Description of Benefits definition

Description of Benefits section”: *For ease of reference, some exclusions may contain headings for categories of health care services. Please note that, exclusions listed under any category of health care services shall apply to all health care services, regardless of the heading under which they are listed.

Description of Benefits means a written determination that an applicant is eligible for health care aid or subsistence aid or both. A description of benefits expires 90 days after the date of eligibility is established and printed by the department unless extended by the department.

Description of Benefits means a written determination that an applicant is eligible for health care aid or subsistence aid or both. A description of benefits expires 90 days after the

Examples of Description of Benefits in a sentence

• Subject to the receipt of satisfactory written proof of loss, all accrued benefits for loss for which the Policy provides installment payments will be paid monthly; any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof, unless otherwise stated in the Description of Benefits.

• Refer to your Master Group Policy or Description of Benefits, on file with your employer, for a complete listing of benefits, maximums, exclusions and limitations.

• All frequency limitations are listed in Schedule A, Description of Benefits and Copayments.

• Any procedure that is not specifically listed under Schedule A, Description of Benefits and Copayments.

• See the Policy Schedule and Description of Benefits sections in the policy for more information.

• The following benefit is added to the Description of Benefits section: AMBULANCE BENEFITWe will pay the benefit shown in the Schedule of Benefits, subject to the following conditions and exclusions, if the Covered Person requires ambulance services due to a Covered Injury resulting directly and independently of all other causes from a Covered Accident.

• Refer to the Out-of-Pocket Maximum in the Description of Benefits section for details on how the Out-of-Pocket Maximum applies.

• Frequency limitations are listed in Schedule A, Description of Benefits and Copayments.

• In the Description of Benefits section the Felonious Assault and Violent Crime benefit is replaced with the following: FELONIOUS ASSAULT BENEFITWe will pay the amount shown in the Schedule of Benefits, subject to the following conditions and exclusions, when the Covered Person suffers a Covered Loss resulting directly and independently of all other causes from a Covered Accident that occurs during a felonious assault as described below.

• Subject to the receipt of satisfactory written proof of loss, all accrued benefits for loss for which the Policy provides installments will be paid monthly; any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof, unless otherwise stated in the Description of Benefits.

More Definitions of Description of Benefits

Description of Benefits. The term Description of Benefits means the document which describes for the Employer the Benefit Program.

Description of Benefits means the document describing the Covered Benefits applicable to the dental services provided by Dentist pursuant to this Addendum. The Description of Benefits specifies by dental procedure code: prior authorization requirements; claim submission requirements; frequency limitations; duration limitations; other limitations; and, additional documentation requirements. The Description of Benefits applicable to this Addendum shall be the version posted by LIBERTY on the Provider Web Portal, which may be amended by LIBERTY from time to time.

Description of Benefits. Class l: Class ll: Covered Dental Expenses in any calendar year: the plan pays 85% of such expenses. Effective September 1, 2005, the 85% will be increased to 90%. Covered Dental Expenses in any calendar year: the plan pays 50% of such expenses. Effective September 1 2010 the maximum lifetime benefit for expenses incurred in connection with orthodontic treatment i Will be increased to $1500.00 The maximum benefit for all other Covered Dental Expenses incurred in any calendar year is $1,650.00. Included under the plan are the charges which the employee is required to pay for the following services and supplies up to the amount specified in the current Provincial Dental Tariff: Class l Covered Expenses: * Oral Examination, but not more than one examination in any period of six consecutive months. * Dental x-rays as required by the attending dentist with full mouth x-rays not more often than once every thirty-six (36) month period. * Cleaning and scaling of teeth. * Topical application of sodium or stannous fluoride. * Space maintainers when placed primarily to maintain space and not for orthodontic purposes. * Extraction and other surgical procedures including excision of impacted teeth, and anesthetics administered in connection with such surgery or other covered services. * All necessary procedures for filling teeth with amalgam, synthetic porcelain and stainless steel crowns. Gold may be used only where no other material is adequate and with prior approval of the insurance company. Restoration services will include, where necessary: * Gold inlays or onlays will be provided as a filling material only when teeth, in the professional opinion of the dentist cannot be restored with amalgam, synthetic porcelain or stainless steel crowns. Gold foil will be provided only in cases of repair to pre-existing gold restorations. * Repairs to or re-cementing of crown, inlays, bridgework or dentures or relining of dentures. * Necessary procedure for treatment of pulpally involved teeth including root canal therapy. * Treatment for diseases of the gums and soft tissues of the mouth. Services and supplies, in the case of each dental expense, must have been rendered and dispensed by a legally qualified dentist except that:

Description of Benefits means a written determination that an