Limitations/Terms of Coverage Sample Clauses

Limitations/Terms of Coverage. 1. When You are receiving inpatient care in a Facility, We will not cover additional charges for medications and supplies You take home from the Facility.
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Limitations/Terms of Coverage. Ambulance services are covered only when Medically Necessary, except: o When ordered by an employer, school, fire or public safety official and the Member is not in a position to refuse; or o When a Member is required by Us to move from a Non-Network Provider to a Network Provider. • We do not cover travel or transportation expenses, unless connected to an Emergency Medical Condition or due to a Facility transfer approved by Us, even though prescribed by a Physician. • We do not cover: o Non-ambulance transportation such as ambulette, van or taxi cab; o Trips to a Physician’s office or clinic; or o Trips to a morgue or funeral home. • Ambulance trips must be made to the closest local facility that can give Covered Services appropriate for Your condition. If none of these facilities are in Your local area, You are covered for trips to the closest facility outside Your local area. Ambulance usage is not covered when another type of transportation can be used without endangering the Member’s health. Any ambulance usage for the convenience of the Member, family or Physician is not a Covered Service.

Related to Limitations/Terms of Coverage

  • Terms of Coverage The plan takes effect upon check-in on the booked arrival date to an iTrip unit. All coverage shall terminate upon normal check-out time of the iTrip unit or the departure of the Covered Guest, whichever occurs first.

  • Limitations of Coverage For the repair or replacement of the outside line, we will pay a maximum of $2,000 in the aggregate per Agreement term. After the outside gas service line is repaired or replaced, our independent service provider will provide basic site restoration to the affected area, limited to backfill of excavated soil, raking and reseeding.

  • 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.

  • Types of Coverage We offer the following types of coverage:

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

  • Waiver of Coverage Any bargaining unit member covered under family coverage of the school district’s health insurance who is eligible for family coverage or any bargaining unit member who subsequently becomes eligible for family coverage because of a change in marital status, who declares in writing to the District Treasurer before September 15 that he/she does not elect to be covered under one of the District’s insurance options under Section A and E for the entire school year may opt out of the District Plan, if he/she is covered by another plan outside the District. Said election shall be effective at the 1st day of the month following election and shall continue until a new election is made pursuant to the provisions of this section. Additionally, employees hired after September 1 and employees who first become eligible for benefits after September 1 may declare in writing to the District Treasurer that he/she does not elect to be covered under Section A and E or the remainder of the period from the date of hire through the subsequent August 31 may opt out of the District Plan, if he/she is covered by another plan outside the District. If an employee opts out of the medical plan coverage of the District, that employee may only be permitted to change his/her election and to reenroll under the health plan prior to the following August 31 if (1) there has been a change in status that would permit the employee to change his/her election under the applicable rules and regulations of the IRS under Section 125 of the Federal tax law, and (2) such change would be a qualifying event defined by the health plan of the school district. If the employee’s election of no coverage remains in effect until the following August 31, said bargaining unit member shall be paid $1,000 for the 12-month period from the effective date of his/her election [or number of months employed or eligible for benefits to August 31 if a new employee or first time eligible employee or to the end of the month for which coverage has not been received if the election is changed as permitted in this paragraph] (prorated for persons who have prorated insurance to the same percentage as paid by the Board for prorated insurance). The payment provided in this section shall be paid in a lump sum no later than June 30 in that school year that coverage was waived. Any bargaining unit member under single coverage of the school district’s health insurance plan who declares in writing to the District Treasurer before September 15 that he/she does not elect to be covered under one of the District’s insurance options under Section A and E for the entire school year may opt out of the District Plan, if he/she is covered by another plan outside the District. Said election shall be effective at the first day of the month following election and shall continue until a new election is made pursuant to the provisions of this section. Additionally, employees hired after September 1 and employees who first become eligible for benefits after September 1 may declare in writing to the District Treasurer that he/she does not elect to be covered under section A and E for the remainder of the period from the date of hire through the subsequent August 31 may opt out of the District Plan, if he/she is covered by another plan outside the District. If an employee opts out of the medical plan coverage of the District, that employee may only be permitted to change his/her election and to reenroll under the health plan prior to the following August 31 if (1) there has been a change in status that would permit the employee to change his/her election under the applicable rules and regulations of the IRS and under Section 125 of the Federal tax law, and (2) such change would be a qualifying event defined by the health plan of the school district. If the employee’s election of no coverage remains in effect until the following August 31, said bargaining unit member shall be paid $500 for the 12-month period from the effective date of his/her election [or number of months employed or eligible for benefits to August 31 if a new employee or first time eligible employee or to the end of the month for which coverage has not been received if the election is changed as permitted in this paragraph] (prorated for persons who have prorated insurance to the same percentage as paid by the Board for prorated insurance). The payment provided in this section shall be paid in a lump sum no later than June 30th in that school year that coverage was waived.

  • Agreement of Coverage  The Eligible Person and/or Dependent loses eligibility under Medicaid or Children's Health Insurance Program (CHIP). Coverage will begin only if SHL receives the completed enrollment form and any required Premium within 60 days of the date coverage ended.  Any other event which affects a Dependent’s eligibility. If the Subscriber fails to give notice which would have resulted in termination of coverage, SHL shall have the right to terminate coverage. A Dependent’s coverage terminates on the same day as the Subscriber.

  • COLORADO SPECIAL PROVISIONS (COLORADO FISCAL RULE 3-3) These Special Provisions apply to all contracts except where noted in italics.

  • Insurance Terms and Conditions Company must maintain the following limits and coverages uninterrupted or amended through the term of this Agreement. In the event Company becomes in default of the following requirements, Authority reserves the right to take whatever actions it deems necessary to protect its interests. Required liability policies other than Workers’ Compensation / Employer’s Liability will provide that Authority, members of Authority’s governing body, and Authority’s officers, volunteers and employees are included as additional insureds.

  • GENERAL TERMS & CONDITIONS 23.1 TRAINING: Service Provider shall train designated Bank officials on the configuration, operation/ functionalities, maintenance, support & administration for software, application architecture and components, installation, troubleshooting processes of the proposed Services as mentioned in this Agreement.

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