Fully insured plan definition

Fully insured plan means a Plan as to which Company assumes all or a majority of healthcare cost and/or utilization risk.
Fully insured plan means insurance coverage of one
Fully insured plan means a Plan funded exclusively by the purchase of individual insurance and/or annuity Policies. The provisions of Section 3.07 shall apply to a Fully Insured Plan.

Examples of Fully insured plan in a sentence

  • Company shall not contest the timeliness of bills for Covered Services provided under a Fully-Insured Plan if such bills are received by Company within 180 days after the later of: (i) the date of service and (ii) the date of the Physician’s receipt of the EOB from the primary payor, when Company is the secondary payor.

Related to Fully insured plan

  • Self-insured employer means an employer or group of employers certified under ORS

  • 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 in an aggregate amount acceptable to Seller’s regulators.

  • Liability Insurance means compulsory professional liability errors and omissions insurance required by a governing body;

  • Sum Insured means the sum as specified in the Schedule to this Policy against the name of Insured / each Insured Person, which sum represents the Company's maximum liability for any or all claims under this Policy during the Policy period for the respective benefit(s) against which the sum is mentioned in the Schedule to this Policy.

  • 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.

  • Special Hazard Coverage The Special Hazard Coverage on the most recent anniversary of the Cut-Off Date (calculated in accordance with the second sentence of this paragraph) or, if prior to the first such anniversary, $4,725,230, in each case reduced by Special Hazard Losses allocated to the Certificates since the most recent anniversary of the Cut-Off Date (or, if prior to the first such anniversary, since the Cut-Off Date). On each anniversary of the Cut-Off Date, the Special Hazard Coverage shall be reduced, but not increased, to an amount equal to the lesser of (1) the greatest of (a) the aggregate principal balance of the Mortgage Loans located in the single California zip code area containing the largest aggregate principal balance of Mortgage Loans, (b) 1.0% of the aggregate unpaid principal balance of the Mortgage Loans and (c) twice the unpaid principal balance of the largest single Mortgage Loan, in each case calculated as of the Due Date in the immediately preceding month, and (2) $4,725,230, as reduced by the Special Hazard Losses allocated to the Certificates since the Cut-Off Date. The Special Hazard 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.

  • Insured Amount As defined in the Policy.

  • First party insurance means an insurance policy or contract in which the insurer agrees to pay a claim submitted to it by the insured for the insured's losses.

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

  • Insured Casualty has the meaning set forth in Section 5.1(x)(iv)(B).

  • Covered policy means a policy of commercial risk insurance, professional liability insurance or public entity insurance.

  • Covered Accident means an Accident that occurs while coverage is in force and results in a loss for which benefits are payable.

  • Self-insured retention means the individual own risk employer's or group self-insurance association's retained amount of risk under a specific excess insurance policy, before the liability is transferred to an insurance carrier.

  • Insured Persons means the person/s named in the Schedule to the Policy, who is/are Indian Resident /s and for whom the insurance is also proposed and appropriate premium paid.

  • Excess Insurance means insurance purchased from an insurance company authorized or admitted in the State of New Jersey or deemed eligible by the Commissioner as a surplus lines insurer or from any other entity authorized to provide said coverage in this state pursuant to law, covering losses in excess of an amount set forth in insurance contracts on a specific occurrence, or per accident or annual aggregate basis.

  • 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.

  • Reinsured Policies has the meaning assigned to it in the Reinsurance Agreement.

  • Insured Amounts means, with respect to any Distribution Date, the Deficiency Amount for such Distribution Date.

  • Insured Person s year” means a year from the date of commencement of the insured person’s policy, or from the anniversary date of the commencement of the insured person.

  • Accidental Bodily Injury means an Injury sustained as the result of an Accident and independently of all other causes by an outside traumatic event or due to exposure to the elements.

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

  • Policy means Related Party Transaction Policy.

  • Force-Placed Insurance shall have the meaning set forth in Section 4.4.

  • Professional liability insurance means insurance against legal liability incident to the practice of a profession and provision of a professional service.

  • Primary Insurance Policy Each policy of primary mortgage guaranty insurance or any replacement policy therefor with respect to any Mortgage Loan.