Maximum Benefit Payments Sample Clauses

Maximum Benefit Payments. The maximum annual benefit payment is (b) (4) of paid allowable charges, per enrollee per contract year. The maximum lifetime benefit for orthodontic services is (b) (4) per enrollee. The allowable amount paid by the contractor for some diagnostic and preventive care services (except sealants), and emergency services shall not be included in the annual benefit maximum (See Attachment 2, Benefits, Exclusions and Limitations for a complete listing). In addition, the allowable amounts paid for all other covered services shall be included in the annual benefit maximum. Enrollee cost shares shall not count against benefit maximums. C.5.5.1. In OCONUS areas, the allowable charges used to reach the annual benefit maximum shall be calculated based on the contractor’s approved provider fee schedule. The contractor shall base its allowable charge schedule on the ninety-fifth (95th) percentile of undiscounted charge data obtained from the contractor's most current (2004 or later) District of Columbia region provider fee schedule. This fee schedule shall be updated by the contractor on an annual basis to coincide with the start date of the next contract option period. The contractor shall pay OCONUS claims for covered services at the lesser of: C.5.5.1.1. Billed charges, less applicable cost shares, or H94002-05-D-0001 C.5.5.1.2. The ninety-fifth (95th) percentile of the contractor's most current (2004 or later) provider fee schedule for the District of Columbia region, less applicable cost shares.
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Related to Maximum Benefit Payments

  • Benefit Payments Benefit Payments, as referred to in this Agreement, means the sum of (i) Claims, as described in Xxxxxxxxx 0 xxxxx, (xx) Cash Surrender Values, as described in Paragraph 3 below, and (iii) Annuity Payments, as described in Paragraph 7 below.

  • Tax Benefit Payments Section 3.1 Payments 12 Section 3.2 No Duplicative Payments 13

  • Post-Retirement Benefits The present value of the expected cost of post-retirement medical and insurance benefits payable by the Borrower and its Subsidiaries to its employees and former employees, as estimated by the Borrower in accordance with procedures and assumptions deemed reasonable by the Required Lenders is zero.

  • Retirement Benefits Due to either investment or employment during the marriage, either the Husband or Wife: (check one)

  • Accrued Benefit 1.05 1.16 Nonforfeitable ............................................. 1.05 1.17 Plan Year/Limitation Year .................................. 1.05 1.18 Effective Date ............................................. 1.05 1.19 Plan Entry Date ............................................ 1.05 1.20

  • Early Retirement Benefits If elected in the Adoption Agreement, an Early Retirement benefit may be available to individuals who meet the age and Service requirements that are specified in the Adoption Agreement. A Participant who attains his or her Early Retirement Date will become fully vested, regardless of any vesting schedule which otherwise might apply. If a Participant separates from Service with a nonforfeitable benefit before satisfying the age requirements, but after having satisfied the Service requirement, the Participant will be entitled to elect an Early Retirement benefit upon satisfaction of the age requirement.

  • Retirement Benefit Should the Director still be in the Directorship ------------------ of the Association upon attainment of his 70th birthday, the Association will commence to pay him $590 per month for a continuous period of 120 months. In the event that the Director should die after becoming entitled to receive said monthly installments but before any or all of said installments have been paid, the Association will pay or will continue to pay said installments to such beneficiary or beneficiaries as the Director has directed by filing with the Association a notice in writing. In the event of the death of the last named beneficiary before all the unpaid payments have been made, the balance of any amount which remains unpaid at said death shall be commuted on the basis of 6 percent per annum compound interest and shall be paid in a single sum to the executor or administrator of the estate of the last named beneficiary to die. In the absence of any such beneficiary designation, any amount remaining unpaid at the Director's death shall be commuted on the basis of 6 percent per annum compound interest and shall be paid in a single sum to the executor or administrator of the Director's estate.

  • Early Retirement Benefit Upon Termination of Service prior to the Normal Retirement Age for reasons other than death, Change of Control or Disability, the Company shall pay to the Director the benefit described in this Section 4.2 in lieu of any other benefit under this Agreement.

  • Group Benefits To determine if a leave under the provisions of the Family and Medical Leave Act will be a paid or unpaid leave, contact the District’s Human Resources Department.

  • Salary Deductions Salaried employees (E-level classifications) who are permanently assigned to full-time job classifications are paid on a bi-weekly salary basis. Salaried employees are paid a bi-weekly salary based on a minimum of two (2) forty (40) hour workweeks. The bi-weekly salary received by salaried employees will not be reduced regardless of the number of hours the salaried employee actually works in any week in which the salaried employee performs any work except for the following deductions: (A) Deductions from a salaried employee's salary may be made for any workweek in which the salaried employee performs no work. (B) Deductions from a salaried employee's salary may be made when the employee absents himself from work for a full day or days for personal reasons, other than sickness or accident. This provision shall not prevent appropriate deductions from being made from any employee's vacation leave balance pursuant to Article 11 of this Agreement for absences of less than a day for personal reasons, other than sickness or accident. (C) Deductions from an employee's salary may be made when a salaried employee absents himself from work for a day (or days) for sickness or accident disability in accordance with the provisions of Articles 13 and 14 of this Agreement. (D) Deduction in a salaried employee's salary may be made for the initial or terminal week of the salaried employee if the salaried employee fails to work the entire workweek.

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