Stop Loss Coverage Sample Clauses

Stop Loss Coverage. During the term of this Agreement, Group shall either obtain professional stop loss coverage through Blue Shield under the terms and conditions set forth in Exhibit H attached hereto or shall obtain professional stop loss coverage from a third party insurer acceptable to Blue Shield. Upon request, certificates and other proof of such coverage shall be provided to Blue Shield. Group shall provide Blue Shield with timely notice of cancellation of coverage or change in carrier. If Group elects to have Blue Shield provide such stop loss coverage, by so indicating on the Signature Page hereto, Blue Shield shall provide and charge Group for stop loss coverage as set forth in Exhibit H.
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Stop Loss Coverage. Guardian shall have the right to provide Contractholders with stop-loss insurance or reinsurance with respect to HMO Plans that are Managed Care Contracts subject to this Agreement. Guardian shall have the right to bid on stop-loss reinsurance protection for all other business of PHS. Nothing herein shall require PHS to reinsure HMO Plans that are not Managed Care Contracts with Guardian. In addition, Guardian acknowledges that PHS has certain existing arrangements, and may enter into additional arrangements in the future, for stop-loss reinsurance coverage for HMO Plans that are not Managed Care Contracts which shall remain in effect regardless of this Agreement.
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Stop Loss Coverage. (Check the applicable provisions for A. and B.)
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Stop Loss Coverage. A. BCBSND agrees to reimburse the Insured for Plan Benefits that exceed the Individual Stop-Loss Attachment Point and/or the greater of the Minimum Aggregate Deductible or the Aggregate Stop-Loss Attachment Point during a Contract Period only when and to the extent the Plan Benefits are actually paid. A Plan Benefit is deemed to have been paid as of the date the payment instrument issued by the Insured is tendered for payment and subsequently honored within a reasonable time. Benefits that are incurred other than during the Contract Period are not eligible for reimbursement under this Contract.
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Stop Loss Coverage. (a) As soon as administratively feasible following the written request of Buyer, Seller shall use commercially reasonable efforts to purchase, to the extent reasonably available in the market, a stop loss coverage insurance policy providing coverage to Seller with regard to benefits provided under the health and welfare Employee Benefit Plans of Seller for participants and beneficiaries whose coverage under such plan is on account of services provided to the Company, upon such terms (including attachment levels and early termination procedures) reasonably requested by the Buyer and subject to Buyer’s approval, which policy is expected to be effective as of January 1, 2020 and to continue, unless earlier terminated in accordance with the following sentence, through December 31, 2020 (not including any runoff period for incurred but not reported claims) (such policy the “Stop Loss Coverage”). Upon the request of the Buyer, Seller shall use commercially reasonable efforts to terminate the Stop Loss Coverage early to the extent permitted under the terms of the insurance contract. All premiums, brokerage fees and commissions payable for or in connection with, and all other reasonable and documented out-of-pocket costs and expenses incurred by Seller in connection with obtaining the Stop Loss Coverage shall be paid by the Buyer. Any payments made to Seller under the Stop Loss Coverage shall be treated as a payment by the Buyer to the Seller under Section 6.04 in furtherance of Buyer’s obligations to provide benefits coverage under such Section 6.04.
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Stop Loss Coverage. IPA shall provide and maintain a Stop-Loss program, at IPA expense, providing protection against excessive Part A and/or Part B costs for Members as required by any applicable state or federal laws, rules and regulations. The Stop-Loss program shall be funded directly by IPA, in its sole discretion, and not as a carve-out from the capitation allocated to the Part A and Part B Funds, with a stop loss insurance carrier on terms and conditions reasonably acceptable to IPA.
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Stop Loss Coverage. Stop-Loss Fund PPM shall provide and maintain a Humana approved Stop-Loss program, at PPM expense, to provide protection against excessive medically necessary Part A, Part B and/or pharmacy costs for members as required by any applicable state or federal laws, rules and regulations. PPM will ensure that the Stop-Loss program provider will accept Humana’s standard electronic data provided to PPM monthly as proof of loss for PPM’s reinsurance claims filing. Humana shall not furnish any type of hard copy claim information or adhoc reports to PPM for the purpose of reporting proof of loss to Stop-Loss program providers. If PPM fails to provide and maintain a HUMANA approved Stop-Loss program then, HUMANA shall provide and maintain a Stop-Loss program, at PPM expense, after providing written notification to PPM thirty (30) days prior to the inception of the HUMANA provided coverage
Sample 1
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Stop Loss Coverage. Employer has entered into a stop loss arrangement with a stop loss vendor. BlueCross’s duties with regard to this stop loss arrangement are set forth in Exhibit C.
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Related to Stop Loss Coverage

  • Indemnity Insurance a. The Service Provider agrees to indemnify and save harmless the City, its officers, agents and employees against and from any and all actions, suits, claims, demands or liability of any character whatsoever brought or asserted for injuries to or death of any person or persons, or damages to property arising out of, result from or occurring in connection with the performance of any service hereunder.

  • Continuing Coverage If a letter of assurance is obtained from any insurer under a Hazard Insurance policy or a Flood Insurance policy that the insurance coverage shall continue in full force and effect, the Servicer shall deposit such letter in the appropriate Servicer Mortgage Loan File.

  • Tail Coverage If any of the required insurance is on a claims made basis and does not include an extended reporting period of at least 24 months, Grantee shall maintain either tail coverage or continuous claims made liability coverage, provided the effective date of the continuous claims made coverage is on or before the effective date of this Grant Agreement, for a minimum of 24 months following the later of (i) Grantee’s completion and Agency’s acceptance of all Services required under this Grant Agreement, or, (ii) Agency or Grantee termination of this Grant Agreement, or, iii) The expiration of all warranty periods provided under this Grant Agreement.

  • Coverage i) It is expected that both job sharers will cover each other's incidental illnesses. If, because of unavoidable circumstances, one cannot cover the other, the unit supervisor must be notified to book coverage. Job sharers are not required to cover for their partner in the case of prolonged or extended absences.

  • Indemnification; Liability Insurance The Company and Executive shall enter into the Company’s standard form of indemnification agreement governing his conduct as an officer and director of the Company.

  • OWNER'S LIABILITY INSURANCE The Owner shall be responsible for purchasing and maintaining the Owner’s usual liability insurance.

  • Product Liability Insurance insurance against claims for bodily injury, death or Property damage resulting from the use of products sold by the Company or any of its Subsidiaries in such amounts as are then customarily maintained by responsible persons engaged in businesses similar to that of the Company and its Subsidiaries.

  • Excess Liability Insurance $___________________ minimum required insurance policy for anything other than General Liability or Automobile coverage. ☐ - Additional Insurance Requirement: Client, Contractor, and any other entity which the Contractor is required to name as an additional insured under the Prime Contract shall be named as additional insureds under the General Liability Insurance required by this Section and any such insurance afforded to the additional insureds shall apply as primary insurance. Any other insurance maintained by the Client or Contractor shall be excess insurance and shall not be called upon to contribute to Subcontractor’s primary or excess insurance carrier’s duty to defend or indemnify unless required by law. The excess insurance required above shall also afford additional insured protection to Client and Contractor. This Section shall in no event be construed to require that additional insured insurance coverage be provided to a greater extent than permitted under the statutes or public policy governed under State law. Certificates of Insurance. Certificates of insurance, and the required additional insured and other endorsements, including waivers of subrogation shall be furnished to Contractor before the performance of any Services.

  • Other Coverage Borrower shall provide to Lender evidence of such other reasonable insurance in such reasonable amounts as Lender may from time to time request against such other insurable hazards which at the time are commonly insured against for property similar to the subject Property located in or around the region in which the subject Property is located. Such coverage requirements may include but are not limited to coverage for earthquake, acts of terrorism, business income, delayed business income, rental loss, sink hole, soft costs, tenant improvement or environmental.

  • REINSURANCE COVERAGE Reinsurance under this Agreement will apply to insurance issued by the Ceding Company on the Plans of Insurance shown in Schedule A. Such Plans of Insurance shall be reinsured with the Reinsurer on an automatic basis, subject to the requirements set forth in Section A below, or on a facultative basis, subject to the requirements set forth in Section B below, or on a facultative obligatory basis, subject to the requirements set forth in Section C below. The specifications for all reinsurance under this Agreement are provided in Schedule B.

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