Limitations for Duplicate Coverage Sample Clauses

Limitations for Duplicate Coverage. Medicare Eligible Members
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Limitations for Duplicate Coverage. When you are eligible for Medi-Cal Your Blue Shield of California plan always provides Benefits first. When you are a qualified veteran If you are a qualified veteran your Blue Shield of California plan will pay the reasonable value or Blue Shield of Califor- nia’s or a contracted Dental Plan Administrator’s Allowable Amount for Covered Services provided to you at a Veteran’s Administration facility for a condition that is not related to military service. If you are a qualified veteran who is not on active duty, your Blue Shield of California plan will pay the reasonable value or Blue Shield of California’s, or a con- tracted Dental Plan Administrator’s Allowable Amount for Covered Services provided to you at a Department of Defense facility, even if provided for conditions related to military ser- vice. When you are covered by another governmental agency If you are also entitled to benefits under any other federal or state governmental agency, or by any municipality, county, or other political subdivision, the combined benefits from that coverage and your Blue Shield of California Dental Plan will equal, but not exceed, what Blue Shield of California or a contracted Dental Plan Administrator would have paid if you were not eligible to receive benefits under that coverage (based on the reasonable value or Blue Shield of California or a contracted Dental Plan Administrator’s Allowable Amount). Contact the Customer Service department at the telephone number shown at the end of this document if you have any questions about how Blue Shield of California coordinates your plan Benefits in the above situations. written endorsement is issued. No representative has author- ity to change this Agreement or to waive any of its provisions. Benefits, such as Covered Services, Calendar Year Benefits, Deductible, Copayment, or maximum per Member and family Calendar Year Copayment/Coinsurance responsibility amounts are subject to change at any time. Blue Shield of California will provide at least 60 days written notice of any such changes. Benefits provided after the effective date of any change will be subject to the change. There is no vested right to obtain Benefits.
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Limitations for Duplicate Coverage. When you are eligible for Medicare
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Limitations for Duplicate Coverage. When you are eligible for Medi-Cal Your Blue Shield of California plan always provides Benefits first. When you are a qualified veteran If you are a qualified veteran your Blue Shield of California plan will pay the reasonable value or Blue Shield of Califor- nia’s or a contracted Dental Plan Administrator’s Allowable Amount for Covered Services provided to you at a Veteran’s Administration facility for a condition that is not related to mil- itary service. If you are a qualified veteran who is not on active duty, your Blue Shield of California plan will pay the reason- able value or Blue Shield of California’s, or a contracted Den- tal Plan Administrator’s Allowable Amount for Covered Ser- vices provided to you at a Department of Defense facility, even if provided for conditions related to military service. When you are covered by another governmental agency If you are also entitled to benefits under any other federal or state governmental agency, or by any municipality, county, or other political subdivision, the combined benefits from that coverage and your Blue Shield of California Dental Plan will equal, but not exceed, what Blue Shield of California or a con- tracted Dental Plan Administrator would have paid if you were not eligible to receive benefits under that coverage (based on the reasonable value or Blue Shield of California or a con- tracted Dental Plan Administrator’s Allowable Amount). Contact the Customer Service department at the telephone number shown at the end of this document if you have any questions about how Blue Shield of California coordinates your plan Benefits in the above situations.
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Limitations for Duplicate Coverage. Medicare If you receive Medicare, Blue Shield will provide your Bene- fits, but Medicare will typically be the primary payor and Blue Shield will be the secondary payor as determined by Medicare regulations. When Blue Shield is the secondary payor, your combined Benefits from Medicare and Blue Shield will equal but not exceed what Blue Shield would pay if you were not eligible for Medicare. Blue Shield’s payment will be based on an amount that may be lower than the Medicare allowed amount but will not exceed the Medicare allowed amount. You must pay any applicable Deductibles, Copayments, and Coinsur- ance for your Blue Shield plan before Blue Shield will pro- vide Benefits.
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Related to Limitations for Duplicate Coverage

  • General Provisions for all Insurance Coverage 8.24.1 Without limiting Contractor's indemnification of County, and in the performance of this Contract and until all of its obligations pursuant to this Contract have been met, Contractor shall provide and maintain at its own expense insurance coverage satisfying the requirements specified in Paragraphs 8.24 and 8.25 of this Contract. These minimum insurance coverage terms, types and limits (the “Required Insurance”) also are in addition to and separate from any other contractual obligation imposed upon Contractor pursuant to this Contract. The County in no way warrants that the Required Insurance is sufficient to protect the Contractor for liabilities which may arise from or relate to this Contract.

  • General Requirements for Insurance Coverage and Policies A. All required insurance policies shall be maintained with companies that may lawfully issue the required policy and have an A.M. Best rating of at least A- / “VII” or a Standard and Poor’s rating of at least A, unless prior written approval is obtained from the City Law Department.

  • Waiver of Medical Coverage a. Regular, full-time employees who provide proof of alternate medical coverage may waive coverage through Kitsap County’s sponsored medical plans and for that waiver receive a one hundred dollar ($100.00) per month waiver-incentive payment; however, such payment is subject to employment taxes. Regular, full-time employees may not waive their individual medical coverage in lieu of coverage as a spouse/domestic partner on a County-sponsored medical plan.

  • Duplicative Coverage This section applies to married County employees or employees with domestic partners when both are employed by the County. The intent of this section limits County employees who are married or in a domestic partnership from both covering each other within the same medical plan. Married County employees or employees with a domestic partner, (as defined in the appendices) both employed by the County, shall be entitled to one choice from the following list of health medical plan coverages:

  • Exclusions from Coverage The Long-Term Disability Plan does not cover total disabilities resulting from:

  • TAM Service Coverage Each TAM Service Subscription will be limited to certain parameters (that is, a region, a customer team and/or a product line) and will be listed in the Order Form and, if not listed, the TAM parameters will be established upon the initiation of the TAM Service. • Regions: North America, Latin America, EMEA, Asia-Pacific (excluding Japan, China and India), China, India or Japan. • Customer Team: The customer team supported by the TAM, such as your development team, your system administration team, your support team, etc. • Red Hat Product Line: The supported Red Hat product line, such as the Red Hat Enterprise Linux, Red Hat JBoss Middleware, Red Hat Storage or Red Hat Cloud product lines.

  • GMP Cost Limitation The Guaranteed Maximum Price shall not be in excess of the GMP Cost Limitation.

  • Retiree Coverage Pre-Medicare: Employees who retire on or after January 1, 2011, will be provided the same health care benefits, including but not limited to, cost sharing, that it provides to its active employees until the retiree becomes eligible for Medicare. In the event health care benefits for active employees are eliminated in their entirety, which shall include a change to a one-hundred (100%) percent employee contributory health savings plan, the last health care benefits plan in effect for retirees preceding the elimination of the plan shall remain in effect (absent a contrary order from a Court of competent jurisdiction) until the Employer again provides a health care benefits plan to active employees. Medicare: Retirees must enroll in the Part B Medicare program commencing on the date they first become eligible to participate in the program. Retirees shall be responsible for the cost of such coverage. The Employer shall make available to those retirees who are properly enrolled in the Part B Medicare Program as above provided, a Supplemental Plan, with a $100 deductible. Such Plan will have the same Rx drug benefits the County provides its active employees. In the event Rx drug benefits for active employees are eliminated in their entirety, which shall include a change to a one-hundred (100%) percent employee contributory health savings plan, the Rx drug benefits last in effect for retirees preceding the elimination of the Rx drug benefits for active employees shall remain in effect (absent a contrary order from a Court of competent jurisdiction) until the Employer again provides Rx drug benefits to active employees.

  • Scope of Coverage 1. This Section shall apply to an investment dispute between a Member State and an investor of another Member State that has incurred loss or damage by reason of an alleged breach of any rights conferred by this Agreement with respect to the investment of that investor.

  • Minimum scope of coverage Commercial general coverage shall be at least as broad as Insurance Services Office Commercial General Liability occurrence form CG 0001 (ed. 11/88) or Insurance Services Office form number GL 0002 (ed. 1/73) covering comprehensive General Liability and Insurance Services Office form number GL 0404 covering Broad Form Comprehensive General Liability. Automobile coverage shall be at least as broad as Insurance Services Office Automobile Liability form CA 0001 (ed. 12/90) Code 1 (“any auto”). No endorsement shall be attached limiting the coverage.

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