Basic Benefits. 1. Blue Shield will pay the following:
a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period;
b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after;
c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization will be paid at the appropriate standard of payment which has been ap- proved by Medicare, subject to a lifetime maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime);
d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician.
2. Blue Shield will pay the following:
a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations;
b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services.
c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses.
3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency response sys...
Basic Benefits. Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. • Medical Expenses: Part B coinsurance (generally 20% of Medicare - approved expenses) or copayments for hospital outpatient services. Plans K, L, and N require insureds to pay a portion of Part B coinsurance or co-payments. • Blood: First three pints of blood each year. • Hospice: Part A coinsurance. Basic, including 100% Part B co- insurance Basic, including 100% Part B co- insurance Basic, including 100% Part B co- insurance Basic, including 100% Part B co- insurance Basic, including 100% Part B co- insurance Basic, including 100% Part B co- insurance Hospitalization and preventive care paid at 100%; other basic benefits paid at 50% Hospitalization and preventive care paid at 100%; other basic benefits paid at 75% Basic, including 100% Part B coinsurance Basic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled nursing facility co- insurance Skilled nursing facility co- insurance Skilled nursing facility co- insurance Skilled nursing facility co- insurance 50% Skilled nursing facility co- insurance 75% Skilled nursing facility co- insurance Skilled nursing facility co- insurance Skilled nursing facility co- insurance Part A deductible Part A deductible Part A deductible Part A deductible Part A deductible 50% Part A deductible 75% Part A deductible 50% Part A deductible Part A deductible Part B deductible Part B deductible Part B excess (100%) Part B excess (100%) Foreign travel emergency Foreign travel emergency Foreign travel emergency Foreign travel emergency Foreign travel emergency Foreign travel emergency *Plan F also has an option called a high deductible plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year $2,490 deductible. Benefits fromhigh deductible plan F will not begin until out-of-pocket expenses exceed $2,490. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan’s separate foreign travel emergency deductible. Out-of- pocket limit $6,620; paid at 100% after limit reached Out-of- pocket limit $3,310; paid at 100% after limit reached An independent licensee of the Blue Cross and Blue Shield Association. Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Fed...
Basic Benefits. You are credited with 10 days of Basic Benefits upon attainment of seniority and with 10 additional days on your employment anniversary in each subsequent year of continuous employment, up to a maximum of 130 days. When you are disabled, you will receive 75% of your basic rate of pay, from the third scheduled work day of disability and for the number of days of Basic Benefits you have to your credit, as long as the disability continues. The two-day waiting period is waived if the disability results from an accident or if you are hospitalized. In addition, if you remain disabled for fourteen (14) calendar days beginning with the first day of disability, the waiting period will also be waived and Basic Benefits will be paid retroactively to the first day of disability, provided you still have Basic Benefits available. When you return to work after an absence, the Basic Benefits period is fully reinstated once you have been back at work for at least four (4) weeks.
Basic Benefits. Upon expiration or termination of this Agreement for any reason, and subject to the provisions of Section 12(e), Executive will be entitled to: (i) payment for all Base Salary and unused vacation accrued and prorated, but unpaid, as of the effective date of termination, provided that payment for such amounts will be made no later than 30 days after the effective date of termination, (ii) payment, when due, of any earned but unpaid Incentive Bonus for the preceding fiscal year, (iii) any unreimbursed business expenses authorized by this Agreement, provided that such reimbursement will be paid to Executive no later than 30 days after the effective date of termination, (iv) continuation of any benefits under Section 6(a) as required by applicable law (e.g., COBRA), and (v) such rights as then exist with respect to then vested stock options, restricted stock or other rights under similar plans.
Basic Benefits. In the event your employment with the Company and any subsidiary of the Company terminates by reason of a Qualifying Termination within two years after a Change of Control, you shall receive, within thirty days after your employment terminates, a lump sum amount equal to Two Hundred Forty Thousand Dollars ($240,000.00). In addition, if your employment with the Company and any subsidiary by which you are employed is terminated by the Company or any such subsidiary for any reason (other than your willful misconduct or gross negligence in the performance of your duties as an employee which results in a material detriment to either the Company or the Holding Corporation) within six months prior to the occurrence of a Change of Control, you shall be paid the lump sum referred to in the immediately preceding sentence, minus the gross amount of any severance benefits otherwise paid to you, within ten days following such Change of Control.
Basic Benefits. Educational incentive pay shall not start for one year after employment with the City of San Xxxx Obispo, but credit will be given for approved education obtained prior to that time. The basic benefit will consist of $46.16 bi-weekly for possession of an A.A., or equivalent degree from an accredited community or junior college; and $92.31 bi-weekly for a B.A. or equivalent degree from an accredited four year college or university. Total incentive pay shall in no case exceed $92.31 bi-weekly.
Basic Benefits. Charges for prescribed drugs, medicines, serums and vaccines obtainable only upon a written prescription, but excluding any charges made for the administration of injectable drugs, serums and vaccines.
Basic Benefits. If (x) on or before the second anniversary of the Change of Control Date (i) the Company terminates the Executive’s employment for any reason other than for Cause or Disability or (ii) the Executive voluntarily terminates his employment for Good Reason at any time on or before the second anniversary of the Change of Control Date or (y) if the Executive voluntarily terminates his employment, with or without Good Reason, at any time within the 60 day period beginning on the 181st day following the Change of Control Date, then the Company shall pay the Executive the following amounts:
(i) the Executive’s Base Salary earned through the Date of Termination (the “Earned Salary”);
(ii) a cash amount (the “Severance Amount”) equal to one times the sum of
(A) one-half (1/2) of the Executive’s Annual Base Salary; and
(B) the amount that would have been payable to the Executive as a target bonus for the year in which the Change of Control occurs; and
(iii) any vested amounts or benefits owing to the Executive under the Company’s otherwise applicable employee benefit plans and programs, including any compensation previously deferred by the Executive (together with any accrued earnings thereon) and not yet paid by the Company and any accrued vacation pay not yet paid by the Company (the “Accrued Obligations”). The Earned Salary and Severance Amount shall be paid in a single lump sum as soon as practicable, but in no event more than ten business days (or at such earlier date required by law) following the Executive’s Date of Termination. Accrued Obligations shall be paid in accordance with the terms of the applicable plan, program or arrangement.
Basic Benefits. If on or before the second anniversary of the Change of Control Date (x) the Company terminates the Employee's employment for any reason other than for Cause or Disability or (y) the Employee voluntarily terminates his employment for Good Reason, then the Company shall pay the Employee the following amounts:
(i) the Employee's Base Salary earned through the Date of Termination (the "Earned Salary");
(ii) a cash amount (the "Severance Amount") equal to the product of two and the sum of
(A) the Employee's annual Base Salary; and
(B) the higher of the annual bonuses payable to the Employee in respect of either of the two fiscal years ended immediately preceding the fiscal year in which the Change of Control occurs; and
(iii) any vested amounts or benefits owing to the Employee under the Company's otherwise applicable employee benefit plans and programs, including any compensation previously deferred by the Employee (together with any accrued earnings thereon) and not yet paid by the Company and any accrued vacation pay not yet paid by the Company (the "Accrued Obligations"). The Earned Salary and Severance Amount shall be paid in a single lump sum as soon as practicable, but in no event more than ten business days (or at such earlier date required by law) following the Employee's Date of Termination. Accrued Obligations shall be paid in accordance with the terms of the applicable plan, program or arrangement. In addition to the other benefits provided in this Section, on the Change of Control Date, the Employee shall, subject to the provisions of Section 3(e)(iii), become fully vested in any and all outstanding stock options granted to Employee for shares of common stock of the Company or to the extent that such options are not vested, shall receive a lump-sum cash payment equal to the spread of all non-vested, forfeited options as of the date such options are forfeited.
Basic Benefits. Upon expiration or termination of this Agreement for any reason, and subject to the provisions of Section 12(e) below, Executive will be entitled to: (i) payment for all Base Salary and unused vacation accrued and prorated, but unpaid, as of the effective date of termination, (ii) payment, when due, of any earned but unpaid Incentive Bonus for the preceding fiscal year, (iii) any unreimbursed business expenses authorized by this Agreement, (iv) continuation of any benefits under Section 6 as required by applicable law, and (v) such rights as then exist with respect to then vested stock options, restricted stock or other rights under similar plans
