Non-Network Benefits Sample Clauses

Non-Network Benefits. Benefits for Covered Services received from Non-Network Providers (Providers not contracted in the Preferred Care or another Blue plan’s PPO Network). These are Non-Participating Providers.
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Non-Network Benefits. See your Non-Network Benefits individual out-of-pocket limit under your Medical Plan Benefits Chart. Family Calendar Year Out-of-Pocket Limit
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Non-Network Benefits. See your Non-Network Benefits family deductible under your Medical Plan Benefits Chart. Your Individual and Family deductible amounts may be indexed to allow for deductible amount changes under federal rules. Individual Calendar Year Out-of-Pocket Limit
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Non-Network Benefits. Non-network benefits will be provided when:
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Non-Network Benefits. Non-Network Benefits apply when a Covered Person decides to obtain Health Services from non-Network Providers. Non-Network Providers may request payment of all charges when services are rendered. A claim must be filed with The Company for reimbursement of Eligible Expenses. If a Co-payment applies to Non-Network Benefits, the amount of the Co-payment will be deducted from the amount reimbursed to the Primary Insured.
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Non-Network Benefits. See your Non-Network Benefits individual deductible under your Medical Plan Benefits Chart.
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Non-Network Benefits. For all other services that meet the home health services requirements described in the SPD, there is a maximum of 60 visits per calendar year. Each visit provided under the Network Benefits and Non-Network Benefits, combined, counts toward the maximums shown above. Routine Postnatal Well Child Visits Network Benefits 100% of the charges incurred. Deductible does not apply. Non-Network Benefits 55% of the charges incurred, after you pay the deductible. The routine postnatal well child visits do not count toward the visit limits above. Not Covered: • Please refer to the “SERVICES NOT COVERED” section. HOME HOSPICE SERVICES‌ Covered Services: Home Hospice Program. The Plan covers the services described below for Covered Persons who are terminally ill patients and accepted as home hospice program participants. Covered Persons must meet the eligibility requirements of the program, and elect to receive services through the home hospice program. The services will be provided in the patient's home, with inpatient care available when medically necessary as described below. Covered Persons who elect to receive hospice services do so in lieu of curative treatment for their terminal illness for the period they are enrolled in the home hospice program.
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Non-Network Benefits. See your Non-Network Benefits family out-of- pocket limit under your Medical Plan Benefits Chart. Your Individual and Family Out-of-Pocket amounts may be indexed to allow for out-of-pocket amount changes under federal rules. PREVENTIVE AND DIAGNOSTIC SERVICES Covered Services We cover the following preventive and diagnostic services, with certain limitations which are listed below. Routine dental care examinations for new and existing patients Network Benefits 100% of the charges incurred, limited to twice each calendar year. Non-Network Benefits 50% of the charges incurred, limited to twice each calendar year. Dental cleaning (prophylaxis or periodontal maintenance cleaning) Network Benefits 100% of the charges incurred, limited to twice each calendar year. Non-Network Benefits 50% of the charges incurred, limited to twice each calendar year. Professionally applied topical fluoride (other than silver diamine fluoride) Network Benefits 100% of the charges incurred, limited to twice each calendar year. Non-Network Benefits 50% of the charges incurred, limited to twice each calendar year. Silver diamine fluoride Network Benefits 100% of the charges incurred, limited to twice per tooth each calendar year. Non-Network Benefits 50% of the charges incurred, limited to twice per tooth each calendar year. Pit and Fissure sealant application and preventive resin restoration Network Benefits 100% of the charges incurred, limited to one application per tooth per 36-month period, for unrestored permanent molars. Non-Network Benefits 50% of the charges incurred, limited to one application per tooth per 36-month period, for unrestored permanent molars. Bitewing x-rays Network Benefits 100% of the charges incurred, limited to twice each calendar year. Non-Network] Benefits 50% of the charges incurred, limited to twice each calendar year. Full mouth or panoramic x-rays Network Benefits 100% of the charges incurred, limited to once every sixty months. Non-Network Benefits 50% of the charges incurred, limited to once every sixty months. Other x-rays, except x-rays provided in connection with orthodontic diagnostic procedures and treatment Network Benefits 100% of the charges incurred. Non-Network Benefits 50% of the charges incurred. Space maintainers (fixed or removable appliances designed to prevent adjacent and opposing teeth from moving) Network Benefits 100% of the charges incurred for lost primary teeth. Non-Network Benefits 50% of the charges incurred for lost primar...
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Related to Non-Network Benefits

  • Specific Benefits During the term of this Agreement (and thereafter to the extent this Agreement shall require):

  • Public Benefits This Agreement provides assurances that the Public Benefits identified below will be achieved and developed in accordance with the Applicable Rules and Project Approvals and with the terms of this Agreement and subject to the City’s Reserved Powers. The Project will provide Public Benefits to the City, including without limitation:

  • Health Benefits The method for determining the Employer bi-weekly contributions to the cost of employee health insurance programs under the Federal Employees Health Benefits Program (FEHBP) will be as follows:

  • Standard Company Benefits Executive shall be entitled to participate in all employee benefit programs for which Executive is eligible under the terms and conditions of the benefit plans that may be in effect from time to time and provided by the Company to its employees. The Company reserves the right to cancel or change the benefit plans or programs it offers to its employees at any time.

  • Group Benefits To determine if a leave under the provisions of the Family and Medical Leave Act will be a paid or unpaid leave, contact the District’s Human Resources Department.

  • Intercarrier Compensation Except as specifically described in this Section, the Agreement does not change or amend applicable intercarrier compensation arrangements (including but not limited to Switched Access, Signaling, or Transit charges) between any parties, including between Qwest and Carriers or IXCs.

  • Educational Benefits a. A full-time employee may enroll for credit at the University for a maximum of two courses, or six credit hours, whichever is greater, in any one academic term with exemption from the payment of tuition and fees.

  • Layoff Benefits All rights to which a certificated employee was entitled at the time of his/her layoff including unused accumulated sick leave and credits toward leave eligibility will be restored to the certificated employee upon his/her return to active employment, and the certificated employee will be placed upon the proper step of the salary schedule for the certificated employee's current position according to the certificated employee's experience and education.

  • Standard Benefits During the Employment Period, Executive shall be entitled to participate in all employee benefit plans and programs, including paid vacations, generally available to other similarly situated Company executives, subject to the terms and conditions of the applicable plans.

  • Xxxxxxxxx Benefits Subject to Section 4.C, Executive shall be entitled to the following Severance Benefits if Executive experiences a Termination under the circumstances described in Section 4.A above:

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