Direct coverage definition

Direct coverage means coverage under which an insurance company or health carrier assumes a direct obligation to an individual, under the policy or evidence of coverage, with respect to health care expenses incurred by the individual or a member of the individual's family.
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Direct coverage means coverage under which an insurance company or health carrier assumes a direct obligation to an individual, under the policy or
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Examples of Direct coverage in a sentence

  • Direct coverage is provided for children with access to cost effective ESI that meets the BBL only during the provisional eligibility period and the time span while the Commonwealth is investigating availability of and enrolling the child in ESI.

  • Direct coverage Family Assistance under the title XXI program is provided through an MCO, ACO, or the PCC plan for children without access to ESI.

  • Direct coverage Family Assistance under the separate title XXI program is provided through an MCO or the PCC plan for children without access to ESI.

  • Direct coverage will be provided through a fee- for- service (FFS) system.

  • Direct coverage refers to the area that is targeted by the project’s site intervention.

  • The Issuer [and the Guarantor] will take such steps (in conjunction with the Dealers, where appropriate) to ensure that any laws and regulations or requirements of any governmental agency, authority or institution which may from time to time be applicable to any Notes shall be fully observed and complied with, including (without limitation) its obligations under Clauses 3.17 (U.S. selling restrictions), 5.9 (Yen Notes)[, 5.10 (Renminbi Notes)] and 5.11 9 (United Kingdom).

  • If the PA received from Medicaid Direct does not include a procedure code, it can be omitted in file transfers back to NC Tracks.4. PHPs are expected to ensure that they do not accept or process any new PAs for the beneficiaries that have transitioned to Medicaid Direct after their Medicaid Direct coverage effective date.

  • Direct coverage is provided by DUA through enrollment in a health plan for an individual who does not have continued ESI available, or if the individual qualifies for a hardship waiver.

  • Direct coverage is provided for children only during the presumptive eligibility period and the time span while the Commonwealth is investigating availability of and enrolling the child in ESI.

  • PHPs are expected to ensure that they do not accept or process any new PAs for the beneficiaries that have transitioned to Medicaid Direct after their Medicaid Direct coverage effective date.

Related to Direct coverage

  • Lot coverage means the portion or percentage of the area of a lot upon which buildings are erected.

  • Asset Coverage means “asset coverage” of a class of senior security which is a stock, as defined for purposes of Section 18(h) of the 1940 Act as in effect on the date hereof, determined on the basis of values calculated as of a time within 48 hours (only including Business Days) next preceding the time of such determination.

  • Site Coverage means ratio expressed in percentage between the area covered by the ground floor of building and the area of the site;

  • Coverage means the types of persons to be eligible as the beneficiaries of the Scheme to health services provided under the Scheme, subject to the terms, conditions and limitations.

  • Interest Coverage means as of the last day of any fiscal quarter, the quotient, expressed as a percentage (which may be in excess of 100%), determined by dividing EBITDA by Interest Expense; all of the foregoing calculated by reference to the immediately preceding four fiscal quarters of the Company ending on such date of determination.

  • Fraud Coverage During the period prior to the first anniversary of the Cut-Off Date, 2.00% of the aggregate principal balance of the Mortgage Loans as of the Cut-Off Date (the "Initial Fraud Coverage"), reduced by Fraud Losses allocated to the Certificates since the Cut-Off Date; during the period from the first anniversary of the Cut-Off Date to (but not including) the fifth anniversary of the Cut-Off Date, the amount of the Fraud Coverage on the most recent previous anniversary of the Cut-Off Date (calculated in accordance with the second sentence of this paragraph) reduced by Fraud Losses allocated to the Certificates since such anniversary; and during the period on and after the fifth anniversary of the Cut-Off Date, zero. On each anniversary of the Cut-Off Date, the Fraud Coverage shall be reduced to the lesser of (i) on the first, second, third and fourth anniversaries of the Cut-Off Date, 1.00% of the aggregate principal balance of the Mortgage Loans as of the Due Date in the preceding month and (ii) the excess of the Initial Fraud Coverage over cumulative Fraud Losses allocated to the Certificates since the Cut-Off Date. The Fraud Coverage may be reduced upon written confirmation from the Rating Agencies that such reduction will not adversely affect the then current ratings assigned to the Certificates by the Rating Agencies.

  • Fraud Loss Coverage Amount As of the Closing Date, $2,500,000, subject to reduction from time to time, by the amount of Fraud Losses allocated to the Certificates. In addition, on each anniversary of the Cut-off Date, the Fraud Loss Coverage Amount will be reduced as follows: (a) on the first, second, third and fourth anniversaries of the Cut-off Date, to an amount equal to the lesser of (i) 1.00% of the then current Stated Principal Balance of the Mortgage Loans in the case of the first and second anniversaries and 0.50% of the then-current Stated Principal Balance of the Mortgage Loans in the case of the third and fourth such anniversaries and (ii) the excess of the Fraud Loss Coverage Amount as of the preceding anniversary of the Cut-off Date over the cumulative amount of Fraud Losses allocated to the Certificates since such preceding anniversary; and (b) on the fifth anniversary of the Cut-off Date, to zero.

  • Insurance Coverage Contractor shall, at Contractor’s sole expense, procure, maintain and keep in force for the duration of this Contract the following insurance conforming to the minimum requirements specified below. Unless specified herein or otherwise agreed to by the City, the required insurance shall be in effect prior to the commencement of work by Contractor and shall continue in force as appropriate until the latter of:

  • Period of Coverage means the Plan Year, with the following exceptions: (a) for Employees who first become eligible to participate, it shall mean the portion of the Plan Year following the date on which participation commences, as described in Section 3.1; and (b) for Employees who terminate participation, it shall mean the portion of the Plan Year prior to the date on which participation terminates, as described in Section 3.2.

  • group insurance means insurance, other than creditor’s group insurance and family insurance, whereby the lives of a number of persons are insured severally under a single contract between an insurer and an employer or other person; (“assurance collective”)

  • extended reduction (qualifying contributory benefits means a reduction under this scheme for which a person is eligible in accordance with paragraph 88 or 95;

  • Continuation Coverage means coverage under a COBRA continuation provision or a similar state program. Coverage provided by a plan that is subject to a COBRA continuation provision or similar state program, but that does not satisfy all the requirements of that provision or program, will be deemed to be continuation coverage if it allows an individual to elect to continue coverage for a period of at least 18 months. Continuation coverage does not include coverage under a conversion policy required to be offered to an individual upon exhaustion of continuation coverage, nor does it include continuation coverage under the Federal Employees Health Benefits Program.

  • Claims-made coverage means an insurance contract or provision limiting

  • D&O Liability Insurance Policies means all insurance policies (including any “tail policy”) of any of the Debtors for liability of any current or former directors, managers, officers, and members.

  • Creditable coverage means, with respect to an individual, coverage of the individual provided under any of the following:

  • Company Insurance Policies has the meaning set forth in Section 3.14.

  • policy of life insurance means any instrument by which the payment of money is assured on death (except death by accident only) or the happening of any contingency dependent on human life, or any instrument evidencing a contract which is subject to payment of premiums for a term dependent on human life;

  • Property Insurance is defined in Section 6.10(a).

  • Individual health insurance coverage means health insurance coverage offered to individuals in the

  • Special Primary Insurance Policy Any Primary Insurance Policy covering a Mortgage Loan the premium of which is payable by the Trustee pursuant to Section 4.04(a), if so identified in the Mortgage Loan Schedule. There are no Special Primary Insurance Policies with respect to any of the Mortgage Loans.

  • Special Hazard Loss Coverage Amount With respect to the first Distribution Date, $10,348,874. With respect to any Distribution Date after the first Distribution Date, the lesser of (a) the greatest of (i) 1% of the aggregate of the principal balances of the Mortgage Loans, (ii) twice the principal balance of the largest Mortgage Loan and (iii) the aggregate of the principal balances of all Mortgage Loans secured by Mortgaged Properties located in the single California postal zip code area having the highest aggregate principal balance of any such zip code area and (b) the Special Hazard Loss Coverage Amount as of the Closing Date less the amount, if any, of Special Hazard Losses allocated to the Certificates since the Closing Date. All principal balances for the purpose of this definition will be calculated as of the first day of the calendar month preceding the month of such Distribution Date after giving effect to Scheduled Payments on the Mortgage Loans then due, whether or not paid.

  • Co-insurance means the percentage of the usual, reasonable, customary, and fair market value expense that a covered person must pay.

  • General Liability Insurance Subcontractor shall carry minimum primary General Liability Insurance for the following amounts:

  • Fidelity Insurance means insurance coverage with respect to employee errors, omissions, dishonesty, forgery, theft, disappearance and destruction, robbery and safe burglary, property (other than money and securities) and computer fraud.

  • Group long-term care insurance means a long-term care insurance policy which is delivered or issued for delivery in this State and issued to:

  • Insurance producer means a person required to be licensed under the laws of this state to sell, solicit or negotiate insurance, including annuities.