PLAN ALLOWANCE Sample Clauses

PLAN ALLOWANCE the amount used to determine payment by the Plan for Covered Services provided to a Member as set forth in SECTION SB - SCHEDULE OF BENEFITS of this Agreement, and to determine Member liability. Plan Allowance is based on the type of Provider who renders such Services or as required by law. In the case of a Network Provider, or Dentist, Telemedicine Provider, and Vision Provider, each of whom is a Network Provider, the Plan Allowance is the contractual allowance for Covered Services rendered by a Network Provider in a specific geographic region. A Network Provider, or Dentist, Telemedicine Provider or Vision Provider, each of whom is a Network Provider, will accept the Plan Allowance, plus any Member liability, as payment-in-full for Covered Services. In the case of an In-Area Out-of-Network Provider, the Plan Allowance shall be based on an adjusted contractual allowance for like services rendered by a Network Provider in the same geographic region. The Member will be responsible for any difference between the Provider’s billed charges and the Plan’s payment. In the case of a Provider located Out-of-Area, whether or not such Provider has an agreement with the local licensee of the Blue Cross Blue Shield Association, the Plan Allowance shall be determined, for other than pediatric dental and vision care and telemedicine Covered Services, based on prices received from the local licensee in accordance with the Plan’s participation in the INTER-PLAN ARRANGEMENTS as set forth in SECTION GP - GENERAL PROVISIONS of this Agreement.

PLAN ALLOWANCE the amount used to determine payment by the Plan for Covered Services provided to a Member as set forth in SECTION SB - SCHEDULE OF BENEFITS of this Agreement, and to determine Member liability. Plan Allowance is based on the type of Provider who renders such Services or as required by law. In the case of a Network Provider or Dentist, Telemedicine Provider and Vision Provider, each of whom is a Network Provider, the Plan Allowance is the contractual allowance for Covered Services rendered by a Network Provider in a specific geographic region. A Network Provider or Dentist, Telemedicine Provider or Vision Provider, each of whom is a Network Provider, will accept the Plan Allowance, plus any Member liability, as payment in full for Covered Services. In the case of an Out-of-Area Provider, the Plan Allowance shall be determined, for other than pediatric dental and vision care and telemedicine Covered Services, based on prices received from the local licensee of the Blue Cross Blue Shield Association in accordance with the Plan’s participation in the INTER-PLAN ARRANGEMENTS as set forth in SECTION GP - GENERAL PROVISIONS of this Agreement. 110. PLAN SERVICE AREA - the geographic area consisting of the following counties in western Pennsylvania: Allegheny Centre (Part) Forest ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ Clarion ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇ Clearfield Huntingdon Somerset Bedford ▇▇▇▇▇▇▇▇ Indiana Venango ▇▇▇▇▇ Elk ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇ Erie ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ Cambria ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ 111. PRECERTIFICATION (CERTIFICATION) - a process whereby the Medical Necessity and Appropriateness of Inpatient admissions, Services or place of Services is determined by the Plan prior to, or after, an admission or the performance of a procedure or Service. 112. PREFERRED VALUE - the level of Network benefits providing for the lowest level of Member cost-sharing for Covered Services.

PLAN ALLOWANCE the amount used to determine payment by the Plan for Covered Services provided to a Member and to determine Member liability. Plan Allowance is based on the type of Provider who renders such Services or as required by law. In the case of a Network Provider, the Plan Allowance is the contractual allowance for Covered Services rendered by a Network Provider in a specific geographic region. A Network Provider will accept the Plan Allowance, plus any Member liability, as payment in full for Covered Services. In the case of a Network Dental Provider, the Plan Allowance is expressed in terms of the Maximum Allowable Charge.

PLAN ALLOWANCE. Provided that Subtenant is in full compliance with this Sublease, Sublandlord agrees to contribute $0.12 per rentable square foot of the Subleased Premises (“Plan Allowance”) toward the cost of preparing Subtenant’s Plans based on the Approved Plans. Within thirty (30) days following Subtenant’s written request to Sublandlord, Sublandlord shall pay such sum to Subtenant, provided such written request may not be submitted until the Subtenant has delivered to Sublandlord all mechanics’ lien releases or other lien releases on account of Subtenant’s Work, which are notarized, unconditional and in recordable form or in such form as Sublandlord shall have approved. To the extent the Plan Allowance exceeds the costs of preparing Subtenant’s Plans, the excess amount will be applied toward the Improvement Allowance described in Section 5.4 below.

PLAN ALLOWANCE. The Benefit payment amount is based on the Plan Allowance on the date the Covered Drug is dispensed or the date the service is rendered.

PLAN ALLOWANCE a. Employees will be responsible for choosing their own voice or data plan as well as their carrier. Employees may also, at his or her own expense, add extra services or equipment features, as desired. b. Employees will also be responsible for choosing their own equipment. There is no additional allowance for the purchase of cell phones, since most carriers offer a number of phones free in connection with a service plan. c. The Town will provide a flat-rate monthly taxable allowance, independent of the cell phone provider selected by the employee. The allowance amounts shown below will be reviewed annually and may be adjusted to reflect changes in available rate plans. d. The Town will pay only the approved allowance amount even if actual monthly costs may occasionally exceed the allowance as follows: i. $30.00 monthly taxable for base cell defined as a long-range, portable electronic device used for mobile communication which is connected to a cellular network of base stations. Cellular phones include basic phones, which may also provide texting capability. ii. $75.00 monthly taxable for Personal Digital Assistant (PDA) defined as a small handheld computer typically providing calendar, contacts, and note-taking applications, but may include other applications such as web browser and media player. PDA’s can access the Internet, intranets or extranets via Wi-Fi or wireless wide area networks; and Smartphone defined as a mobile phone offering advanced capabilities that are beyond that of a typical mobile phone, often with PC-like functionality. A Smartphone is a single device combining a cellular telephone with a personal digital assistant (PDA). e. All monthly allowances will be paid as a taxable “cellular allowance” to the employee’s regular paycheck and are subject to FICA, withholding and is considered non-pensionable. f. Exceptional usage situations which require cellular phone service beyond the normal usage and control of the employee will be reviewed and reimbursement (with appropriate documentation) may be approved by the appropriate Department Director and Town Manager.

PLAN ALLOWANCE. Effective October the Company will pro- vide on weekly paycheques, a payment of per week to in lieu of Company contributions formerly paid into the pension plan. This is based upon conditions expressed in letter of understanding attached. Effective January the Company will cease pay- ing employees per week on weekly paycheques, and make a lump sum payment of on December of each year. For those employees who do not work weeks during the calendar year, the amount will be