What Your Plan Pays Sample Clauses

What Your Plan Pays. Coverage: The coverage selected for your dental benefits program uses Delta Dental’s PPO network of Participating Dentists. This Delta Dental PPO network program allows you to go to any Dentist of your choice and receive a level of benefits for Covered Services, but you will generally receive the best value from your plan if you visit a Delta Dental PPO Dentist. For the purpose of determining applicable Out-of-Pocket Cost, only Delta Dental PPO Dentists shall be deemed to be “Plan Providers” under the Agreement. Only your payments to Delta Dental PPO Dentists shall accrue to the Out- of-Pocket Costs for Plan Providers as specified in your Schedule of Benefits. Your plan’s payment is based on the “allowed charge” for a Covered Service received. The allowed charge is determined by whether the provider of the services is a Delta Dental PPO Dentist, participates with Delta Dental as a Premier Dentist, or does not participate with Delta Dental.
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What Your Plan Pays. Coverage: The coverage for your dental plan uses Delta Dental’s PPO network of Participating Dentists. This plan allows you to go to any Dentist of your choice and receive a level of benefits for covered services. You will receive the best value from your plan if you visit a Delta Dental PPO Dentist. Delta Dental PPO Dentists are Participating Dentists who offer lower fees to their Delta Dental PPO patients. Delta Dental PPO Dentists are reimbursed by Delta Dental based on the lesser of the submitted charge or Delta Dental’s allowed charge for PPO Dentists in the area in which the services were provided. PPO Dentists agree to accept Delta Dental’s allowed charge for PPO Dentists as payment in full, and agree not to charge the difference between their fees and the amount paid by Delta Dental back to their Delta Dental patients. PPO Dentists are allowed to charge for Deductibles, Co-Payments, Coinsurance, or services not covered under your plan. SAMPLE You will also receive benefits if you choose to visit a Delta Dental Premier Dentist. Delta Dental Premier Dentists are reimbursed by Delta Dental based on the lesser of the Dentist’s charge or Delta Dental’s allowed charge for PPO Dentists in the area in which the services were provided. You will be responsible for the difference in the cost of services between the “allowed charge” (based upon Delta Dental’s allowance for PPO Dentists) and Delta Dental’s allowed charge for Premier Dentists, in addition to any Deductible, Co-payment, and Coinsurance. Premier Dentists agree to accept this allowance for Premier Dentists as payment in full and agree not to charge the difference between their fees and the Premier allowance back to their Delta Dental patients. Payments you make to Premier Dentists do not count toward the Maximum Out-of-Pocket (MOOP) for Pediatric Enrollees.
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Related to What Your Plan Pays

  • Termination of Employment and Severance Benefits The Executive’s employment hereunder shall terminate under the following circumstances:

  • Description of Severance Benefits In the event the Executive becomes entitled to receive Severance Benefits, as provided in Sections 3.1 and 3.2 herein, the Company shall pay to the Executive and provide him with the following:

  • Synopsis and Benefit to Xxxxxxx County Xxxxxxx County has been working with the State of Oregon for several years to provide correctional services for the supervision of Senate Bill 1145 cases. Xxxxxxx County is assigned responsibility for all offenders on probation, parole, post-prison supervision, and those offenders sentenced or revoked for periods of one year or less, and on conditional release to the County. The State reimburses the County for expenses associated with housing and supervision of these offenders through Community Corrections Act Funding.

  • Change in Control Severance Benefits If there is a Change in Control, and within one (1) year of such Change in Control, the Executive’s employment is terminated under the circumstances described in Sections 4(a) through 4(f) above, the Executive shall be entitled to the following: (I) if such termination is a termination by the Company without Cause pursuant to Section 4(a) or the Executive resigns for Good Reason pursuant to Section 4(b), the Company shall pay the Executive the Accrued Obligations and the Pro Rata Bonus and, in addition, subject to the provisions of Section 19, (A) an amount equal to twenty-four (24) months of the Executive’s Base Salary at the rate in effect on the date of termination or resignation, payable in a lump sum within sixty (60) calendar days of the date of termination or resignation; and (B) provided the Executive timely elects continuation coverage under COBRA, the Company shall also pay, on the Executive’s behalf, the portion of monthly premiums for the Executive’s group health insurance, including coverage for the Executive’s dependents, that the Company paid immediately prior to the date of termination or resignation, during the eighteen (18) month period following the date of termination or resignation, subject to the Executive’s continued eligibility for COBRA coverage. The Company will pay for such COBRA coverage for eligible dependents only for those dependents who were enrolled immediately prior to the date of termination or resignation. The Executive will continue to be required to pay that portion of the premium for the Executive’s health coverage, including coverage for the Executive’s eligible dependents, that the Executive was required to pay as an active employee immediately prior to the date of termination or resignation. Notwithstanding the foregoing, in the event that under applicable guidance the reimbursement of COBRA premiums causes the Company’s group health plan to violate any applicable nondiscrimination rule, the parties agree to negotiate in good faith a mutually agreeable alternative arrangement; and (II) if such termination is a termination or resignation under the circumstances described in Sections 4(c), 4(d), 4(e) or 4(f), the Executive shall be entitled to the compensation and benefits for which the Executive is eligible under such sections.

  • Termination of Employment with Severance Benefits (a) The Executive shall be entitled to the severance benefits described in section 9(b) in the event that:

  • USING YOUR ACCOUNT If you are approved for an account, the Credit Union will establish a line of credit for you. You agree that your credit limit is the maximum amount (purchases, cash advances, finance charges, plus "other charges") which you will have outstanding on your account at any time. Unless disclosed otherwise, the Credit Union will not allow advances over the credit limit. If the Credit Union has a program whereby it allows payment of advances that exceed your credit limit, subject to a fee, the Credit Union will provide you with notice, either orally, in writing, or electronically (notwithstanding the requirements of the paragraph entitled “Statements and Notices”) explaining your right to opt in to the Credit Union’s program whereby it will honor advance requests over the credit limit. In the event you opt in to such a program, you agree to the terms of such a program. You may request an increase in your credit limit only by a method acceptable to the Credit Union. The Credit Union may increase or decrease your credit limit, refuse to make an advance and/or terminate your account at any time for any reason not prohibited by law. If you are permitted to obtain cash advances on your account, we may, from time to time, issue convenience checks to you that may be drawn on your account. Convenience checks may not be used to make a payment on your account balance. If you use a convenience check, it will be posted to your account as a cash advance. We reserve the right to refuse to pay a convenience check drawn on your account for any reason and such refusal shall not constitute wrongful dishonor. You may request that we stop the payment of a convenience check drawn on your account. You agree to pay any fee imposed to stop a payment on a convenience check issued on your account. You may make a stop payment request orally, if permitted, or in writing. Your request must be made with sufficient time in advance of the presentment of the check for payment to give us a reasonable opportunity to act on your request. In addition, your request must accurately describe the check including the exact account number, the payee, any check number that may be applicable, and the exact amount of the check. If permitted, you may make a stop payment request orally but such a request will expire after 14 days unless you confirm your request in writing within that time. Written stop payment orders are effective only for six months and may be renewed for additional six month periods by requesting in writing that the stop payment order be renewed. We are not required to notify you when a stop payment order expires. If we re-credit your account after paying a check or draft over a valid and timely stop payment order, you agree to sign a statement describing the dispute with the payee, to assign to us all of your rights against the payee or other holders of the check or draft and to assist us in any legal action. You agree to indemnify and hold us harmless from all costs and expenses, including attorney's fees, damages, or claims, related to our honoring your stop payment request or in failing to stop payment of an item as a result of incorrect information provided to us or the giving of inadequate time to act upon a stop payment request.

  • Payments to Plan Participants and Their Beneficiaries (a) Company shall deliver to Trustee a schedule (the "Payment Schedule") that indicates the amounts payable in respect of each Plan participant (and his or her beneficiaries), that provides a formula or other instructions acceptable to Trustee for determining the amounts so payable, the form in which such amount is to be paid (as provided for or available under the Plan), and the time of commencement for payment of such amounts. Except as otherwise provided herein, Trustee shall make payments to the Plan participants and their beneficiaries in accordance with such Payment Schedule. The Trustee shall make provision for the reporting and withholding of any federal, state or local taxes that may be required to be withheld with respect to the payment of benefits pursuant to the terms of the Plan and shall pay amounts withheld to the appropriate taxing authorities or determine that such amounts have been reported, withheld and paid by Company.

  • Oregon Public Service Retirement Plan Pension Program Members For purposes of this Section 2, “employee” means an employee who is employed by the State on or after August 29, 2003 and who is not eligible to receive benefits under ORS Chapter 238 for service with the State pursuant to Section 2 of Chapter 733, Oregon Laws 2003.

  • Long Term Disability Benefits A benefit level of seventy percent (70%) of monthly earnings shall apply. Benefits would commence after a waiting period of seventeen (17) weeks, when Short Term Disability Benefits terminate. Terms of the Master Policy with the Insurance Company shall apply. Statement of Intent In order to go on LTD, the person must:

  • COBRA/Rhode Island Extended Benefits (XXXX) If this plan is provided to you under COBRA or XXXX, and you are covered under another plan as an employee, retiree, or dependent of an employee or retiree, the plan covering you as an employee, retiree or dependent of an employee or retiree will be primary and the COBRA or XXXX plan will be the secondary plan.

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