Dental Plan Definitions Sample Clauses

Dental Plan Definitions. The following are words that have special or technical meanings under the pediatric dental services and Benefits described in this Part, and made available under this Contract. a. Accepted Fee means the amount the attending Dental Provider agrees to accept as payment in full for services rendered. b. Benefits mean the amounts that will be paid for covered pediatric dental services. c. Claim Form means the standard form used to file a dental claim, request a dental Pre-Treatment Estimate, or request Prior Authorization. d. Contract Benefit Level is the percentage of the Maximum Contract Allowance paid under the dental plan. e. Dental Deductible means the dollar amount that an Enrollee must satisfy for certain covered dental services before dental Benefits are paid. f. Dental Out-of-Pocket Maximum means the maximum amount that a Member will pay during a Calendar Year for Pediatric dental Benefits from a PPO Provider before Delta Dental begins to pay 100% of the PPO Contracted Fee. Coinsurance and other cost-sharing, including balance billed amounts, will continue to apply for covered Dental Services from Dental Premier Providers and Non-Participating Providers even after the Out-of-Pocket Maximum has been met. g. Dental Provider means a person licensed to practice dentistry when and where services are performed and may be referred to as a “PPO Provider”, a “Premier Provider” or a “Non-Delta Dental Provider”. A Dental Provider will also include a dental partnership, dental professional corporation or dental clinic. h. Eligible Pediatric Individual means a Covered Dependent child under age 20 who is eligible for the pediatric dental Benefits described herein. i. Enrollee means a Covered Dependent child who is an Eligible Pediatric Individual (“Pediatric Enrollee”) enrolled to receive Benefits under the dental plan.
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Dental Plan Definitions. The following are words that have special or technical meanings under the pediatric dental services and Benefits described in this Part, and made available under this Contract. a. Accepted Fee means the amount the attending Dental Provider agrees to accept as payment in full for services rendered. b. Benefits mean the amounts that will be paid for covered pediatric dental services.
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Dental Plan Definitions. The following are words that have special or technical meanings under the pediatric dental services and Benefits described in this Part, and made available under this Contract.
Sample 1

Related to Dental Plan Definitions

  • Plan Definitions Except where the context clearly implies or indicates the contrary, a word, term, or phrase used in the Plan is similarly used in this Agreement.

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  • SECTION I - DEFINITIONS As used in this Agreement, the following terms shall have the meanings ascribed herein unless otherwise stated or reasonably required by the Agreement, and other forms of any defined words shall have a meaning parallel thereto.

  • ARTICLE I DEFINITIONS 1 SECTION 1.01.

  • DPA Definitions The definition of terms used in this DPA is found in Exhibit “C”. In the event of a conflict, definitions used in this DPA shall prevail over terms used in any other writing, including, but not limited to the Service Agreement, Terms of Service, Privacy Policies etc.

  • Transfer Definitions For purposes of this Article 7 “

  • Change in Control Definition For purposes of this Agreement, “Change in Control” shall mean the occurrence of any of the following events, provided that such event or occurrence constitutes a change in the ownership or effective control of the Company, or a change in the ownership of a substantial portion of the assets of the Company, as defined in Treasury Regulation §§ 1.409A-3(i)(5)(v), (vi) and (vii): (i) the acquisition by an individual, entity or group (within the meaning of Section 13(d)(3) or 14(d)(2) of the Securities Exchange Act of 1934 (the “Exchange Act”)) (a “Person”) of beneficial ownership of any capital stock of the Company if, after such acquisition, such Person beneficially owns (within the meaning of Rule 13d-3 under the Exchange Act) fifty percent (50%) or more of either (x) the then-outstanding shares of common stock of the Company (the “Outstanding Company Common Stock”) or (y) the combined voting power of the then-outstanding securities of the Company entitled to vote generally in the election of directors (the “Outstanding Company Voting Securities”); provided, however, that for purposes of this subsection (i), the following acquisitions shall not constitute a Change in Control: (1) any acquisition directly from the Company or (2) any acquisition by any entity pursuant to a Business Combination (as defined below) which complies with clauses (x) and (y) of subsection (iii) of this definition; or (ii) a change in the composition of the Board that results in the Continuing Directors (as defined below) no longer constituting a majority of the Board (or, if applicable, the Board of Directors of a successor corporation to the Company), where the term “Continuing Director” means at any date a member of the Board (x) who was a member of the Board on the Effective Date or (y) who was nominated or elected subsequent to such date by at least a majority of the directors who were Continuing Directors at the time of such nomination or election or whose election to the Board was recommended or endorsed by at least a majority of the directors who were Continuing Directors at the time of such nomination or election; provided, however, that there shall be excluded from this clause (y) any individual whose initial assumption of office occurred as a result of an actual or threatened election contest with respect to the election or removal of directors or other actual or threatened solicitation of proxies or consents, by or on behalf of a person other than the Board; or (iii) the consummation of a merger, consolidation, reorganization, recapitalization or share exchange involving the Company, or a sale or other disposition of all or substantially all of the assets of the Company (a “Business Combination”), unless, immediately following such Business Combination, each of the following two (2) conditions is satisfied: (x) all or substantially all of the individuals and entities who were the beneficial owners of the Outstanding Company Common Stock and Outstanding Company Voting Securities immediately prior to such Business Combination beneficially own, directly or indirectly, more than fifty percent (50%) of the then-outstanding shares of common stock and the combined voting power of the then-outstanding securities entitled to vote generally in the election of directors, respectively, of the resulting or acquiring corporation in such Business Combination (which shall include, without limitation, a corporation which as a result of such transaction owns the Company or substantially all of the Company’s assets either directly or through one (1) or more subsidiaries) (such resulting or acquiring corporation is referred to herein as the “Acquiring Corporation”) in substantially the same proportions as their ownership of the Outstanding Company Common Stock and Outstanding Company Voting Securities, respectively, immediately prior to such Business Combination and (y) no Person (excluding any employee benefit plan (or related trust) maintained or sponsored by the Company or by the Acquiring Corporation) beneficially owns, directly or indirectly, fifty percent (50%) or more of the then-outstanding shares of common stock of the Acquiring Corporation, or of the combined voting power of the then-outstanding securities of such corporation entitled to vote generally in the election of directors (except to the extent that such ownership existed prior to the Business Combination); or (iv) the liquidation or dissolution of the Company.

  • UCC Definitions Unless otherwise defined herein or the context otherwise requires, terms for which meanings are provided in the UCC are used in this Security Agreement, including its preamble and recitals, with such meanings.

  • – SCOPE & DEFINITIONS 2.01 The Employer recognizes the Union as the bargaining agent of all Registered and Graduate Nurses employed by Revera Long Term Care Inc. operating as Columbia Forest Long Term Care Centre, Waterloo, Ontario, in a nursing capacity save and except the Assistant Director of Care and persons above the rank of Assistant Director of Care. (a) A full-time employee shall mean an employee covered by this Agreement who is committed to and regularly works the full work period of seventy- five (75) bi-weekly hours, exclusive of overtime. (b) A regular part-time employee is one who is committed to and regularly works less than the full prescribed bi-weekly hours of work. (c) A casual part-time employee means an employee who is called to work on a call in basis, but who does not work a regular schedule, or does so only for a specified period. Such employee has the option of refusing work when it is made available to her, however, it is also understood that a casual part-time employee cannot unreasonably or consistently refuse to work shifts. 2.03 Whenever the feminine pronoun is used in this agreement, it includes the masculine pronoun, where the context so requires and vice-versa. Where the singular is used, it may also be deemed to mean the plural and vice-versa.

  • Definition of the Terms “Business Day”, “Affiliate” and “Subsidiary”. For purposes of this Agreement, (a) “business day” means each Monday, Tuesday, Wednesday, Thursday or Friday that is not a day on which banking institutions in New York are generally authorized or obligated by law or executive order to close, and (b) “affiliate” and “subsidiary” have the meanings set forth in Rule 405 under the Securities Act.

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