Health Benefit Programs definition

Health Benefit Programs means: 1) the Commonwealth’s program under the ACA for the enrollment of individuals in qualified health plans (“QHPs”), including the federal program of advanced premium tax credits and the Commonwealth’s program of premium assistance payments, which are designed to make coverage through a QHP more affordable, administered by CCA in accord with Sections 1311, 1401 and 1411 of the ACA, Section 36B of the Internal Revenue Code of 1986, 45 C.F.R. part 155, M.G.L. c. 176Q, s. 3, and other applicable federal and state laws, regulations and waivers (the “CCA Programs”); 2) the Commonwealth’s Medicaid and Children’s Health Insurance Programs, each administered by EOHHS in accord with Titles XIX and XXI of the Social Security Act, M.G.L. c. 118E and other applicable federal and state laws, regulations, waivers and demonstration projects (“MassHealth”); and 3) the Health Safety Net Trust Fund, administered by EOHHS pursuant to M.G.L. c. 118E and applicable regulations (the “HSNTF” and, together with MassHealth, the “EOHHS Programs”).
Health Benefit Programs means the program(s) underwritten or administered by Crystal Run setting forth covered benefits provided to a Covered Person pursuant to a subscriber contract between the Payor and the Covered Person.
Health Benefit Programs means the medical care offered by the HBA to its members.

Examples of Health Benefit Programs in a sentence

  • Problem 5.11 – Principal Liability for Agent Diversion of Funds Lawyer is a trial lawyer employed by firm, which through its lawyers, is engaged in the practice of law, specializing in general civil litigation.

  • Malone, Adequacy of Employer-Sponsored Retiree Health Benefit Programs, in Providing Health Care Benefits in Retirement 60 (Judith F.

  • Renewal of Contract 09-0138 for the Employee Health Benefit Programs with Blue Cross Blue Shield of Illinois for the 2018-2019 plan year (Tollway Request for Proposal).

  • The site has been inspected and the appeal file has been reviewed.

  • Renewal of Contract 09-0138 for the Employee Health Benefit Programs with Blue Cross Blue Shield of Illinois for the 2019- 2020 plan year (Tollway Request for Proposal).

  • Thus, negative values of α are considered, which refer to expansion during phase transformation, despite decreasing temperature.First, temperature history of all nodes during heating process is calculated, solving electromagnetic-thermal problem.

  • As alleged further below, Luketich’s “concurrent” surgery practices violate the statutes and regulations governing surgical practice at teaching hospitals, and the conditions of payment for the relevant Government Health Benefit Programs, in at least three ways, and has resulted in the submission of materially false claims for payment to the United States.

  • As such, UPMC receives direct graduate medical education (“GME”) funds from the Government to subsidize the cost of its medical residency program, including payments for resident salaries and to cover the cost of the training that teaching physicians provide to residents, and must abide by additional conditions of payment to receive reimbursement from Medicare, Medicaid, or other Government Health Benefit Programs.

  • See the Health Benefit Programs and Medicare Parts A & B for Retirees Fact Sheet for more information regarding Medicare Coverage.GENERAL CONDITIONS OF THE PLANAll benefits listed in this guidebook may be subject to limitations and exclusions as described in subsequent sections.

  • Luketich – through UPP – regularly submits claims to Government Health Benefit Programs for surgical procedures that were performed when he was simultaneously leading, participating, and/or assisting in at least one other surgical procedure, and was thus not “immediately available” throughout the course of the claimed procedure, in violation of the above- described conditions of payment.

Related to Health Benefit Programs

  • Health Benefits means health maintenance organization, insured or self-funded medical, dental, vision, prescription drug and behavioral health benefits.

  • Health benefits plan means a benefits plan which pays or

  • Health benefit plan means a policy, contract, certificate or agreement offered or issued by a health carrier to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services.

  • Group health benefit plan means any health care plan, subscription contract, evidence of

  • Basic health benefit plan means any plan offered to an individual, a small group,

  • Medical benefit plan means a plan established and maintained by a carrier, a voluntary employees' beneficiary association described in section 501(c)(9) of the internal revenue code of 1986, 26 USC 501, or by 1 or more public employers, that provides for the payment of medical benefits, including, but not limited to, hospital and physician services, prescription drugs, and related benefits, for public employees or elected public officials. Medical benefit plan does not include benefits provided to individuals retired from a public employer or a public employer's contributions to a fund used for the sole purpose of funding health care benefits that are available to a public employee or an elected public official only upon retirement or separation from service.

  • Retiree Health Plan means an "employee welfare benefit plan" within the meaning of Section 3(1) of ERISA that provides benefits to individuals after termination of their employment, other than as required by Section 601 of ERISA.

  • Retiree means any person who has begun accruing a retirement

  • Health Plans means any and all individual and family health and hospitalization insurance and/or self-insurance plans, medical reimbursement plans, prescription drug plans, dental plans and other health and/or wellness plans.

  • Health insurance plan means any health insurance policy or health benefit plan offered by a health insurer or a subcontractor of a health insurer, as well as Medicaid and any other public health care assistance program offered or administered by the State or by any subdivision or instrumentality of the State. The term includes vision care plans but does not include policies or plans providing coverage for a specified disease or other limited benefit coverage.

  • Health plan or "health benefit plan" means any policy,

  • Medical Benefits means the monthly fair market value of benefits provided to the Employee and the Employee’s dependents under the major medical, dental and vision benefit plans sponsored and maintained by the Company, at the level of coverage in effect for such persons immediately prior to the Employee’s termination of employment date. The “monthly fair market value” of such benefits shall be equal to the monthly cost as if such persons elected COBRA continuation coverage at such time at their own expense.

  • Health and Welfare Benefits means any form of insurance or similar benefit programs, which may include but not be limited to, medical, hospitalization, surgical, prescription drug, dental, optical, psychiatric, life, or long-term disability.

  • Retirement Plans means the retirement income, supplemental executive retirement, excess benefits and retiree medical, life and similar benefit plans providing retirement perquisites, benefits and service credit for benefits at least as great in value in the aggregate as are payable thereunder prior to a Change in Control.

  • Gap medical benefits means the benefits (if any) payable in respect of medical expenses that are less than, greater than or equal to the schedule fee, provided always that the medical expenses relate to a professional service that:

  • Essential Health Benefits means, under section 1302(b) of the Patient Protection and Affordable Care Act, those health benefits to include at least the following general categories and the items and services covered within the categories: ambulatory patient services; Emergency Services; hospitalization; maternity and newborn care; mental health and substance abuse disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Compensation and Benefits Programs means all compensation and benefit plans, policies, and programs of the Debtors, and all amendments and modifications thereto, applicable to the Debtors’ employees, former employees, retirees, and non-employee directors and the employees, former employees and retirees of their subsidiaries, including all savings plans, retirement plans, health care plans, disability plans, and incentive plans, deferred compensation plans, and life, accidental death, and dismemberment insurance plans.

  • Health insurance means protection which provides payment of benefits for covered sickness or injury.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Medical Benefits Schedule means the Medicare Schedule of Benefits produced by the Department of Health to which all fees and benefits relate for inpatient hospital services.

  • health worker means a person who has completed a course of

  • Group health insurance coverage means in connection with a group health plan, health insurance

  • Welfare Benefits means the types of benefits described in Section 3(1) of ERISA (whether or not covered by ERISA).

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Welfare Plan means a “welfare plan” as defined in Section 3(1) of ERISA.