Health plan member definition

Health plan member means any person participating in the state group health insurance plan or in a health maintenance organization plan under the state group insurance program, including enrollees and covered dependents thereof.
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Examples of Health plan member in a sentence

  • Health plan member information is kept confidential in accordance with the law.

  • Health plan member experience with point-of-service prescription step therapy.

  • Any transfer for a Heritage Health plan member under a restricted services provision must be completed per restricted services procedures (see 482-000-7).

  • Any disenrollment fora Heritage Health plan member under a restricted services provision must be completed per restricted services procedures (see 482-000-7).

  • Health plan member benefits, as described in their Certificate of Coverage or Summary Plan Description, typically include language promoting the utilization of participating providers.

  • For this purpose, the Company has entered into an agreement with National Securities Depository Limited (“NSDL”) for facilitating voting through electronic means, as the authorized e-Voting’s agency.

  • Deductible means fixed dollar amounts that an MA Health plan member normally must pay out-of- pocket before the costs of services are covered by an MA Health Plan.

  • Nebraska DHHS MLTC Medicaid IDYou must have a Nebraska Medicaid provider ID number to render services for a Nebraska Heritage Health plan member and receive payment from us.

  • Health plan member information is kept confidential in accordance with the law.AARP® Vision Discounts Provided by EyeMed*As an AARP Medicare Supplement plan holder, you have access to exclusive savings on eye health services that include:• Routine eye exams** for just $50• Only at LensCrafters, take an additional $50 off the AARP Vision Discount or best in-store offer on no-line multifocal lenses with frame purchaseEyeMed Vision Care (EyeMed) is the network administrator of AARP Vision Discounts.

  • Its purpose is simple: to promote prevention and early detection and to provide valuable information to your primary care doctor.If you are a Peoples Health plan member, you can earn a gift card from us for retailers such as CVS Pharmacy, Shell, Walmart, or others — just for getting that wellness assessment.

Related to Health plan member

  • Plan Member means each Member any of the assets of which are subject to any Plan Governing Law.

  • Health plan issuer means an entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the superintendent of insurance, that contracts, or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services under a health benefit plan, including a sickness and accident insurance company, a health insuring corporation, a fraternal benefit society, a self-funded multiple employer welfare arrangement, or a nonfederal, government health plan. “Health plan issuer” includes a third party administrator to the extent that the benefits that such an entity is contracted to administer under a health benefit plan are subject to the insurance laws and rules of this state or subject to the jurisdiction of the superintendent. The “Health plan issuer” is also called the Administrator in this Benefit Booklet.

  • Staff member means a staff member as defined in section 1(1) of the Public Service Act, 1995 (Act No. 13 of 1995);

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Teaching staff member means an employee who holds a position for which a certificate issued by the New Jersey State Board of Examiners is required.

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

  • Team Member means an individual who is allowed to access the Cloud Service but is only granted membership in groups associated with “Team Member” permissions for the Cloud Service.2

  • Executive Member means any elected member of the authority appointed to the executive of that authority;

  • Pharmacy benefits management means the administration or management of prescription drug

  • county executive committee member means the county executive committee member responsible for matters relating to land;

  • Association Member means an owner or a member of an association.

  • Executive manager means an individual employed by a new motor vehicle dealer in an executive capacity and who has a written employment agreement with the dealer that includes a right for the executive manager to purchase a controlling interest in the dealership at a future time or on the death or incapacity of the dealer.

  • Eligible Member means an employee who is enrolled in one of the designated benefits plans for which you offer participation in the wellness incentive program prior to the end of the first six months of the policy year and who remains enrolled in one of the designated benefits plans at the end of the policy year. Eligible Member also means the employee’s dependents to the extent that dependents are eligible to participate in the Blue Cross and Blue Shield wellness incentive program.) To qualify for a group wellness incentive award, you must meet the following program participation conditions: • You are a group eligible to offer the program as determined by Blue Cross and Blue Shield; and • You elect to offer the Blue Cross and Blue Shield wellness incentive program to your Members who are eligible to participate in the program at the start of your policy year and you continue the program for eligible Members through the end of the policy year; and • At least 20% of your Members who are eligible for the program must participate in the program during the policy year in which you offer the wellness incentive program; and • This Agreement is not be terminated before the end of the policy year in which you offer the wellness incentive program. When you offer a Blue Cross and Blue Shield wellness incentive program, Blue Cross and Blue Shield will determine if you qualify for a group incentive award within 90 days after the end of the policy year. Your group wellness incentive award will be calculated as a percentage of the total medical insurance premium you paid for the policy year for benefits plans for which you offer wellness incentive program participation, excluding any premium payments that are received by Blue Cross and Blue Shield after the end of the policy year. The percentage used to calculate your wellness incentive award will vary depending on how many of your eligible Members participate in the program during the policy year as follows: 1.25% when 20% to 49% of eligible Members participate; or 2.5% when 50% to 79% of eligible Members participate; or 7.5% when 80% to 100% of eligible Members participate. For the purpose of calculating your group wellness incentive award, an eligible Member who earns his or her individual maximum member wellness incentive payment in the policy year is considered to have participated in the program for that policy year. If you qualify for a group incentive award, Blue Cross and Blue Shield will issue the incentive amount to you (by means of a credit and/or a check) once the incentive amount has been calculated. You are solely responsible for determining whether you have any obligation to distribute all or part of your group wellness incentive award to your employees, or to credit a portion of your group wellness incentive award toward their benefits, or otherwise to notify them of your group wellness incentive award. You agree to indemnify and hold Blue Cross and Blue Shield harmless from any and all actions that may be brought against you or Blue Cross and Blue Shield due to your failure to provide any required distribution of, credit, or notification about, your group wellness incentive award to your employees.

  • Bank Member means Standard Chartered PLC or any of its Affiliates and "Group" means all Bank Members.

  • Pharmacy benefit manager means a person, business or other

  • Former Member means a member that has withdrawn from a qualified authority under this section or a prior member of a qualified authority that has been dissolved under this section.

  • flight crew member means a licensed crew member charged with duties essential to the operation of an aircraft during a flight duty period;

  • Employee Member means a member of the “Bargaining Unit”.

  • Executive Management means the CEO and the CFO for purposes of administering this Plan.

  • Designated Employer Representative (DER) means a designated school district representative authorized to take immediate action to remove employees from safety-sensitive duties, to make required decisions in the testing and evaluation process, and to receive test results and other communications for the school district.

  • Participating member means an eligible employee who elects to participate in the defined contribution retirement plan established under this chapter.

  • crew member means a person assigned by an operator to duty on an aircraft during a flight duty period;

  • Participating Employer means any trade or business (whether or not incorporated) which adopts this Plan with the consent of the Company identified in the Adoption Agreement.

  • Employer/Owner means the DAKSHIN HARYANA BIJLI VITRAN NIGAM and the legal successors in title to the Employer/Owner but not (Except with the consent of the Contractor) any assignees of the Employer/Owner.

  • Deferred member means a person who elected to receive deferred vested retirement

  • Participating physician means a physician licensed in Virginia to practice medicine, who practices