Common use of Arranging for Benefits Clause in Contracts

Arranging for Benefits. Except for Emergency Services and Out-of-Area Urgent Care Services, each Member must obtain all Benefits from or through the Plan Providers specified in Sections 2.4 and 2.5, below. Additionally, except for Emergency Services and Out-of-Area Urgent Care Services, each Member is responsible for obtaining all necessary Authorization for Benefits. Except for Emergency Services and Out-of-Area Urgent Care Services, if Benefits are not provided by the Plan Providers specified in Sections 2.4 and 2.5, or if Benefits are provided without the necessary Authorization, the Member shall be responsible to pay for such Benefits.

Appears in 6 contracts

Samples: Group Agreement, Group Agreement, Group Agreement

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Arranging for Benefits. Except for Emergency Services and Out-of-Out of Area Urgent Care Services, each Member must obtain all Benefits from or through the Plan Providers specified in Sections 2.4 and 2.5, below. Additionally, except for Emergency Services and Out-of-Out of Area Urgent Care Services, each Member is responsible for obtaining all necessary Authorization for Benefits. Except for Emergency Services and Out-of-Out of Area Urgent Care Services, if Benefits are not provided by the Plan Providers specified in Sections 2.4 and 2.5, below, or if Benefits are provided without the necessary Authorization, the Member shall be responsible to pay for such Benefits.

Appears in 1 contract

Samples: Group Agreement

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