Benefit Period Maximum Clause Samples
The Benefit Period Maximum clause defines the longest duration for which benefits will be paid under an insurance policy or benefits plan. Typically, this clause specifies a set number of months or years, or it may end when a certain event occurs, such as the insured reaching a particular age. For example, disability insurance might pay benefits for up to two years from the date of disability, regardless of whether the condition persists beyond that period. The core function of this clause is to limit the insurer's or plan provider's financial exposure by capping the total time benefits are payable, thereby providing predictability and managing risk for both parties.
Benefit Period Maximum. The Benefit Period Maximum is the maximum dollar amount the Plan will pay for all Covered Services for each Subscriber during a Benefit Period, according to the terms of this Contract and the coverage outlined in the Schedule of Benefits. Each Subscriber’s Benefit Period Maximum amount is given on the Schedule of Benefits. Orthodontic Services, if covered under this Contract, do not apply to the Benefit Period Maximum.
Benefit Period Maximum. The maximum We pay for specific Covered Services during a Benefit Period.
Benefit Period Maximum. A Benefit Period Maximum is the limit of coverage placed on a specific Benefit(s) provided under this coverage within a Benefit Period. Such limits on Benefits may be in the form of visit limits, day limits, or dollar limits; and there may be more than one limit on a specific Benefit. This coverage has no dollar limits on Essential Health Benefits, as that term is defined by PPACA. Members should refer to the Summary of Cost Sharing and Benefits to determine if any Benefit Period Maximums apply to their coverage.