Maximum Eligible Expense definition

Maximum Eligible Expense or “MEE” means the maximum amount considered for payment by this Plan for any covered treatment, service, or supply, subject however, to all Plan annual and lifetime maximum benefit limitations. The following criteria will apply to determination of the Maximum Eligible Expense:
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Examples of Maximum Eligible Expense in a sentence

  • Charges therefore do not exceed the Maximum Eligible Expense limits of the Plan.

  • The Plan will pay the Benefit Percentage of the Maximum Eligible Expense indicated.

  • Charges above the Maximum Eligible Expense are the Covered Person’s responsibility and will not apply to the Deductible or annual Out-of-Pocket Maximum.

  • In the case of services other than those described in item (2.) directly above, the Plan will adjust the Maximum Eligible Expense for items and services furnished to a participant by a billing provider that is not a Preferred Provider if the facility where the services are provided is a Preferred Provider.

  • This bonus will not be payable for charges in excess of the Maximum Eligible Expense or Procedure Based Limit, regardless of whether the charges are or are not reduced.PHARMACY BENEFIT This benefit applies only to Outpatient Prescription charges.

  • Charges in connection with an Accidental Injury are payable at 100% of the Maximum Eligible Expense, or Procedure Based Limit, whichever is applicable, up to the maximum benefit stated in the Schedule of Benefits.

  • According to the records of the Company examined by us and the information and explanations provided to us, the Company has not defaulted in repayment of loans or borrowings to any Financial Institutions or Banks or dues to debenture holders as at the Balance Sheet date.

  • The Maximum Eligible Expense, when reduced by any coinsurance amount, will equal the Benefit Period Maximum outlined under Paramedical Services on the Schedule of Benefits.

  • Eligible Expenses will include only the appropriate Maximum Eligible Expense or Procedure Based Limit for those procedures necessary to eliminate oral disease and to replace missing teeth.

  • If the charge exceeds the Maximum Eligible Expense or the Procedure-Based Limit for the treatment, test service or supply, the excess is not an Eligible Charge.Charges for treatments, tests, services or supplies excluded by this Plan may be reimbursable if such charges are approved by the Plan Administrator before the treatment begins or tests, services or supplies are provided.

Related to Maximum Eligible Expense

  • Eligible Expense means the lesser of the reasonable, customary, usual, fair market value charge for a covered service or the provider's actual charge.

  • Eligible Expenses means expenses incurred for Medical Services rendered with respect to a Disability.

  • Maximum Basic Grant Amount’ has the same meaning as set out in item 1 of Schedule 1 of HESA; ‘National Law’ means (a) for a state or territory other than Western Australia – the Health Practitioner Regulation National Law as set out in the Schedule to the Health Practitioner Regulation National Law Act 2009 (Qld) as it applies (with or without modification) as a law of the State or Territory; and (b) for Western Australia – the legislation enacted by the Health Regulation National Law (WA) Xxx 0000 that corresponds to the Health Practitioner Regulation National Law;

  • Base Year Value means the assessed value of eligible property January 1 preceding the execution of the agreement plus the agreed upon value of eligible property improvements made after January 1 but before the execution of the agreement.

  • Allowable Expense means a necessary, reasonable and customary item of expense for health care, which is: • covered at least in part under one or more plans covering the person for whom the claim is made; and • incurred while this plan is in force. When a plan provides healthcare coverage in the form of services, the reasonable cash value of each service is considered as both an allowable expense and a benefit paid. Vision care services covered under other plans are not considered an allowable expense under this plan. PLAN means any of the following that provides benefits or services for medical, pharmacy, or dental care treatment. If separate contracts are used to provide coordinated coverage for members of a group, the separate contracts are considered parts of the same plan and there is no COB among those separate contracts.

  • Minimum Disbursement Amount means Twenty-Five Thousand and No/100 Dollars ($25,000).

  • Maximum Distributable Amount means any maximum distributable amount relating to the Issuer and/or the Group (if any) which is determined pursuant to Article 141 of the CRD IV Directive (or, as the case may be, any provision of Danish law transposing or implementing Article 141 of the CRD IV Directive), or any successor provision thereto;

  • Maximum Allowable Payment means the maximum amount, as established by AvMed, which AvMed will pay for any Covered Service rendered by a Non-Participating Provider or supplier of services, medications or supplies, except for Emergency Medical Services and Care as defined herein. The Maximum Allowable Payment may be changed at any time by AvMed without notice to you or your consent.

  • Maximum Benefit means the maximum benefit amount of each of the benefits covered under this Policy as stated in the Schedule of Benefits.

  • Eligible Expenditures means the expenditures for goods, works and consultants’ services referred to in Section 2.02 of this Agreement;

  • Base Period Income Base Period Income" is an amount equal to Executive's "annualized includable compensation" for the "base period" as defined in Sections 280G(d)(1) and (2) of the Code and the regulations adopted thereunder. Generally, Executive's "annualized includable compensation" is the average of Executive's annual taxable income from Company for the "base period," which is the five calendar years prior to the year in which the Change of Control occurs. These concepts are complicated and technical and all of the rules set forth in the applicable regulations apply for purposes of this Agreement.

  • Eligible Expenditure means expenditure solely for the purpose of delivering the Services agreed and set out in the Appendices and Annexes of this Funding Agreement;

  • Maximum Benefit Amount means the maximum amount payable for coverage provided to You as shown in the Schedule of Benefits.

  • Maximum allowable cost means the maximum amount that a pharmacy benefit manager will reimburse a pharmacy for the cost of a drug.

  • Maximum Face Amount means, with respect to any outstanding Letter of Credit, the face amount of such Letter of Credit including all automatic increases provided for in such Letter of Credit, whether or not any such automatic increase has become effective.

  • Quarterly Excess Available Funds Percentage means, with respect to the July 2008 Transfer Date and each Transfer Date thereafter, the percentage equivalent of a fraction the numerator of which is the sum of the Excess Available Funds Percentages with respect to the immediately preceding three Monthly Periods and the denominator of which is three.

  • Maximum Available Amount means, at any time, the least of:

  • Annual Deferral Amount means that portion of a Participant's Base Annual Salary and Annual Bonus that a Participant elects to have, and is deferred, in accordance with Article 3, for any one Plan Year. In the event of a Participant's Retirement, Disability (if deferrals cease in accordance with Section 8.1), death or a Termination of Employment prior to the end of a Plan Year, such year's Annual Deferral Amount shall be the actual amount withheld prior to such event.

  • Daily Maximum Cash Amount means, with respect to the conversion of any Note, the quotient obtained by dividing (A) the Specified Dollar Amount applicable to such conversion by (B) forty (40).

  • Maximum Put Amount means the lesser of (i) Two Hundred Fifty Thousand Dollars ($250,000), or (ii) Two Hundred Fifty percent (250%) of the average of the Dollar Volume for the twenty (20) Trading Days immediately preceding the Put Date.

  • Minimum DSCR means, with respect to a Supplemental Loan, (i) if the Senior Indebtedness bears interest at a fixed rate, 1.25:1, or (ii) if the Senior Indebtedness bears interest at a floating rate, 1.10:1.

  • Minimum Quarterly Distribution means $0.35 per Unit per Quarter (or with respect to the period commencing on the Closing Date and ending on September 30, 2005, it means the product of $0.35 multiplied by a fraction of which the numerator is the number of days in such period and of which the denominator is 92), subject to adjustment in accordance with Section 6.6 and Section 6.9.

  • Payout Period means the time frame during which certain benefits payable hereunder shall be distributed. Payments shall be made in monthly installments commencing on the first day of the month following the occurrence of the event which triggers distribution and continuing for a period of one hundred eighty (180) months. Should the Executive make a Timely Election to receive a lump sum benefit payment, the Executive's Payout Period shall be deemed to be one (1) month.

  • Maximum allowable cost list means a list of drugs for

  • Total Available Amount With respect to any Distribution Date, the sum of the Available Interest and the Available Principal for such Distribution Date and the amount of all cash or other immediately available funds on deposit in the Reserve Account immediately prior to such Distribution Date.

  • Maximum Undrawn Amount means with respect to any outstanding Letter of Credit, the amount of such Letter of Credit that is or may become available to be drawn, including all automatic increases provided for in such Letter of Credit, whether or not any such automatic increase has become effective.