Enrolled Member definition

Enrolled Member means an Eligible Employee, Eligible Retiree, or Eligible Dependent identified to BCBSRI by GROUP as a person who shall receive Health Care Coverage under this Agreement.

Enrolled Member means a person whose name appears on the tribal role of an Indian tribe or whose status as an enrolled member of a tribe is recognized by the tribal council of that tribe.

Enrolled Member means a person who is either (a) certified by the Tribe as having been a member of the Tribe for at least five (5) years, or (b) a holder of confirmation of membership issued by the Bureau of Indian Affairs.

Examples of Enrolled Member in a sentence

• Nonparticipating Providers Outside Our Service Area • Enrolled Member Liability Calculation When covered healthcare services are provided outside of BCBSRI service area by nonparticipating providers, the amount an enrolled member pays for such services will generally be based on either the Host Blue’s nonparticipating provider local payment or the pricing arrangements required by applicable law.

• BCBSRI shall protect the personal information pertaining to an Enrolled Member as required by Massachusetts Regulation 201.

• Regarding all amounts owed by GROUP as a result of any retroactive adjustment(s), upon billing of GROUP by BCBSRI, GROUP agrees to reimburse all payments or allocations made by BCBSRI on behalf of an Enrolled Member determined not to be eligible to receive Health Care Coverage, following the confirmed date of ineligibility.

• This may occur in situations where an Enrolled Member did not have reasonable access to a participating provider, as determined by BCBSRI in BCBSRI sole and absolute discretion or by applicable law.

• Unless subject to a fixed dollar copayment, the calculation of the Enrolled Member liability on claims for covered healthcare services will be based on the lower of the participating provider's billed covered charges or the negotiated price made available to BCBSRI by the Host Blue.

More Definitions of Enrolled Member

Enrolled Member means, at any time, an individual registered at that time on the Inuit Enrolment List maintained by Nunavut Tunngavik Inc. pursuant to Article 35 of the NLCA who has regularly resided in the Qikiqtani Region for a period of not less than a year in accordance with the “General Member” residency requirements set forth in QIA Restated By-law #5, subject to such by-law requirements being amended, replaced or restated from time to time.

Enrolled Member means any member of a voluntary ambulance

Enrolled Member or "Enrollee", means a Hoosier Healthwise-eligible member who is listed by the Offices on the enrollment rosters to receive covered services from the Contractor or its subcontractors, employees, agents, or providers, as of the Effective Date of Enrollment, under this contract.

Enrolled Member means any member of the Turtle Mountain Band of Chippewa Indians listed on the membership roll maintained by the Secretary of Interior, or designated representatives.

Enrolled Member means a person who is officially enrolled as a member of the Stockbridge-Munsee Band of Mohican Indians.

Enrolled Member means the contract holder who may be the Employee, Retiree, Contract Employee, or Extended Beneficiary who is currently enrolled in Coverage and who has paid the necessary Deduction or Premium for such Coverage.

Enrolled Member means a qualified permanent employee who has enrolled in the Catastrophic Leave Program.