PLAN PAYMENT AND MEMBER LIABILITY Sample Clauses

PLAN PAYMENT AND MEMBER LIABILITY. The Plan uses the Plan Allowance to calculate the benefit payable and the financial liability of the Member for Medically Necessary and Appropriate Services covered under this Agreement. In the case of Outpatient Prescription Drug benefits, the Plan uses the Provider’s Allowable Price for this calculation. See SECTION DE - DEFINITIONS of this Agreement for the definitions of “Plan Allowance” and “Provider’s Allowable Price”.
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PLAN PAYMENT AND MEMBER LIABILITY. The Plan uses the plan allowance to calculate the benefit payable and the financial liability of the member for services and products covered under the Agreement. Plan allowance is
PLAN PAYMENT AND MEMBER LIABILITY. The Plan uses the Plan Allowance to calculate the benefit payable and the financial liability of the Member for Services covered under this Agreement. See SECTION DE - DEFINITIONS of this Agreement for the definitions of “Plan Allowance”.
PLAN PAYMENT AND MEMBER LIABILITY. The Plan uses the plan allowance to calculate the benefit payable and the financial liability of the member for Medically Necessary and Appropriate Services covered under the Agreement. In the case of prescription drug (outpatient) benefits, the Plan uses the provider’s allowable price for this calculation. See Section III, Subsection J. Benefit Amounts, Durations, Limits,

Related to PLAN PAYMENT AND MEMBER LIABILITY

  • Employer Liability 45.1 The Employer shall indemnify and save harmless all Employees from legal liability and all actions, causes of action, claims or demands whatsoever arising out of any occurrence occurring during the course of or performed pursuant to and within the scope of their employment, save and except in the case of gross negligence or wilful misconduct, provided timely notice is given to the Employer of any occurrence giving rise or likely to give rise to a claim against a member of the Employer.

  • Member Liability You are responsible for all transactions you authorize using your EFT services under this Agreement. If you permit someone else to use an EFT service, your card or your access code, you are responsible for any transactions they authorize or conduct on any of your accounts. TELL US AT ONCE if you believe your card or access code has been lost or stolen, if you believe someone has used your card or access code or otherwise accessed your accounts without your authority, or if you believe that an electronic fund transfer has been made without your permission using information from your check. Telephoning is the best way of keeping your possible losses down. You could lose all the money in your account (plus your maximum overdraft line-of-credit). If a transaction was made with your card or card number without your permission and was a Visa transaction, you will have no liability for the transaction, unless you were grossly negligent in the handling of your account or card or access code. For all other EFT transactions, if you were grossly negligent in the handling of your account or card or access code, your liability for an unauthorized transaction is determined as follows. If you tell us within two (2) business days after you learn of the loss or theft of your card or access code, you can lose no more than $50.00 if someone used your card or access code without your permission. If you do NOT tell us within two (2) business days after you learn of the loss or theft of your card or access code and we can prove we could have stopped someone from using your card or access code without your permission if you had told us, you could lose as much as $500.00. Also, if your statement shows transfers that you did not make including those made by card, access code or other means, TELL US AT ONCE. If you do not tell us within 60 days after the statement was mailed to you, you may not get back any money lost after the 60 days if we can prove that we could have stopped someone from making the transfers if you had told us in time. If a good reason (such as a hospital stay) kept you from telling us, we will extend the time periods. If you believe your card or access code has been lost or stolen or that someone has transferred or may transfer money from your accounts without your permission, call:

  • ’ Compensation and Employer’s Liability The policy is required only if Contractor has employees. The policy must include workers’ compensation to meet minimum requirements of the California Labor Code, and it must provide coverage for employer’s liability bodily injury at minimum limits of $1,000,000 per accident or disease.

  • Other Group Benefits 7.4.1 Payments towards benefit plans by the Employer shall permit it to retain and not pass on to teachers, any rebates of premiums otherwise required under Canada Employment and Immigration Commission (previously Unemployment Insurance Commission) regulations.

  • Compensation Claims (a) The Employer agrees to cooperate toward the prompt disposition of employee on-the-job injury claims. The Employer shall provide worker’s compensation protection for all employees even though not required by state law, or the equivalent thereof, if the injury arose out of or in the course of employment. No employee will be disciplined or threatened with discipline as a result of filing an on-the-job injury report. The Employer or its designee shall not visit an injured worker at his/her home, at a hospital or any location outside the employee’s home terminal without his/her consent.

  • Customer Liability Customer is solely liable in respect of any loss or cost (including losses or costs suffered by third parties) due to goods not being stored or handled in accordance with this clause 8.

  • Cyber Liability identity theft insurance with a combined limit of Two Million Dollars ($2,000,000) per claim and Two Million Dollars ($2,000,000) general aggregate;

  • Our Liability (a) The quality and reliability of your electricity supply and the quality, pressure and continuity of your gas supply is subject to a variety of factors that are beyond our control as your retailer, including accidents, emergencies, weather conditions, vandalism, system demand, the technical limitations of the distribution system and the acts of other persons (such as your distributor), including at the direction of a relevant authority.

  • Compensation and Professional Liability All Liability policies including Workers’ Compensation written on behalf of Consultant shall contain a waiver of subrogation in favor of County and members of Commissioners Court.

  • Your Liability The following determines your liability for any unauthorized EFT or any series of related unauthorized EFTs:

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