Annual Dental Maximum d. The PPO dental annual maximum allowable shall be one-thousand five-hundred and fifty dollars ($1550).
Annual Dental Maximum Sample Clauses
Related to Annual Dental Maximum
Annual maximums State Dental Plan coverage is subject to a one thousand dollar ($1,000) annual maximum benefit payable (excluding orthodontia) per person. "Annual" means per insurance year.
Contribution Formula Dental Coverage a. Faculty Member Coverage. For faculty member dental coverage, the Employer contributes an amount equal to the lesser of ninety percent (90%) of the faculty member premium of the State Dental Plan, or the actual faculty member premium of the dental plan chosen by the faculty member. However, for calendar years beginning January 1, 2014, and January 1, 2015, the minimum employee contribution shall be five dollars ($5.00) per month.
Orthodontia lifetime maximum Orthodontia benefits are subject to a three thousand dollar ($3,000) lifetime maximum benefit.
Copayments and annual out-of-pocket maximums For the first and second year of the contract: Tier 1 copayment: Fourteen dollar ($14) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five dollar ($25) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty dollar ($50) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight hundred dollars ($800) per person or one thousand six hundred dollars ($1,600) per family.
Contribution Formula - Basic Life Coverage For employee basic life coverage and accidental death and dismemberment coverage, the Employer contributes one-hundred (100) percent of the cost.
Benefit Waiting Period Allowance (a) An employee who qualifies for and takes leave pursuant to 21.1 or 21.2 and is required by Employment Insurance to serve a one-week waiting period for Employment Insurance Maternity/Parental benefits, shall be paid a leave allowance equivalent to one week at 85% of the employee's basic pay.
Reimbursable Expenses; Maximum Total Payment; Invoicing District will make no payment until this Contract is fully executed by the authorized representatives of both parties.
Medical/Dental Expense Account The Employer agrees to allow insurance eligible employees to participate in a medical and dental expense reimbursement program to cover co- payments, deductibles and other medical and dental expenses or expenses for services not covered by health or dental insurance on a pre-tax basis as permitted by law or regulation, up to the maximum amount of salary reduction contributions allowed per calendar year under Section 125 of the Internal Revenue Code or other applicable federal law.
Lifetime maximums and non-prescription out-of-pocket maximums Coverage under Advantage is not subject to a per person lifetime maximum. In the first and second years of the contract, coverage under Advantage is subject to a plan year, non-prescription drug, out-of-pocket maximum of one thousand seven hundred dollars ($1,700) per person or three thousand four hundred dollars ($3,400) per family for members whose primary care clinic is in Cost Level 1 or Cost Level 2; two thousand four hundred dollars ($2,400) per person or four thousand eight hundred dollars ($4,800) per family for members whose primary care clinic is in Cost Level 3; and three thousand six hundred dollars ($3,600) per person or seven thousand two hundred dollars ($7,200) per family for members whose primary care clinic is in Cost Level 4.
Expenditure Limit The Contractor shall notify the County of Orange assigned Deputy Purchasing Agent in writing when the expenditures against the Contract reach 75 percent of the dollar limit on the Contract. The County will not be responsible for any expenditure overruns and will not pay for work exceeding the dollar limit on the Contract unless a change order to cover those costs has been issued.
