruption of such communication systems or services resulting from the act or omission of any third party, or from any other cause not reasonably within the control of the Credit Union.

  • DNS service availability Refers to the ability of the group of listed-­‐as-­‐authoritative name servers of a particular domain name (e.g., a TLD), to answer DNS queries from DNS probes. For the service to be considered available at a particular moment, at least, two of the delegated name servers registered in the DNS must have successful results from “DNS tests” to each of their public-­‐DNS registered “IP addresses” to which the name server resolves. If 51% or more of the DNS testing probes see the service as unavailable during a given time, the DNS service will be considered unavailable.

  • Shift Differential Compensation Any employee in the bargaining unit whose assigned work shift commences (for unit-1) prior to 5:30 a.m. or whose work shift ends after 5:30 p.m., or (for unit-2 members) commences after 2:00 p.m. shall be paid a shift differential premium of five (5%) percent above the regular rate of pay for all hours worked.

  • Insurance Availability The teacher will be given an opportunity to continue insurance coverage in the school insurance program during the leave of absence, but will be required to pay all premiums connected with this coverage. All premiums must be paid in advance of the month due. Such premiums shall be prorated on an annual basis from August to August. Teachers initiating leaves of absence shall be charged the prorated amounts during the school year in which their leave begins. As leaves of absence extend into the next school year, the teacher will be expected to pay full premiums.

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