Covered Benefit Clause Samples

The "Covered Benefit" clause defines the specific services, treatments, or items that an insurance policy or benefits plan will pay for or reimburse. In practice, this clause outlines the scope of coverage, detailing which medical procedures, prescription drugs, or healthcare services are included under the plan, and may reference exclusions or limitations. Its core function is to provide clarity to policyholders and providers about what is eligible for payment, thereby preventing misunderstandings and disputes over coverage.
Covered Benefit. The DMMA shall provide or arrange for the provision of pharmacy services to Medicaid Recipients.
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Covered Benefit. The Department or Medicaid MCO shall provide or arrange for the provision of Covered Outpatient Drug services to Illinois Medicaid Enrollees.
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Covered Benefit. Exclusion Urgent Care, Emergency Health Care Services, and Observation Services The Member will be responsible for charges that we do not Cover.
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Covered Benefit. Each Participating Medicaid Program shall provide or arrange for the provision of pharmacy services to Medicaid Recipients.
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Covered Benefit. The Department or Medicaid MCO shall provide or arrange for the provision of pharmacy and DME services to Illinois Medicaid Enrollees.
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Related to Covered Benefit

  • Covered Benefits Benefits for Bone Mass Measurement for the prevention, diagnosis, and treatment of osteoporosis are covered when requested by a Health Care Provider for a Qualified Individual.

  • Accrued Benefit 1.05 1.16 Nonforfeitable ............................................. 1.05 1.17 Plan Year/Limitation Year .................................. 1.05 1.18 Effective Date ............................................. 1.05 1.19 Plan Entry Date ............................................ 1.05 1.20

  • Insured Benefits A transferring employee will be covered by the benefit plans at the designated Employer. There will be no break in coverage and/or no waiting period prior to being able to receive benefits so long as the waiting period has already been served, subject to the requirements of the carrier.

  • Death Benefit Should Employee die during the term of employment, the Company shall pay to Employee's estate any compensation due through the end of the month in which death occurred.

  • Retirement Benefit (i) In consideration of the Executive's past services to the Company, the Executive shall be entitled to a retirement benefit, payable monthly for his life, in an amount equal to 50 percent of his highest monthly Base Salary during the Employment Term. Such payments shall commence on the first day of the month coincident with or next following the later of the Executive's attainment of age 58 or the end of the Employment Term (the "Commencement Date"); provided, however, that if the Employment Term terminates prior to his attainment of age 58, the Executive may elect by written notice to the Company to have such payments commence on the first day of any month after such termination of employment (the "Early Commencement Date") in a monthly amount equal to the monthly amount that the Executive would have received at the Commencement Date, reduced by one-third of one percent (.33%) per month for each month by which the Early Commencement Date precedes the Commencement Date. The amount of each payment hereunder shall be increased on each January 1 following the Early Commencement Date or Commencement Date, as applicable, by an amount determined by multiplying the amount of each monthly payment made in the preceding year by the percentage increase, if any, in the cost of living from the preceding January 1, as reflected by the Consumer Price Index. The Executive's election to have his retirement benefit payments commence on the Early Commencement Date shall not affect the Company's obligation to pay consulting fees to the Executive in accordance with Section 4 hereof. The retirement benefit shall be an unconditional, but unsecured, general credit obligation of the Company to the Executive, and nothing contained in this Agreement, and no action taken pursuant to it, shall create or be construed to create a trust of any kind between the Company and the Executive. The Executive shall have no right, title or interest whatever in or to any investments which the Company may make (including, but not limited to, an insurance policy on the life of the Executive) to aid it in meeting its obligations hereunder. (ii) From time to time, the Company shall make such contributions to the trust established under the Trust Agreement dated as of December 18, 1986 (the "1986 Trust") between the Company, as grantor, and Wi▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, as successor trustee, to provide a sufficient reserve for the discharge of its obligation to pay the retirement benefit to the Executive as provided in clause (i) of this Section 3(c) and clauses (ii) and (iii) of Section 5(a) hereof.