COVERED SERVICES & SPECIAL COVERAGE PROVISIONS Sample Clauses

COVERED SERVICES & SPECIAL COVERAGE PROVISIONS. 2.6.1 DCH will use submitted Encounter Data, and other data sources, to determine Contractor compliance with federal requirements that eligible Members under the age of twenty-one (21) receive periodic screens and preventive/well child visits in accordance with the specified periodicity schedule. DCH will use the participant ratio as calculated using the CMS 416 methodology for measuring the Contractor’s performance.
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COVERED SERVICES & SPECIAL COVERAGE PROVISIONS. 2.6.1 For Medicaid and PeachCare for Kids®, Medically Necessary Services and Benefits pursuant to the Georgia State Medicaid and CHIP State Plans and the Georgia Medicaid Policies and Procedures Manuals are covered. Such Medically Necessary Services shall be furnished in an amount, duration, and scope that is no less than the amount, duration, and scope for the same services furnished to recipients under Fee-for-Service Medicaid. The Contractor may not arbitrarily deny or reduce the amount, duration or scope of a required service solely because of the diagnosis, type of illness or Condition.
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COVERED SERVICES & SPECIAL COVERAGE PROVISIONS. ‌ DCH will use submitted Encounter Data, and other data sources, to determine Contractor compliance with federal requirements that eligible Members under the age of twenty-one
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Related to COVERED SERVICES & SPECIAL COVERAGE PROVISIONS

  • Special Coverages Tenant shall carry “Builder’s All Risk” insurance in an amount approved by Landlord covering the construction of the Tenant Improvements, and such other insurance as Landlord may require, it being understood and agreed that the Tenant Improvements shall be insured by Tenant pursuant to the Lease immediately upon completion thereof. Such insurance shall be in amounts and shall include such extended coverage endorsements as may be reasonably required by Landlord, and in form and with companies as are required to be carried by Tenant as set forth in the Lease.

  • Additional Coverage To the extent that insurance coverage provided by Consultant maintains higher limits than the minimums appearing in Exhibit B, City requires and shall be entitled to coverage for higher limits maintained.

  • ADDITIONAL COVERAGES We cover the following in addition to the limits of liability:

  • General Coverages All of Tenant’s Agents shall carry worker’s compensation insurance covering all of their respective employees, and shall also carry public liability insurance, including property damage, all with limits, in form and with companies as are required to be carried by Tenant as set forth in the Lease.

  • Dental Coverage 206. Each employee covered by this agreement shall be eligible to participate in the City's dental program.

  • Optional Coverages If chosen by You, and shown as applicable on the Declarations Page, the following optional coverages apply separately to each Pet per Policy year. Some coverage options may be restricted by Pets age at time of sign-up. Defender/DefenderPlus We will reimburse You, if shown on the Declarations Page, for the Preventive Care listed below that Your Pet(s) receives from a licensed Veterinarian during the Policy period. Benefits will not exceed the Maximum Allowable Limits shown below. Coinsurance and Deductible requirements do not apply to Preventive Benefits. Our total liability of each Pet for each Policy Year is shown in the Maximum Allowable Limits. Benefit Schedule Maximum Allowable Limits Preventive Benefit Defender DefenderPlus Spay/Neuter or Teeth Cleaning $0 $150 Rabies Vaccine $15 $15 Flea/Tick/Heartworm Prevention $80 $95 Vaccination/Titer $30 $40 Wellness Exam $50 $50 Heartworm test or FELV (Feline Leukemia Virus) screen $25 $30 Blood, fecal, parasite exam $50 $70 Microchip $20 $40 Urinalysis or ERD Test (Early Renal Disease Test) $15 $25 Deworming $20 $20 *Benefits may be combined or separate up to the maximum allowable limit. SupportPlus Coverage We will reimburse You, if shown on the Declarations Page, for the cost of final expenses for necropsy, cremation and urns upon the death of each Pet covered for such costs incurred after the Waiting Period and during the Coverage Period up to a maximum benefit of three hundred dollars ($300) subject to the Annual Limit amount. Coinsurance and Deductible provisions do not apply to SupportPlus Coverage. ExamPlus Coverage We will reimburse You, if shown on the Declarations Page, for the Covered Expenses that occur during the Coverage Period subject to Policy limits and exclusion including, but not limited to, Coinsurance, Deductible and Annual Limit for physical examination; including costs and/or fees for telephone consultation; to diagnose a current covered Injury. This endorsement does not provide coverage for annual wellness office exams.

  • General Covenants The Corporation covenants with the Warrant Agent that so long as any Warrants remain outstanding:

  • Medical Coverage The Executive shall be entitled to such continuation of health care coverage as is required under, and in accordance with, applicable law or otherwise provided in accordance with the Company’s policies. The Executive shall be notified in writing of the Executive’s rights to continue such coverage after the termination of the Executive’s employment pursuant to this Section 3(d)(iv), provided that the Executive timely complies with the conditions to continue such coverage. The Executive understands and acknowledges that the Executive is responsible to make all payments required for any such continued health care coverage that the Executive may choose to receive.

  • Health and Dental Coverage A dependent child is an eligible employee’s child to age twenty-six (26).

  • Proof of Compliance with Disability Benefits Coverage Requirements In order to provide proof of compliance with the requirements of the Workers’ Compensation Law pertaining to disability benefits, a contractor shall:

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