Duplicate Coverage. PROVIDER will collect information concerning duplicate coverage, workers’ compensation and personal injury liability at the time of treatment or admission and will provide such information to MSHN. In the event that benefits available through MSHN are determined to be secondary to those of any other health care coverage with respect to Covered Services, PROVIDER shall seek reimbursement pursuant to such other coverage prior to submitting a claim to MSHN. Any secondary payment shall be determined in accordance with applicable terms of MSHN policies and procedures and Medicaid Plan in effect for each consumer, taking into account amounts billed to and that portion paid by the primary payor. PROVIDER shall cooperate in administering coordination of benefits and other third-party reimbursement provisions. PROVIDER agrees to accept the lesser of the primary allowable or MSHN contracted amount as payment in full for a covered service or activity if MSHN is the secondary coverage for any combination of payors, including other carriers which pay before MSHN in the coordination of benefits order of benefit determination.
Duplicate Coverage. This subsection applies to married ACFD employees, employees in domestic partnerships (as defined in Appendix C-Domestic Partner), and employees in parent-young adult dependent (YAD) relationships where the YAD employee is under age 26 when both parties are employed by the ACFD. The intent of this subsection is to limit ACFD employees from both covering each other or having duplicate coverage within the same dental plan. Married ACFD employees and employees in domestic partnerships who are both employed by the ACFD, shall be entitled to up to one (1) choice from the following list of dental plan coverages, if eligible to elect such options:
a. Up to one (1) full family PPO plan together with up to one (1) PPO supplemental plan;
b. Up to one (1) full family PPO plan. For ACFD employees in a parent-YAD relationship, the YAD employee cannot have duplicate coverage within the same plan as the parent employee if the parent employee has the YAD employee on a family plan.
Duplicate Coverage. This subsection applies to married County employees, employees in domestic partnerships (as defined in Appendix C), and employees in parent-young adult dependent (YAD) relationships where the YAD employee is under age 26 when both parties are employed by the County. The intent of this subsection is to limit County employees from both covering each other or having duplicate coverage within the same dental plan. Married County employees and employees in domestic partnerships who are both employed by the County, shall be entitled to one (1) choice from the following list of dental plan coverages:
a. Up to one (1) full family PPO plan together with up to one (1) PPO supplemental plan;
b. Up to one (1) full family PPO plan together with up to one (1) full family DHMO plan;
c. Up to one (1) full family DHMO plan; or
d. Up to one (1) full family PPO plan. For County employees in a parent-YAD relationship, the YAD employee cannot have duplicate coverage within the same plan as the parent employee if the parent employee has the YAD employee on a family plan.
Duplicate Coverage. When a member of the bargaining unit and a spouse are both employees of the City of East Providence, then the City of East Providence need not buy both spouses medical or dental coverage, but the City shall provide the member and spouse with the plan having the best coverage for the spouses so employed. In the event the spouse employed with the coverage shall retire, resign, or be terminated for any reason, then the spouse without the coverage shall be immediately granted the coverage of that employee's bargaining unit without any waiting period. In the event the spouse without the coverage shall receive a better plan than the other spouse during the course of any negotiations, the City shall immediately implement the better of the two plans in conformance with the spirit of this Section.
Duplicate Coverage. If both husband and wife are employed by the District, they may carry only one hospitalization and one dental insurance policy between them.
Duplicate Coverage. If the Insured Person effects coverage under more than one Generali Travel Insurance policy, annual or for single trip, for the same Covered Trip, then the Company will only be liable to pay for one covered loss under all such policies, whichever is highest. This Policy, together with the Schedule, all amendments and any other documents attached hereto, constitute the entire contract of insurance. No change in this Policy will be valid unless and until approved by the Company in writing and unless such approval is endorsed hereon or attached hereto and signed by an authorized representative of the Company. If a proposal form is completed by the Policyholder or the Insured Person, that proposal form will be part of the Policy.
Duplicate Coverage. Insurance contracts entered into by the Board shall contain duplicate coverage, or coordination of benefits, clauses.
Duplicate Coverage. This subsection applies to married County employees, employees in domestic partnerships (as defined in Appendix B), and employees in parent-young adult dependent (YAD) relationships where the YAD employee is under age 26, when both parties are both employed by the County. The intent of this subsection is to limit County employees from both covering each other or having duplicate coverage within the same dental plan. Married County employees and employees in domestic partnerships who are both employed by the County, shall be entitled to one (1) choice from the following list of dental plan coverages: • Up to one (1) full family PPO plan together with up to one (1) PPO supplemental plan. • Up to one (1) full family PPO plan or Operating Engineers plan together with up to one (1) full family DHMO plan. • Up to one (1) full family DHMO plan. • Up to one (1) full family PPO plan or Operating Engineers plan. For County employees in a parent-YAD relationship, the YAD employee cannot have duplicate coverage within the same plan as the parent employee if the parent employee has the YAD employee on a family plan. Effect of Leave Without Pay and Re-Enrollment: Employees on leave without pay (including vacation purchase hours referenced in subsection 10.M. (Vacation Purchase Plan)) during a pay period that the semi-monthly premium is paid, who are on paid status less than fifty percent (50%) of the normal full-time biweekly pay period, shall be responsible for one hundred percent (100%) of the semi-monthly dental premium. Employees may elect to continue uninterrupted dental coverage for the duration of their leave without pay by paying 100% of their current plan’s dental premiums or enroll in and pay 100% of the premiums of a lower level of dental plan coverage while on leave without pay. Employees who elect to enroll in and pay for a lower level of dental plan coverage while on leave without pay shall maintain the same lower level of coverage through the duration of the Plan Year and may only restore to their prior level of coverage during Open Enrollment. Failure to pay for premiums will result in a lapse of coverage. Employees on leave without pay, who lose their dental plan coverage for a duration of three (3) months or less, will be able to re-enroll as a continuing member in the same plan under which they had coverage prior to the leave by completing the appropriate enrollment form within 30 calendar days of the date they return to work. The deductibles, maximum...
Duplicate Coverage. This section applies to married County employees (and employees in domestic partnerships (as defined in Appendix B) when both are employed by the County. The intent of this section limits County employees who are married or in a domestic partnership from both covering each other within the same medical plan. Married County employees and employees in a domestic partnership, both employed by the County, shall be entitled to one choice from the following list of medical plan coverages:
a. Up to one full family PPO/ Indemnity membership.
b. Up to one full family HMO membership.
c. Up to one full family HMO membership together with up to one full family PPO/Indemnity membership.
d. Up to one full HMO membership with up to one full family alternative HMO option membership.
Duplicate Coverage. When a member of the bargaining unit and a spouse are both employees of the City of East Providence, then the City of East Providence need not buy both employees health or dental coverage; but the City shall provide the spouse so employed with the better of either plan. In the event the spouse employed with the coverage shall retire, resign or be terminated for any reason, then the other spouse without the coverage shall be immediately granted coverage without any waiting period. In the event the spouse without coverage shall receive a better plan than the other spouse during the course of any negotiations, the City shall immediately implement the better of the two plans in conformance with the spirit of this section.
