Covered Dependent Sample Clauses

Covered Dependent. Any person in a Subscriber’s family who meets all the eligibility requirements of the Eligibility and Enrollment section of this Certificate and the Dependent Eligibility section of the Schedule of Benefits, has enrolled in HMO, and is subject to Premium requirements set forth in the Premiums section of the Group Agreement.
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Covered Dependent. Shall be defined as a Dependent eligible to receive benefits under the terms of this Plan.
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Covered Dependent. Any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate and has enrolled and complied with the Premium requirements. Covered Services Those charges for Medically Necessary health care services, treatment and supplies intended to improve a condition or Member’s health that are (a) defined as Covered Services in the Member’s Contract, (b) not excluded under such Contract, (c) not Experimental or Investigational and (d) provided in accordance with such Contract. Covered Services are determined based upon all other Contract provisions. When more than one treatment option is available, and one option is no more effective than another, the Covered Service is the least costly option that is no less effective than any other option. The Covered Services are also subject to the Maximum Allowable Cost (MAC), as defined herein and all Contract exclusions will be taken into consideration to determine the Covered Service. Creditable Coverage Coverage under another health benefit plan is medical expense coverage with no greater than a ninety (90) day gap in coverage under any of the following: (a) Medicare or Medicaid; (b) an employer-based accident and sickness insurance or health benefit arrangement; (c) an individual accident and sickness insurance policy; (d) a spouse’s benefits or coverage under Medicare or Medicaid or an employer-based health insurance benefit arrangement; (e) a conversion policy; or similar coverage as defined in OCGA 33-30-15.
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Covered Dependent. Any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate and has enrolled and complied with the Premium requirements set forth in the Group Health Care Contract.
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Covered Dependent. A Covered Dependent’s coverage will automatically end at 12:01 a.m. on the termination date provided in your termination notice. A Covered Dependent’s coverage will end for the following reasons:
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Covered Dependent. If your employer purchased this coverage outside of the Health Insurance Marketplace then if eligible, any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate Booklet, has enrolled in Alliant’s healthcare Plan, and is subject to Premium requirements set forth in the Group Master Contract.
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Covered Dependent. Any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate and has enrolled and complied with the Premium requirements set forth in the Group Health Care Contract. Covered Services Those charges for Medically Necessary health care services, treatment and supplies intended to improve a condition or Member’s health that are (a) defined as Covered Services in the Member’s Contract, (b) not excluded under such Contract, (c) not Experimental or Investigational and (d) provided in accordance with such Contract. Covered Services are determined based upon all other Contract provisions. When more than one treatment option is available, and one option is no more effective than another, the Covered Service is the least costly option that is no less effective than any other option. The Covered Services are also subject to the Maximum Allowable Cost (MAC), as defined herein and all Contract exclusions will be taken into consideration to determine the Covered Service. Creditable Coverage Coverage under another health benefit plan is medical expense coverage with no greater than a ninety (90) day gap in coverage under any of the following: (a) Medicare or Medicaid; (b) an employer-based accident and sickness insurance or health benefit arrangement; (c) an individual accident and sickness insurance policy; (d) a spouse’s benefits or coverage under Medicare or Medicaid or an employer-based health insurance benefit arrangement; (e) a conversion policy; or similar coverage as defined in OCGA 33-30-15.
Sample 1
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Covered Dependent. ‌ If your employer purchased this coverage outside of the Health Insurance Marketplace then if eligible, any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate Booklet, has enrolled in Alliant’s healthcare Plan, and is subject to Premium requirements set forth in the Group Master Contract. Covered Services‌ Those charges for Medically Necessary health care services and supplies that are (a) defined as Covered Services in the Member’s Contract, (b) not excluded under such Contract, (c) not Experimental or Investigational and (d) provided in accordance with such contract. Creditable Coverage‌ Coverage under another health benefit plan is medical expense coverage with no greater than a 90- day gap in coverage under any of the following: (a) Medicare or Medicaid; (b) an employer-based accident and sickness insurance or health benefit arrangement; (c) an individual accident and sickness insurance policy; (d) a spouse’s benefits or coverage under Medicare or Medicaid or an employer-based health insurance benefit arrangement; (e) a conversion policy; or similar coverage as defined in OCGA 33-30-15.
Sample 1
Covered Dependent. Any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate and has enrolled and complied with the Premium requirements. Covered Services Those charges for Medically Necessary health care services, treatment and supplies intended to improve a condition or Member’s health that are (a) defined as Covered Services in the Member’s Contract, (b) not excluded under such Contract, (c) not Experimental or Investigational and (d) provided in accordance with such Contract. Covered Services are determined based upon all other Contract provisions. When more than one treatment option is available, and one option is no more effective than another, the Covered Service is the least costly option that is no less effective than any other option. The Covered Services are also subject to the Maximum Allowable Cost (MAC), as defined herein and all Contract exclusions will be taken into consideration to determine the Covered Service. Creditable Coverage Coverage under another health benefit plan is medical expense coverage with no greater than a ninety (90) day gap in coverage under any of the following: (a) Medicare or Medicaid; (b) an employer-based accident and sickness insurance or health benefit arrangement; (c) an individual accident and sickness insurance policy; (d) a spouse’s benefits or coverage under Medicare or Medicaid or an employer-based health insurance benefit arrangement; (e) a conversion policy; or similar coverage as defined in OCGA 33-30-15. Custodial Care Any type of care, including room and board, that (a) does not require the skills of professional or technical personnel; (b) is not furnished by or under the supervision of such personnel or does not otherwisemeet the requirements of post-hospital Skilled Nursing Facility care; (c) is a level such that the Member has reached the maximum level of physical or mental function and is not likely to make further significant improvement. Deductible The portion of the xxxx you must pay before your medical expenses become reimbursable. It is applied on a calendar year basis. Dependent The spouse and all children until attaining age 26. Children include natural children, legally adopted children and stepchildren. Also included are your children (or children of your spouse) for whom you have legal responsibility resulting from a valid court decree. Xxxxxx children whom you expect to raise to adulthood and who live with you in a regular parent-child relationshi...
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Related to Covered Dependent

  • Dependent Child If dependent children are covered under separate plans of more than one person, whether a parent or guardian, benefits for the child will be determined in the following order: • the benefits of the plan covering the parent born earlier in the year will be determined before those of the parent whose birthday (month and day only) falls later in the year; • if both parents have the same birthday, the benefits of the plan that covered the parent longer are determined before those of the plan which covered the other parent for a shorter period of time; • if the other plan does not determine benefits according to the parents' birth dates, but by parents' gender instead, the other plan’s gender rule will determine the order of benefits.

  • Dependents Eligible dependents for the purposes of this Article are as follows:

  • Spouse The spouse of an eligible employee (if legally married under Minnesota law). For the purposes of health insurance coverage, if that spouse works full-time for an organization employing more than one hundred (100) people and elects to receive either credits or cash (1) in place of health insurance or health coverage or (2) in addition to a health plan with a seven hundred and fifty dollar ($750) or greater deductible through his/her employing organization, he/she is not eligible to be a covered dependent for the purposes of this Article. If both spouses work for the State or another organization participating in the State's Group Insurance Program, neither spouse may be covered as a dependent by the other, unless one spouse is not eligible for a full Employer Contribution as defined in Section 3A. Effective January 1, 2015 if both spouses work for the State or another organization participating in the State’s Group Insurance Program, a spouse may be covered as a dependent by the other.

  • Dependent Eligibility To be eligible to enroll as a Covered Dependent, a person must be:

  • Dependent Life Insurance In the event of the death of your spouse or dependent child from any cause whatsoever, while you and your dependents are insured under the plan, the insurance company will pay you $10,000 in respect of your spouse and $5,000 in respect of each insured dependent child. This applies to those employees with family health coverage only.

  • Non-dependent Dependent If you are covered under a plan and you are the main subscriber, the benefits of that plan will be determined before the benefits of a plan that covers you as a dependent. If, however, you are a Medicare beneficiary, then, in some instances, Medicare will be secondary and the plan, which covers you as the main subscriber or as a dependent, will be primary. If one of your dependents covered under this plan is a student, and has additional coverage through a student plan, then the benefits from the student plan will be determined before the benefits under this plan.

  • Dental Care Plan The Welfare Plan will include a Dental Care Plan which will reimburse members for expenses incurred in respect of the coverages summarized in Appendix "1". The Plan will not duplicate benefits provided now or which may be provided in the future by any government program.

  • Health Plans The health plans offered and benefits provided by those plans shall be those approved by the City's JLMBC and administered by the Personnel Department in accordance with LAAC Section 4.

  • Surviving Spouse The term "Surviving Spouse" shall mean the person, if any, who shall be legally married to the Executive on the date of the Executive's death.

  • Health Plan An appropriately licensed entity that has entered into a contract with Subcontractor, either directly or indirectly, under which Subcontractor provides certain administrative services for Health Plan pursuant to the State Contract. For purposes of this Appendix, Health Plan refers to UnitedHealthcare Insurance Company.

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