Benefit Summary definition

Benefit Summary shows the Dependent Limiting Age (the “Student” one is for students, and the “General” one is for non-students). Emergency Dental Care. Dentally Necessary Services to treat Emergency Dental Conditions. Emergency Dental Condition. A dental condition, or exacerbation of an existing dental condition, occurring suddenly and unexpectedly, involving injury, swelling, bleeding, or extreme pain in or around the teeth and gums that would lead a prudent layperson possessing an average knowledge of health and medicine to reasonably expect that immediate dental attention is needed.
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Benefit Summary shows the Dependent Limiting Age (the student Dependent Limiting Age is for students, and the general Dependent Limiting Age is for non-students). Emergency Dental Care. Dentally Necessary Services to treat Emergency Dental Conditions. Emergency Dental Condition. A dental condition, or exacerbation of an existing dental condition, occurring suddenly and unexpectedly, involving injury, swelling, bleeding, or extreme pain in or around the teeth and gums that would lead a prudent layperson possessing an average knowledge of health and medicine to reasonably expect that immediate dental attention is needed. Evidence of Coverage (EOC). This Evidence of Coverage document provided to the Member that specifies and describes benefits and conditions of coverage. This document, on its own, is not designed to meet the requirements of a summary plan description (SPD) under XXXXX. Family. A Subscriber and his or her Spouse and/or Dependents.
Sample 1Sample 2Sample 3
Benefit Summary shows the Dependent Limiting Age (the student Dependent Limiting Age is for students, and the general Dependent Limiting Age is for non-students). Emergency Dental Care. Dentally Necessary Services to treat Emergency Dental Conditions. Emergency Dental Condition. A dental condition, or exacerbation of an existing dental condition, occurring suddenly and unexpectedly, involving injury, swelling, bleeding, or extreme pain in or around the teeth and gums that would lead a prudent layperson possessing an average knowledge of health and medicine to reasonably expect that immediate dental attention is needed. Evidence of Coverage (EOC). This Evidence of Coverage document provided to the Member that specifies and describes benefits and conditions of coverage. This document, on its own, is not designed to meet the requirements of a summary plan description (SPD) under XXXXX. Family. A Subscriber and their Spouse and/or Dependents. Group. The employer, union trust, or association with which we have an Agreement that includes this EOC. Hospital Services. Medical services or dental Services provided in a hospital or ambulatory surgical center. Xxxxxx Permanente. Kaiser Foundation Hospitals (a California nonprofit corporation), Company, and Permanente Dental Associates, PC. Medically Necessary. Our determination that the Service is all of the following: (i) medically required to prevent, diagnose or treat your condition or clinical symptoms; (ii) in accordance with generally accepted standards of medical practice; (iii) not solely for the convenience of you, your family and/or your provider; and, (iv) the most appropriate level of Service which can safely be provided to you. For purposes of this definition, “generally accepted standards of medical practice” means (a) standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community; (b) physician specialty society recommendations; (c) the view of physicians practicing in the relevant clinical area or areas within Xxxxxx Permanente locally or nationally; and/or (d) any other relevant factors reasonably determined by us. Unless otherwise required by law, we decide if a Service is Medically Necessary. You may appeal our decision as set forth in the “Grievances, Claims, and Appeals” section. The fact that a Participating Provider has prescribed, recommended, or approved a Service does not, in itself, make such Service Medically Nec...
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Examples of Benefit Summary in a sentence

  • Compensation has been set at $17.36/hour (degree rate) with benefits per the Instructional Assistants Benefit Summary.

  • Compensation has been set at $17.36/hour with benefits per the Instructional Assistants’ Benefit Summary.

  • Compensation has been set at $17.36/hour with benefits per the Instructional Assistant Benefit Summary.

  • Members age 65 and over (excluding Tax Equity and Fiscal Responsibility Act of 1982 “TEFRA” members) must meet the required eligibility requirements to receive the benefit of either 1) those listed in this Benefit Summary, or 2) benefits covered under Original Medicare.

  • Our medical care program gives you access to all the covered Services you may need, such as routine Services with your own PCP, inpatient hospital, laboratory, pharmacy, and other benefits described in the Benefit Summary section at the front of this Guide, and Chapter 3: Benefit Description.

  • Compensation has been set at $20.00 per hour with benefits per the Instructional Assistants Benefit Summary.

  • If there is a discrepancy between this Benefit Summary and your benefit booklet, the benefit booklet prevails.Definitions shown on this site are in summary form and are for general informational purposes.

  • For coverage Cost Shares and excluded Services, be sure to also read the Benefit Summary in the front of this Guide and Chapter 4: Services not Covered.

  • Compensation has been set at $20.00 per hour, with benefits per the Instructional Assistants’ Benefit Summary.

  • Compensation has been set at $17.22/hour with benefits per the Custodian Benefit Summary.


More Definitions of Benefit Summary

Benefit Summary means an outline of certain covered services provided by the policy but does not include all covered services or limitations. It includes such things as Copayments, Coinsurance, Deductibles, Benefit limitations and plan maximums.
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Benefit Summary shows the Dependent Limiting Age (the “Student” one is for students, and the “General” one is for non-students). Emergency Dental Care. Dentally Necessary Services to treat Emergency Dental Conditions. Emergency Dental Condition. A dental condition, or exacerbation of an existing dental condition, occurring suddenly and unexpectedly, involving injury, swelling, bleeding, or extreme pain in or around the teeth and gums that would lead a prudent layperson possessing an average knowledge of health and medicine to reasonably expect that immediate dental attention is needed. Evidence of Coverage (EOC). This Evidence of Coverage document provided to the Member that specifies and describes benefits and conditions of coverage. This document, on its own, is not designed to meet the requirements of a summary plan description (SPD) under XXXXX. Family. A Subscriber and his or her Spouse and/or Dependents.
Sample 1Sample 2
Benefit Summary means the benefit document that sets forth specific coverages by Participating Employer. The Benefit Summary is incorporated by reference into the plan.
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Related to Benefit Summary

  • Benefit Schedule means a schedule of benefits attached to these Terms and Benefits which sets out, among others, the benefit items and maximum benefits covered.

  • Final Average Compensation means the average annual

  • Average Compensation means the average of your W-2 wages from the Company for the five (5) calendar years completed immediately prior to the calendar year in which the Change in Control is effected. Any W-2 wages for a partial year of employment will be annualized, in accordance with the frequency which such wages are paid during such partial year, before inclusion in Average Compensation.

  • Annual Benefit Limit means the maximum amount of benefits paid by the Company to the Policy Holder in a Policy Year irrespective of whether any limits of any benefit items stated in the Benefit Schedule have been reached. The Annual Benefit Limit is counted afresh in a new Policy Year.

  • BENEFIT LIMIT means the total benefit allowed under this plan for a covered healthcare service. The benefit limit may apply to the amount we pay, the duration, or the number of visits for a covered healthcare service.

  • Public benefit means making capital available, or facilitating the availability of capital, to businesses in this state that have 750 or fewer employees, the intent of which is to create or retain employment opportunities for residents of this state, stabilize or increase the tax base of this state, or support the redevelopment of facilities for use by small businesses.

  • Projected Annual Benefit means the annual retirement benefit (adjusted to an actuarial equivalent straight life annuity if such benefit is expressed in a form other than a straight life annuity or Qualified Joint and Survivor Annuity) to which the Participant would be entitled under the terms of the Plan assuming:

  • Benefit Amount shall have the meaning set forth in Section 20.12 hereof.

  • Pension Benefit means a pension, annuity, gratuity or similar allowance which is payable—

  • Annual Benefit means an annual sum of fifty thousand dollars ($50,000) multiplied by the Applicable Percentage (defined below) and then reduced to the extent required: (i) under the other provisions of this Agreement; (ii) by reason of the lawful order of any regulatory agency or body having jurisdiction over the Employer; and (iii) in order for the Employer to properly comply with any and all applicable state and federal laws, including, but not limited to, income, employment and disability income tax laws (eg., FICA, FUTA, SDI).

  • Basic Plan means as to any Member or Vested Former Member the defined benefit pension plan of the Company or an Affiliated Employer intended to meet the requirements of Code Section 401(a) pursuant to which retirement benefits are payable to such Member or Vested Former Member or to the Surviving Spouse or designated beneficiary of a deceased Member or Vested Former Member.

  • Supplemental Benefit means the monthly benefit payable to the Executive under this Agreement.

  • Net death benefit means the amount of the life insurance policy or certificate to be settled less any outstanding debts or liens.

  • Accrued Benefit means the amount standing in a Participant's Account(s) as of any date derived from both Employer contributions and Employee contributions, if any.

  • Termination Compensation means a monthly cash amount equal to one-twelfth ( 1/12th) of the highest amount of the annual cash compensation (including cash bonuses and other cash-based compensation, including for these purposes amounts earned or payable whether or not deferred) received by Executive during any one of the three (3) calendar years immediately preceding the calendar year in which Executive’s Termination Date occurs; provided, that if the cash compensation received by Executive during the Termination Year exceeds the highest amount of the annual cash compensation received by Executive during any one of the immediately preceding three (3) consecutive calendar years, the cash compensation received by Executive during the Termination Year shall be deemed to be Executive’s highest amount of annual cash compensation. In no event shall Executive’s Termination Compensation include equity-based compensation (e.g., income realized as a result of Executive’s exercise of non-qualified stock options or other stock based benefits).

  • Annual Earnings means your gross annual income from your Employer, not including shift differential, in effect just prior to the date of loss. It includes your total income before taxes. It is prior to any deductions made for pre-tax contributions to a qualified deferred compensation plan, Section 125 plan or flexible spending account. It does not include income received from commissions, bonuses, overtime pay or any other extra compensation or income received from sources other than your Employer.

  • Benefit Commencement Date means, for any Participant or beneficiary, the date as of which the first benefit payment, including a single sum, from the Participant’s Account is due, other than pursuant to a withdrawal under Article VIII.

  • Supplemental Retirement Benefit means the benefit determined under Article V of this Plan.

  • Benefit Continuation Period means the period beginning on the Date of Termination and ending on the last day of the month in which occurs the earlier of (i) the 24-month anniversary of the Date of Termination and (ii) the date on which you elect coverage for you and your covered dependents under substantially comparable benefit plans of a subsequent employer.

  • Benefit Period means the period of time from the date of the Accident causing the Injury for which benefits are payable, as shown in the Schedule of Benefits, and the date after which no further benefits will be paid.

  • SERP has the meaning assigned thereto in Section 5(c) hereof.

  • Monthly Earnings means your gross monthly income from your Employer, not including shift differential, in effect just prior to your date of disability. It includes your total income before taxes. It is prior to any deductions made for pre-tax contributions to a qualified deferred compensation plan, Section 125 plan or flexible spending account. It does not include income received from commissions, bonuses, overtime pay or any other extra compensation or income received from sources other than your Employer.

  • Retirement Benefit means the benefit set forth in Article 5.

  • Non-U.S. Benefit Plan has the meaning set forth in Section 3.20(a).

  • Tax Benefit Schedule is defined in Section 2.02 of this Agreement.

  • Death Benefit means the insurance amount payable under the Certificate at death of the Insured, subject to all Certificate provisions dealing with changes in the amount of insurance and reductions or termination for age or retirement. It does not include any amount that is only payable in the event of Accidental Death.