NETWORK BENEFIT Sample Clauses

NETWORK BENEFIT. Mental Health Coverage • Paid-in-full medically necessary hospitalization services and inpatient physician charges when provided by or arranged through the network. • Outpatient care provided by or arranged through the network will be covered subject to a $20 per visit copay. Effective January 1, 2019, the outpatient visit copayment will be $25. • The copayment for emergency room services will be $70. Effective January 1, 2019, the copayment for emergency room services will be $100. • Up to three visits for crisis intervention provided by, or arranged through, the network will be covered without copay. Alcohol and Other Substance Abuse Coverage • Paid-in-full medically necessary care for hospitalization or alcohol/substance abuse facilities when pro- vided by or arranged through the network; • Outpatient care provided by or arranged through the network will be subject to the participating provider office visit copay.
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NETWORK BENEFIT. Mental Health Coverage  Paid-in-full medically necessary hospital services and inpatient physician charges when provided by, or arranged through, the network;  Effective April 1, 2010, outpatient care provided by, or arranged through, the network will be covered subject to a $20 per visit copayment.  Up to three visits for crisis intervention provided by, or arranged through, the network will be covered without copay. - Alcohol and Other Substance Abuse Coverage  Paid in full medically necessary care for hospitalization or alcohol/substance abuse facilities when provided by, or arranged through, the network;  Outpatient care provided by, or arranged through, the network will be subject to the participating provider office visit copayment. - Benefit Maximums  Effective January 1, 2010 medically necessary inpatient alcohol and substance abuse treatment will be unlimited.
Sample 1
NETWORK BENEFIT. Mental Health Coverage • Paid-in-full medically necessary hospital services and inpatient physician charges when provided by, or arranged through, the network; • Effective April 1,2010, outpatient care provided by, or arranged through, the network will be covered subject to a $20 per visit copayment. • Up to three visits for crisis intervention provided by, or arranged through, the network will be covered without copay. - Alcohol and Other Substance Abuse Coverage • Paid in full medically necessary care for hospitalization or alcohol/substance abuse facilities when provided by, or arranged through, the network; • Outpatient care provided by, or arranged through, the network will be subject to the participating provider office visit copayment. - Benefit Maximums • Effective January 1,2010 medically necessary inpatient alcohol and substance abuse treatment will be unlimited. 80 12.14(b) NON-NETWORK BENEFIT - Mental Health Medically necessary care rendered outside of the network will be subject to the following provisions: • Coincident with the increase in the Basic Medical deductible and coinsurance, the mental health basic medical deductible and coinsurance will increase accordingly. • The methodology for calculating non-network inpatient and outpatient reimbursement will be the same as the methodology for non-rietwork hospital and medical services; - Substance Abuse • Medically necessary inpatient alcohol and substance abuse treatment will be unlimited effective January 1,2010. • Coincident with the increase in the Basic Medical deductible and coinsurance, the substance abuse deductible and coinsurance will increase accordingly effective January 1,2010. • Effective January 1, 2010 the methodology for calculating non-network inpatient and outpatient reimbursement will be the same as the methodology for non­ network hospital and medical services; • Expenses applied against the deductible and coinsurance levels indicated above will not apply against any deductible or coinsurance maximums under the basic medical portion of the Plan. Effective January 1, 2012, covered expenses for non-network mental health and substance abuse treatment will be included in the combined deductible and combined coinsurance maximum. - Disease Management - Under the Mental Health and Substance Abuse Program a disease management program for depression is available. Effective, March 31, 2010, or as soon as practicable, disease management programs for eating disorders, including approp...
Sample 1
NETWORK BENEFIT. Mental Health Coverage • Paid in full medically necessary hospitalization services and inpatient physician charges when provided by, or arranged through, the network; • Outpatient care provided by, or arranged through, the network will be covered subject to a $18 per visit copayment. Effective July 1, 2009, the outpatient per visit copayment will increase to $20. • Up to three visits for crisis intervention provided by, or arranged through, the network will be covered without copay. - Alcohol and Other Substance Abuse Coverage • Paid in full medically necessary care for hospitalization or alcohol/substance abuse facilities when provided by, or arranged through, the network; • Outpatient care provided by, or arranged through, the network will be subject to the participating provider $18 office visit copayment. Effective July 1, 2009, the outpatient per visit copayment will increase to $20. - Benefit Maximums • Effective January 1, 2010 medically necessary inpatient alcohol and substance abuse treatment shall be unlimited.
Sample 1

Related to NETWORK BENEFIT

  • Basic Benefit Effective January 1, 2008, the basic life insurance benefit will be increased from $15,000 to $18,000 for employees. This shall be the default level of life insurance coverage, which shall be provided at no cost to the employee.

  • Public Benefit It is Reaction Retail’s understanding that the commitments it has agreed to herein, and actions to be taken by Reaction Retail under this Settlement Agreement, would confer a significant benefit to the general public, as set forth in Code of Civil Procedure § 1021.5 and Cal. Admin. Code tit. 11, § 3201. As such, it is the intent of Reaction Retail that to the extent any other private party initiates an action alleging a violation of Proposition 65 with respect to Reaction Retail’s failure to provide a warning concerning exposure to DEHP prior to use of the Products it has manufactured, distributed, sold, or offered for sale in California, or will manufacture, distribute, sell, or offer for sale in California, such private party action would not confer a significant benefit on the general public as to those Products addressed in this Settlement Agreement, provided that Reaction Retail is in material compliance with this Settlement Agreement.

  • Program Benefits Under the Probation Status, the Participating Contractor will be eligible for all contractor incentives, its customers will have access to financing offered through the Program, and income- eligible households will be eligible to receive Program incentives.

  • Sick Benefits 15.01 Eligible employees will receive Short Term Disability Benefits in accordance with the terms and conditions outlined in the STD Plan Text, a copy of which has been supplied to the Union. The STD plan forms part of this Collective Agreement.

  • Sponsorship Benefits 3.1 INREV agrees to grant the Sponsor the above chosen and described sponsorship benefits.

  • Education Benefits Notwithstanding the provisions of Article 5, academic staff members who qualify for benefits in accordance with Article 23.5.2.1 may take a credit, or non-credit language class offered by the University provided it does not interfere with performance of duties as determined by the Xxxx. The member and the Xxxx may discuss ways in which duties may be reassigned to make it possible for the member to take the class. Upon successful completion, reimbursement of tuition will be provided for one class per semester.

  • Oregon Public Service Retirement Plan Pension Program Members For purposes of this Section 2, “employee” means an employee who is employed by the State on or after August 29, 2003 and who is not eligible to receive benefits under ORS Chapter 238 for service with the State pursuant to Section 2 of Chapter 733, Oregon Laws 2003.

  • Group Benefits To determine if a leave under the provisions of the Family and Medical Leave Act will be a paid or unpaid leave, contact the District’s Human Resources Department.

  • Retirement Benefit Should the Director still be in the Directorship ------------------ of the Association upon attainment of his 70th birthday, the Association will commence to pay him $590 per month for a continuous period of 120 months. In the event that the Director should die after becoming entitled to receive said monthly installments but before any or all of said installments have been paid, the Association will pay or will continue to pay said installments to such beneficiary or beneficiaries as the Director has directed by filing with the Association a notice in writing. In the event of the death of the last named beneficiary before all the unpaid payments have been made, the balance of any amount which remains unpaid at said death shall be commuted on the basis of 6 percent per annum compound interest and shall be paid in a single sum to the executor or administrator of the estate of the last named beneficiary to die. In the absence of any such beneficiary designation, any amount remaining unpaid at the Director's death shall be commuted on the basis of 6 percent per annum compound interest and shall be paid in a single sum to the executor or administrator of the Director's estate.

  • Retirement Benefits Due to either investment or employment during the marriage, either the Husband or Wife: (check one) ☐ - DO NOT have retirement plans. ☐ - HAVE retirement plans. The Couple has the following retirement plans: (“Retirement Plans”). Upon signing this Agreement, the Retirement Plans shall be owned by: (check one) ☐ - Husband ☐ - Wife ☐ - Both Spouses ☐ - Other. .

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