Covered Dependent. Any person in a Subscriber’s family who meets all the eligibility requirements of the Eligibility and Enrollment section of this Certificate and the Dependent Eligibility section of the Schedule of Benefits, has enrolled in HMO, and is subject to Premium requirements set forth in the Premiums section of the Group Agreement.
Covered Dependent. Shall be defined as a Dependent eligible to receive benefits under the terms of this Plan.
Covered Dependent. Any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate and has enrolled and complied with the Premium requirements. Covered Services Those charges for Medically Necessary health care services, treatment and supplies intended to improve a condition or Member’s health that are (a) defined as Covered Services in the Member’s Contract, (b) not excluded under such Contract, (c) not Experimental or Investigational and (d) provided in accordance with such Contract. Covered Services are determined based upon all other Contract provisions. When more than one treatment option is available, and one option is no more effective than another, the Covered Service is the least costly option that is no less effective than any other option. The Covered Services are also subject to the Maximum Allowable Cost (MAC), as defined herein and all Contract exclusions will be taken into consideration to determine the Covered Service. Creditable Coverage Coverage under another health benefit plan is medical expense coverage with no greater than a ninety (90) day gap in coverage under any of the following: (a) Medicare or Medicaid; (b) an employer-based accident and sickness insurance or health benefit arrangement; (c) an individual accident and sickness insurance policy; (d) a spouse’s benefits or coverage under Medicare or Medicaid or an employer-based health insurance benefit arrangement; (e) a conversion policy; or similar coverage as defined in OCGA 33-30-15.
Covered Dependent. Any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate and has enrolled and complied with the Premium requirements set forth in the Group Health Care Contract.
Covered Dependent. A Covered Dependent’s coverage will automatically end at 12:01 a.m. on the termination date provided in your termination notice. A Covered Dependent’s coverage will end for the following reasons:
Covered Dependent. If your employer purchased this coverage outside of the Health Insurance Marketplace then if eligible, any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate Booklet, has enrolled in Alliant’s healthcare Plan, and is subject to Premium requirements set forth in the Group Master Contract.
Covered Dependent. If your employer purchased this coverage outside of the Health Insurance Marketplace then if eligible, any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate Booklet, has enrolled in Alliant’s healthcare Plan, and is subject to Premium requirements set forth in the Group Master Contract. Covered Services Those charges for Medically Necessary health care services and supplies that are (a) defined as Covered Services in the Member’s Contract, (b) not excluded under such Contract, (c) not Experimental or Investigational and (d) provided in accordance with such contract. Creditable Coverage Coverage under another health benefit plan is medical expense coverage with no greater than a 90- day gap in coverage under any of the following: (a) Medicare or Medicaid; (b) an employer-based accident and sickness insurance or health benefit arrangement; (c) an individual accident and sickness insurance policy; (d) a spouse’s benefits or coverage under Medicare or Medicaid or an employer-based health insurance benefit arrangement; (e) a conversion policy; or similar coverage as defined in OCGA 33-30-15.
Covered Dependent. Any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate and has enrolled and complied with the Premium requirements set forth in the Group Health Care Contract. Covered Services Those charges for Medically Necessary health care services, treatment and supplies intended to improve a condition or Member’s health that are (a) defined as Covered Services in the Member’s Contract, (b) not excluded under such Contract, (c) not Experimental or Investigational and (d) provided in accordance with such Contract. Covered Services are determined based upon all other Contract provisions. When more than one treatment option is available, and one option is no more effective than another, the Covered Service is the least costly option that is no less effective than any other option. The Covered Services are also subject to the Maximum Allowable Cost (MAC), as defined herein and all Contract exclusions will be taken into consideration to determine the Covered Service. Creditable Coverage Coverage under another health benefit plan is medical expense coverage with no greater than a ninety (90) day gap in coverage under any of the following: (a) Medicare or Medicaid; (b) an employer-based accident and sickness insurance or health benefit arrangement; (c) an individual accident and sickness insurance policy; (d) a spouse’s benefits or coverage under Medicare or Medicaid or an employer-based health insurance benefit arrangement; (e) a conversion policy; or similar coverage as defined in OCGA 33-30-15.
Covered Dependent. Any Dependent in a Subscriber’s family who meets all the requirements of the Eligibility section of this Certificate and has enrolled and complied with the Premium requirements. Covered Services Those charges for Medically Necessary health care services, treatment and supplies intended to improve a condition or Member’s health that are (a) defined as Covered Services in the Member’s Contract, (b) not excluded under such Contract, (c) not Experimental or Investigational and (d) provided in accordance with such Contract. Covered Services are determined based upon all other Contract provisions. When more than one treatment option is available, and one option is no more effective than another, the Covered Service is the least costly option that is no less effective than any other option. The Covered Services are also subject to the Maximum Allowable Cost (MAC), as defined herein and all Contract exclusions will be taken into consideration to determine the Covered Service. Creditable Coverage Coverage under another health benefit plan is medical expense coverage with no greater than a ninety (90) day gap in coverage under any of the following: (a) Medicare or Medicaid; (b) an employer-based accident and sickness insurance or health benefit arrangement; (c) an individual accident and sickness insurance policy; (d) a spouse’s benefits or coverage under Medicare or Medicaid or an employer-based health insurance benefit arrangement; (e) a conversion policy; or similar coverage as defined in OCGA 33-30-15. Custodial Care Any type of care, including room and board, that (a) does not require the skills of professional or technical personnel; (b) is not furnished by or under the supervision of such personnel or does not otherwisemeet the requirements of post-hospital Skilled Nursing Facility care; (c) is a level such that the Member has reached the maximum level of physical or mental function and is not likely to make further significant improvement. Deductible The portion of the xxxx you must pay before your medical expenses become reimbursable. It is applied on a calendar year basis. Dependent The spouse and all children until attaining age 26. Children include natural children, legally adopted children and stepchildren. Also included are your children (or children of your spouse) for whom you have legal responsibility resulting from a valid court decree. Xxxxxx children whom you expect to raise to adulthood and who live with you in a regular parent-child relationshi...
