Calculation of Years of Coverage Sample Clauses

Calculation of Years of Coverage. For each Participating Class Member, Blue Cross will calculate the number of years that the Participating Class Member purchased a fully insured contract during the Class Period. The years do not need to be consecutive. A consecutive twelve-month period cannot count toward more than one year. For example, if several subgroups have been combined into a single entity for purposes of Distribution Eligibility, as described in Paragraph 20(A), above, then the Participating Class Member cannot claim the same calendar year as counting toward more than one year of purchase. For purposes of weighting the calculation of distribution, Participating Class Members will be placed into one of three categories: (a) those Participating Class Members that have contracted with Blue Cross for at least one full day but less than one year, as of the Eligibility Date; (b) those Participating Class Members that have contracted with Blue Cross for one year but less than three years, as of the Eligibility Date; and (c) those Participating Class Members that have contracted with Blue Cross for three or more years, as of the Eligibility Date. Groups that have contracted with Blue Cross for one year but less than three years, will receive four times more than groups of the same size category that contracted with Blue Cross for at least one full day but less than one year, but subject to the maximum distribution provision in subparagraph G, below. Groups that have contracted with Blue Cross for three or more years will receive nine times more than groups of the same size category that contracted with Blue Cross for at least one full day but less than one year, but subject to the maximum distribution provision in subparagraph G, below. See Exh. 1.
Sample 1
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Related to Calculation of Years of Coverage

  • 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.

  • Termination of Coverage This Contract may be terminated as follows:

  • Dual Coverage A. Each employee and retiree may be covered only by a single County health (and/or dental) plan, including a CalPERS plan. For example, a County employee may be covered under a single County health and/or dental plan as either the primary insured or the dependent of another County employee or retiree, but not as both the primary insured and the dependent of another County employee or retiree.

  • Duration of Coverage All required insurance shall be maintained during the entire term of the Agreement. In addition, Insurance policies and coverage(s) written on a claims-made basis shall be maintained during the entire term of the Agreement and until 3 years following the later of termination of the Agreement and acceptance of all work provided under the Agreement, with the retroactive date of said insurance (as may be applicable) concurrent with the commencement of activities pursuant to this Agreement. 3.

  • COMPUTATION OF BACK WAGES No claim for back wages shall exceed the amount of wages the employee would otherwise have earned at the employee's regular rate less:

  • Individual Coverage If you have Individual Coverage, only your own health care expenses are cov­ ered, not the health care expenses of other members of your family. FAMILY COVERAGE Under Family Coverage, your health care expenses and those of your enrolled spouse and your (and/or your spouse's) enrolled children who are under the limit­ ing age specified in the BENEFIT HIGHLIGHTS section of this Certificate will be covered. All of the provisions of this Certificate that pertain to a spouse also apply to a party of a Civil Union unless specifically noted otherwise. “Child(ren)” used hereafter in this Certificate, means a natural child(ren), a step­ child(xxx), adopted child(xxx), xxxxxx child(xxx), a child(ren) for whom you are the legal guardian or a child(xxx) for whom you have received a court order requiring that you are financially responsible for providing coverage under 26 years of age. a child(xxx) who is in your custody under an interim court order prior to finaliza­ tion of adoption or placement of adoption vesting temporary care, whichever comes first, child(xxx) for whom you are the legal guardian under 26 years of age, regardless of presence or absence of a child's financial dependency, residency, student status, employment status, marital status, eligibility for other coverage or any combination of those factors. In addition, enrolled unmarried children will be covered up to the age of 30 if they: • Live within the service area of the Plan network for this Certificate; and • Have served as an active or reserve member of any branch of the Armed Forces of the United States; and • Have received a release or discharge other than a dishonorable discharge. Coverage for children will end on the last day of the calendar month in which the limiting age birthday falls. If you have Family Coverage, newborn children will be covered from the moment of birth. Please notify the Plan within 31 days of the birth so that your member­ ship records can be adjusted. Your Group Administrator can tell you how to submit the proper notice through the Plan. Children who are under your legal guardianship or who are in your custody under an interim court order prior to finalization of adoption or placement of adoption vesting temporary care, whichever comes first, and xxxxxx children will be cov­ ered. In addition, if you have children for whom you are required by court order to provide health care coverage, those children will be covered. Any children who are incapable of self‐sustaining employment and are dependent upon you or other care providers for lifetime care and supervision because of a disabled condition occurring prior to reaching the limiting age will be covered regardless of age as long as they were covered prior to reaching the limiting age specified in the BENEFIT HIGHLIGHTS section. This coverage does not include benefits for grandchildren (unless such children have been legally adopted or are under your legal guardianship). Coverage under this Certificate is contingent upon timely receipt by the Plan of necessary information and initial premium. MEDICARE ELIGIBLE COVERED PERSONS A series of federal laws collectively referred to as the ``Medicare Secondary Payer'' (MSP) laws regulate the manner in which certain employers may offer group health care coverage to Medicare eligible employees, spouses, and in some cases, dependent children. Reference to spouse under this section do not include a party to a Civil Union with the Eligible Person or their children. The statutory requirements and rules for MSP coverage vary depending on the basis for Medicare and employer group health plan (“GHP”) coverage, as well as certain other factors, including the size of the employers sponsoring the GHP. In general, Medicare pays secondary to the following:

  • Duration of Insurance Contribution An employee is eligible for School District contributions as provided in this Article as long as an employee is employed by the School District. Employees whose employment terminates during the school year will be eligible for insurance and district contributions to insurance through the end of the month in which they terminate provided they pay the employee portion of the insurance premium for that month. Otherwise, the employee’s insurance will terminate as of the last day of employment.

  • 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.

  • COMPUTATION OF BENEFITS All hours paid to an employee shall be considered as hours worked for the purpose of computing any of the benefits under this Agreement.

  • Spousal Coverage Any new Participants to the COG, after June 30, 2015, with working spouses who have the ability to be covered under an insurance plan through his/her place of employment, will be required to take his/her plan as their primary plan. This provision does not apply to a participant who had insurance with one COG employer and immediately thereafter, moved to another COG employer. If the spouse is required to pay forty (40%) percent or more of the premium with his/her employer, the requirements of this section shall not apply.

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