Benefit trigger definition

Benefit trigger means a contractual provision in a policy of long-term care insurance that conditions the payment of benefits on a determination of the insured’s ability to perform activities of daily living and on cognitive impairment, or on other conditions of the insured as specified in the policy. For purposes of a qualified long-term care insurance contract, “benefit trigger” means a determination by a licensed health care practitioner that an insured is a chronically ill individual. For purposes of this definition, “licensed health care practitioner” means the same as defined in section 7702B(c)(4) of the Internal Revenue Code.
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Benefit trigger means a contractual provision in a long term care insurance pol- icy that conditions the payment of benefits on an insured’s inability to perform activities of daily living or on an insured’s cognitive impairment. For qualified long term care in- surance, the “benefit trigger” is the determi- nation that an insured is a chronically ill individual, as defined in section 7702B(c) of the Internal Revenue Code.
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Benefit trigger means a contractual provision in a
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Examples of Benefit trigger in a sentence

  • The Benefit trigger is determined based on the insured's cognitive impairment or his requiring substantial assistance to perform two out of six activities of daily living (ADLs) of bathing, dressing, eating, toileting, transferring and maintaining continence.

  • WACChapter 284-50 WAC WASHINGTON DISABILITY INSURANCEREGULATIONSThe benefits under this policy are summarized below.• Type of coverage:• Benefit amount:• Benefit trigger (identify any periods of no coverage284-50-440 Standard disclosure form for individual policies—Ill-ness-triggered fixed payment insurance, hospital confinement fixed payment insurance, or other fixed payment insurance.

  • An insured who is not satisfied with the insurer’s Benefit trigger determination may request an independent review of the determination.

  • The decision of the independent review organization with respect to whether the insured met the Benefit trigger will be final and binding on the insurer.

  • The insurer shall consider such information and affirm or overturn its Benefit trigger determination.

  • Benefit trigger, for the purposes of independent review, means a contractual provision in the insured’s policy of long-term care insurance conditioning the payment of benefits on a determination of the insured’s ability to perform activities of daily living and on cognitive impairment.

  • If the IRO overturns the insurer’s decision, it shall: 2.5.6.1. Establish the date that the Benefit trigger was deemed to have been met; 2.5.6.2. Establish the specific period of time under review for which the insurer declined eligibility but during which the IRO deemed the Benefit trigger to have been met; 2.5.6.3. For qualified long-term care insurance contracts, the IRO shall make a determination that the insured is a chronically ill individual.

  • Benefit trigger: The Hospital Confinement Benefit is payable when you are confined as a resident inpatient in a hospital in excess of 24 hours because of sickness or injury.

  • The specific reason that the insurer determined that the insured’s Benefit trigger has not been met.

  • If the determination that the Benefit trigger was not met is upheld after the internal appeal process has been exhausted, and new or additional information has not been provided to the insurer for consideration, the insurer shall provide a written description of the insured’s right to request an independent review of the benefit determination as described in Subsection D.


More Definitions of Benefit trigger

Benefit trigger means a contractual provision in a long term care insurance pol-
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Benefit trigger means a contractual provision in the insureds policy conditioning the payment of benefits on a determination of the insureds ability to perform activities of daily living and on cognitive impairment.
Sample 1
Benefit trigger means a contractual provision in the insureds policy conditioning the
Sample 1
Benefit trigger means a contractual provision in a long term care insurance policy that
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Benefit trigger means a contractual provision in a long term care
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Benefit trigger means a contractual provision in a policy of long-term care insurance conditioning the payment of benefits on a determination of the insured’s ability to perform activities of daily living, or on a cognitive impairment. For purposes of a qualified long-term care insurance contract, “Benefit trigger” shall include a determination by a licensed health care practitioner that an insured is a chronically ill individual.
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Related to Benefit trigger

  • ii) Trigger Date shall have the meaning set forth in Section 11(a)(iii) hereof.

  • Final Trigger Level means 85.00%, being a percentage against which the performance of the Index will be measured in order to determine the Final Redemption Amount.

  • Company Triggering Event means: (i) the failure of the Board of Directors of the Company to recommend that the Company's stockholders vote to adopt this Agreement, or the withdrawal or modification of the Company Board Recommendation in a manner adverse to Parent, or the Board of Directors shall have taken any other action that is or becomes disclosed publicly or to a third party, which indicates that the Board of Directors of the Company does not support the Merger or does not believe that the Merger is in the best interests of the Company's stockholders; (ii) the Company shall have failed to include in the Proxy Statement the Company Board Recommendation or a statement to the effect that the Board of Directors of the Company has determined and believes that the Merger is in the best interests of the Company's stockholders; (iii) an Acquisition Proposal is publicly announced and the Board of Directors of the Company fails to reaffirm without qualification the Company Board Recommendation, or fails to publicly state without qualification, that the Merger is in the best interests of the Company's stockholders, within five business days after Parent requests in writing that such action be taken; (iv) the Board of Directors of the Company shall have approved, endorsed or recommended any Acquisition Proposal; (v) the Company shall have failed to comply with Section 5.04 in any material respect; (vi) a tender or exchange offer relating to securities of the Company shall have been commenced and the Company shall not have sent to its securityholders, within ten business days after the commencement of such tender or exchange offer, a statement disclosing that the Board of Directors recommends rejection of such tender or exchange offer; (vii) an Acquisition Proposal is publicly announced, and the Company fails to issue a press release announcing its opposition to such Acquisition Proposal within ten business days after such Acquisition Proposal is announced; or (viii) either the Company or any of its subsidiaries or any their Representatives shall have breached any of the provisions set forth in Section 5.04 (in any material respect) or Section 6.15.

  • Subsequent Triggering Event means either of the following events or transactions occurring after the date hereof:

  • Change of Control Triggering Event means the occurrence of both a Change of Control and a Rating Event.

  • Appraisal Trigger Event As defined in Section 3.19(a).

  • Initial Triggering Event means any of the following events or transactions occurring after the date hereof:

  • Prepayment Distribution Trigger With respect to any Distribution Date and any Class of Subordinate Certificates (other than the Class M-1 Certificates), a test that shall be satisfied if the fraction (expressed as a percentage) equal to the sum of the Certificate Principal Balances of such Class and each Class of Subordinate Certificates with a Lower Priority than such Class immediately prior to such Distribution Date divided by the aggregate Stated Principal Balance of all of the Mortgage Loans (or related REO Properties) immediately prior to such Distribution Date is greater than or equal to the sum of the related Initial Subordinate Class Percentages of such Classes of Subordinate Certificates.

  • Covenant Trigger Event shall occur at any time that Availability is less than the greater of (a) $12.5 million and (b) 10% of the Line Cap then in effect. Once commenced, a Covenant Trigger Event shall be deemed to be continuing until such time as Availability equals or exceeds the greater of (i) $12.5 million and (ii) 10% of the Line Cap then in effect for 30 consecutive days.

  • Termination After Change in Control means either of the following events occurring within twenty-four (24) months after a Change in Control:

  • Foreign Benefit Event means (a) with respect to any Foreign Pension Plan, (i) the existence of unfunded liabilities in excess of the amount permitted under any applicable law, or in excess of the amount that would be permitted absent a waiver from a Governmental Authority, (ii) the failure to make the required contributions or payments, under any applicable law, on or before the due date for such contributions or payments, (iii) the receipt of a notice by a Governmental Authority relating to the intention to terminate any such Foreign Pension Plan or to appoint a trustee to administer any such Foreign Pension Plan, or to the insolvency of any such Foreign Pension Plan and (iv) the incurrence of any liability of the Borrowers under applicable law on account of the complete or partial termination of such Foreign Pension Plan or the complete or partial withdrawal of any participating employer therein and (b) with respect to any Foreign Plan, (i) the occurrence of any transaction that is prohibited under any applicable law and could result in the incurrence of any liability by the Borrowers, or the imposition on the Borrowers of any fine, excise tax or penalty resulting from any noncompliance with any applicable law and (ii) any other event or condition that could reasonably be expected to result in liability of any of the Borrowers.

  • Covered Termination means any termination of the Executive's employment during the Employment Period where the Termination Date or the date Notice of Termination is delivered is any date on or prior to the end of the Employment Period.

  • Termination Upon a Change in Control means (i) a termination by the Employee of the Employee’s employment with the Employer or Avocent within six (6) months following any “Change in Control” or (ii) any termination by the Employer or Avocent Corporation of the Employee’s employment with the Employer or Avocent(other than a Termination for Cause) within eighteen (18) months following any “Change in Control.”

  • Terminating Event means any of the following events:

  • ERISA Termination Event means (i) a “Reportable Event” described in Section 4043 of ERISA and the regulations issued thereunder (other than a “Reportable Event” not subject to the provision for 30-day notice to the PBGC under such regulations), or (ii) the withdrawal of a Borrower or any of its ERISA Affiliates from a “single employer” Plan during a plan year in which it was a “substantial employer”, both of such terms as defined in Section 4001(a) of ERISA, or (iii) the filing of a notice of intent to terminate a Plan or the treatment of a Plan amendment as a termination under Section 4041 of ERISA, or (iv) the institution of proceedings to terminate a Plan by the PBGC or (v) any other event or condition which might constitute grounds under Section 4042 of ERISA for the termination of, or the appointment of a trustee to administer, any Plan or (vi) the partial or complete withdrawal of a Borrower or any ERISA Affiliate of such Borrower from a “multiemployer plan” as defined in Section 4001(a) of ERISA.

  • Swap Provider Trigger Event With respect to any Distribution Date, (i) an Event of Default under the Swap Agreement with respect to which the Swap Provider is a Defaulting Party, (ii) a Termination Event under the Swap Agreement with respect to which the Swap Provider is the sole Affected Party, or (iii) an Additional Termination Event under the Swap Agreement with respect to which the Swap Provider is the sole Affected Party.

  • Special Hazard Coverage Termination Date The point in time at which the Special Hazard Loss Coverage Amount is reduced to zero.

  • Qualifying exigency means a situation where the eligible employee seeks leave for one or more of the following reasons:

  • Delinquency Trigger Event means, for any Collection Period, the aggregate Principal Balance of Delinquent Receivables that have been Delinquent Receivables for 61 days or more as a percentage of the Pool Balance as of the last day of the Collection Period exceeding or being equal to 6.62%.

  • Cumulative Loss Trigger Event If, with respect to any Distribution Date, the quotient (expressed as a percentage) of (x) the aggregate amount of Realized Losses incurred since the Cut-off Date through the last day of the related Due Period, divided by (y) the Cut-off Date Pool Principal Balance, exceeds the applicable Cumulative Loss Percentages set forth below with respect to such Distribution Date: Distribution Date Occurring In Cumulative Loss Percentage March 2008 through February 1.400% for the first month, plus an additional 2009 1/12th of 1.750% for each month thereafter (e.g., 2.275% in September 2008) March 2009 through February 3.150% for the first month, plus an additional 2010 1/12th of 1.750% for each month thereafter (e.g., 4.025% in September 2009) March 2010 through February 4.900% for the first month, plus an additional 2011 1/12th of 1.400% for each month thereafter (e.g., 5.600% in September 2010) March 2011 through February 6.300% for the first month, plus an additional 2012 1/12th of 0.750% for each month thereafter (e.g., 6.675% in September 2011) March 2012 and thereafter 7.050%

  • Elevated blood lead level means a level of lead in blood that is any of the following:

  • Servicer Termination Test The Servicer Termination Test is failed if either (x) Cumulative Net Losses for the Mortgage Loans exceed 5.10% of the aggregate Original Class Principal Balance of the Offered Certificates or (y) the most recent Three Month 90-Day Delinquency Rate exceeds 30%.

  • Fraud Loss Coverage Termination Date The point in time at which the Fraud Loss Coverage Amount is reduced to zero.

  • Disability Retirement Date means the first day of the month following the last day of paid employment;

  • Expected week of childbirth means the week, starting on a Sunday, during which the mother's doctor or midwife expects her to give birth.

  • Training Event means either a Course or Online Training, or both.