You Pay You Pay Sample Clauses

You Pay You Pay. Acupuncture Services In a provider's office - One initial evaluation per provider per plan year and acupuncture treatments up to a combined total of 12 visits per member per plan year. $45 - After deductible The level of coverage is the same as network provider. Ambulance Services Ground $50 The level of coverage is the same as network provider. Air/water* - Up to the benefit limit of $3,000 per occurrence. 10% - After deductible The level of coverage is the same as network provider.
Sample 1Sample 2Sample 3See All (7)
AutoNDA by SimpleDocs
You Pay You Pay. In a physician’s/dentist’s office - When services are due to accidental injury to sound natural teeth. 10% - After deductible Not Covered Dental Services - Outpatient Services connected to dental care when performed in an outpatient facility * 10% - After deductible Not Covered Dental Care (Pediatric) - for members under age 19 See Dental Services in Section 3 for benefit limits and details. These services only apply to an enrolled member under the age of 19. Oral evaluations 0% Not Covered X-rays 0% Not Covered Cleanings (prophylaxis) 0% Not Covered Fluoride treatments 0% Not Covered Sealants 0% Not Covered Space Maintainers 0% Not Covered Palliative treatment 50% - After deductible Not Covered Fillings 50% - After deductible Not Covered Simple extractions 50% - After deductible Not Covered Denture repairs and relines/rebasing 50% - After deductible Not Covered Crowns & onlays 50% - After deductible Not Covered Therapeutic Pulpotomies 50% - After deductible Not Covered Root canal therapy 50% - After deductible Not Covered Non-surgical periodontal services 50% - After deductible Not Covered Surgical periodontal services 50% - After deductible Not Covered Periodontal maintenance 50% - After deductible Not Covered Fixed bridges and dentures 50% - After deductible Not Covered Implants 50% - After deductible Not Covered Oral surgery services 50% - After deductible Not Covered General anesthesia or IV sedation - dental office 50% - After deductible Not Covered Biopsies 50% - After deductible Not Covered Occlusal (night) guards 50% - After deductible Not Covered Orthodontic services (braces) - when medically necessary. 50% - After deductible Not Covered Dialysis Services Inpatient/outpatient/in your home 10% - After deductible Not Covered Durable Medical Equipment (DME), Medical Supplies, Diabetic Supplies, Prosthetic Devices, and Enteral Formula or Food, Hair Prosthetics Outpatient durable medical equipment* - Must be provided by a licensed medical supply provider. 10% - After deductible Not Covered Outpatient medical supplies* - Must be provided by a licensed medical supply provider. 10% - After deductible Not Covered Outpatient diabetic supplies/equipment purchased at licensed medical supply provider (other than a pharmacy). See the Summary of Pharmacy Benefits for supplies purchased at a pharmacy. 10% - After deductible Not Covered Outpatient prosthesis* - Must be provided by a licensed medical supply provider. 10% - After deductible Not Covered Enteral form...
Sample 1
You Pay You Pay. Pregnancy and Maternity Services Pre-natal, delivery, and postpartum services. 0% - After deductible 20% - After deductible Prescription Drugs and Diabetic Equipment and Supplies Prescription drugs and diabetic equipment and supplies dispensed at a pharmacy. See Summary of Pharmacy Benefits for prescription drugs purchased at a retail, specialty, or mail order pharmacy. Prescription drugs dispensed and administered by a licensed health care provider (other than a pharmacist), and not purchased from a retail, specialty or mail order pharmacy: Injectable drugs* 0% - After deductible 20% - After deductible Infused drugs* 0% - After deductible 20% - After deductible Medications other than injected and infused drugs* Are included in the allowance for the medical service being rendered. Are included in the allowance for the medical service being rendered.
Sample 1
You Pay You Pay. Pregnancy and Maternity Services Pre-natal, delivery, and postpartum services. 0% - After deductible 20% - After deductible Prescription Drugs and Diabetic Equipment and Supplies Prescription drugs and diabetic equipment and supplies purchased at a retail, specialty, or mail order pharmacy. See Summary of PharmacyBenefits See Summary of PharmacyBenefits Prescription drugs requiring administration by a licensed health care provider* : Prescription drugs other than infused drugs - includes but is not limited to: medications by injection or inhalation, as well as nasal, topical, or transdermal medications. 0% - After deductible 20% - After deductible Infused drugs 0% - After deductible 20% - After deductible
Sample 1
You Pay You Pay. In a physician’s/dentist’s office - When services are due to accidental injury to sound natural teeth. $25 - After deductible Not Covered Dental Services - Outpatient Services connected to dental care when performed in an outpatient facility * 0% - After deductible Not Covered Dialysis Services Inpatient/outpatient/in your home 0% - After deductible Not Covered
Sample 1

Related to You Pay You Pay

  • You must also pay (a) Late payment charge a monthly late payment charge at a rate(s) determined by us and notified to you from time to time if we do not receive your full payment of the minimum payment amount specified in the statement of account on or before the payment due date; and

  • SHIFT BONUS 7:01 A day shift shall be a shift that commences after 4:30 a.m. and at or before 10:00 a.m. on the same day.

  • Educational Incentive Pay Effective January 1, 2022, the current Education Incentive Differential (EID) rates from the pre-existing salary schedules shall be eliminated and, in their place, the following Educational Incentive Pay program will be applied. The salary schedules contained in Addendum B reflect the new Educational Incentive pay allowances. Upon successful completion of field training and promotion to the rank of Police Officer, an officer who has received or obtains one of the degrees set forth below from an accredited college or university shall receive an annual incentive allowance added to their hourly rate, as follows: • $1,500 for associate’s degree ($0.723/hour) • $3,000 for bachelor’s degree ($1.446/hour) • $4,500 for master’s degree and above ($2.169/hour) Educational incentives are not cumulative, but rather the employee will be entitled to the highest incentive based on the degree(s) obtained. In the event an employee obtains a new or higher degree during employment, the employee will submit to the Department proof of degree attainment. Upon verification and approval by the Department, within thirty (30) days of submission, the employee’s pay will be adjusted effective on the first day of the pay period following the date of submission by the employee. Any current employee with an EID classification will be adjusted to the non-EID rate, but will receive the annual incentive allowance as part of their hourly rate, spread over twenty-six (26) pay periods. The hourly rate will be calculated by dividing the annual educational incentive by 2,074 hours. Educational incentive pay will be included in the regular rate for overtime purposes. In addition, it will be counted as part of the employee’s annual salary for pension purposes, consistent with the prevailing Fire & Police Employees Retirement System regulations, and reflected on the salary schedules.

  • Employee Compensation The wages, salaries and other compensation paid to employees who will be employed for the benefit of the Project, and to others who perform special services for the benefit of the Project, to the extent not otherwise paid through a Cash Management System, shall be paid by Owner from a Project Account pursuant to this Section 9.2.

  • You must A. keep records in sufficient detail to enable all EPRs to be easily and accurately determined;

  • Holiday Pay for Employees Laid Off An employee who is laid off at the close of business the day before a holiday who has worked not less than five (5) previous consecutive work days shall be paid for the holiday.

  • Employees' Compensation The Consultant shall be solely responsible for the following:

  • Travel Compensation The Contractor shall not be compensated or reimbursed for travel time, travel expenses, meals, or lodging.

  • Holiday Premium Pay A Nurse working on a recognized Holiday is entitled to the following compensation for any hours worked on the calendar date of the recognized Holiday:

  • Travel Pay Any employee required by the Employer to travel to a place of work other than his/her regular official duty station shall be reimbursed for travel costs, if eligible, in accordance with University policy.

Time is Money Join Law Insider Premium to draft better contracts faster.