Common use of Benefit Program Design Clause in Contracts

Benefit Program Design. Under a Point of Service Benefit Program, Members may elect, at the time of obtaining each Covered Service, to utilize either: (1) HMO coverage through their selected or assigned PCP; (2) optional Preferred Provider Organization (“PPO”) coverage available through PPO Participating Providers; or (3) other indemnity coverage through either non-Participating Providers, or Participating Providers where other Benefit Program Requirements are not met.

Appears in 4 contracts

Samples: Provider Services Agreement (Prospect Medical Holdings Inc), Provider Services Agreement (Prospect Medical Holdings Inc), Group Provider Services Agreement (Prospect Medical Holdings Inc)

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Benefit Program Design. Under a Point of Service Benefit ----------------------- Program, Members Beneficiaries may elect, at the time of obtaining each Covered Medical Service, to utilize either: (1) HMO coverage through their selected or assigned PCP; (2) optional Preferred Provider Organization (“PPO”) coverage available through PPO Participating Providers; or (3) other indemnity coverage through either non-Participating Providersnonparticipating providers, or Participating Providers where other Benefit Program Requirements are not met; or (3) optional Preferred Provider Organization ("PPO") coverage by self-referring to PPO Participating Providers.

Appears in 1 contract

Samples: Facility Provider Agreement (Option Care Inc/De)

Benefit Program Design. Under a Point of Service Benefit ---------------------- Program, Members Beneficiaries may elect, at the time of obtaining each Covered Medical Service, to utilize either: (1) HMO coverage through their selected or assigned PCP; (2) optional Preferred Provider Organization (“PPO”) coverage available through PPO Participating Providers; or (3) other indemnity coverage through either non-Participating Providersnonparticipating providers, or Participating Providers where other Benefit Program Requirements are not met; or (3) optional PPO coverage by self-referring to PPO Participating Providers.

Appears in 1 contract

Samples: Facility Provider Agreement (Option Care Inc/De)

Benefit Program Design. Under a Point of Service Benefit Program, Members may elect, at the time of obtaining each Covered Service, to utilize either: either (1) HMO coverage through their selected or assigned PCP; (2) optional Preferred Provider Organization (“PPO”) coverage available through PPO Participating Providers; or (3) other indemnity coverage through either non-Participating Providers, or Participating Providers where other Benefit Program Requirements are not met.

Appears in 1 contract

Samples: Dental Services (Prospect Medical Holdings Inc)

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Benefit Program Design. Under a Point of Service Benefit Program, Members may elect, at the time of obtaining each Covered Service, to utilize either: (1) HMO coverage through their selected or assigned PCP; : (2) optional Preferred Provider Organization (“PPO”) coverage available through PPO Participating Providers; or (3) other indemnity coverage through either non-Participating Providers, or Participating Providers where other Benefit Program Requirements are not met.

Appears in 1 contract

Samples: Group Provider Services Agreement (Prospect Medical Holdings Inc)

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