Common use of Network Covered Services Clause in Contracts

Network Covered Services. When Members under the same Family Coverage have Incurred $14,300 in Deductible, Copayment and Coinsurance expenses for Network Covered Services furnished to the Members in one (1) Benefit Period, the benefits payable for claims received by the Plan thereafter for all Members under that same Family Coverage during the remainder of the Benefit Period will increase to one hundred percent (100%) of the Plan Allowance. In the case of family coverage, no individual Member may contribute cost-sharing expenses greater than their Individual Out-of-Pocket Maximum. However, as each Member reaches their Individual Out-of-Pocket Maximum, the benefits payable for that Member will increase to 100% of the Plan Allowance for the remainder of the Benefit Period, whether or not the Family Out-of-Pocket Maximum has been met. The dollar amount specified shall not include amounts in excess of the Plan Allowance.

Appears in 1 contract

Samples: Individual Comprehensive Major Medical Preferred Provider Subscription Agreement

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Network Covered Services. When Members under the same Family Coverage have Incurred $14,300 13,700 in Deductible, Copayment and Coinsurance expenses for Network Covered Services furnished to the Members in one (1) Benefit Period, the benefits payable for claims received by the Plan thereafter for all Members under that same Family Coverage during the remainder of the Benefit Period will increase to one hundred percent (100%) of the Plan Allowance. In the case of family coverage, no individual Member may contribute cost-sharing expenses greater than their Individual Out-of-Pocket Maximum. However, as each Member reaches their Individual Out-of-Pocket Maximum, the benefits payable for that Member will increase to 100% of the Plan Allowance for the remainder of the Benefit Period, whether or not the Family Out-of-Pocket Maximum has been met. The dollar amount specified shall not include amounts in excess of the Plan Allowance.

Appears in 1 contract

Samples: Individual Comprehensive Major Medical Preferred Provider Subscription Agreement

Network Covered Services. When Members under the same Family Coverage have Incurred $14,300 in Deductible, Copayment and Coinsurance expenses for Network Covered Services furnished to the Members in one (1) Benefit Period, the benefits payable for claims received by the Plan thereafter for all Members under that same Family Coverage during the remainder of the Benefit Period will increase to one hundred percent (100%) of the Plan Allowance. In the case of family coverageFamily Coverage, no individual Member may contribute cost-sharing expenses greater than their Individual Out-of-Pocket Maximum. However, as each Member reaches their Individual Out-of-Pocket Maximum, the benefits payable for that Member will increase to one hundred percent (100% %) of the Plan Allowance for the remainder of the Benefit Period, whether or not the Family Out-of-Pocket Maximum has been met. The dollar amount specified shall not include any amounts in excess of the Plan Allowance.

Appears in 1 contract

Samples: Individual Comprehensive Major Medical Preferred Provider Subscription Agreement

Network Covered Services. When Members under the same Family Coverage have Incurred $14,300 12,000 in Deductible, Copayment Deductible and Coinsurance expenses for Network Covered Services furnished to the Members in received during one (1) Benefit Period, the benefits payable for claims received by the Plan thereafter for all Members under that same Family Coverage during the remainder of the Benefit Period will increase to one hundred percent (100%) of the Plan Allowance. In the case of family coverageFamily Coverage, no individual Member may contribute cost-sharing Deductible and Coinsurance expenses greater than their his or her Individual Out-of-Pocket Maximum. However, as each Member reaches their his or her Individual Out-of-Pocket Maximum, the benefits payable for that Member will increase to one hundred percent (100% %) of the Plan Allowance for the remainder of the Benefit Period, whether or not the Family Out-of-Pocket Maximum has been met. The dollar amount specified shall not include amounts in excess of the Plan Allowance.

Appears in 1 contract

Samples: Individual Comprehensive Major Medical Preferred Provider Qualified High Deductible Health Plan Subscription Agreement

Network Covered Services. When Members under the same Family Coverage have Incurred $14,300 11,800 in Deductible, Copayment Deductible and Coinsurance expenses for Network Covered Services furnished to the Members in received during one (1) Benefit Period, the benefits payable for claims received by the Plan thereafter for all Members under that same Family Coverage during the remainder of the Benefit Period will increase to one hundred percent (100%) of the Plan Allowance. In the case of family coverageFamily Coverage, no individual Member may contribute cost-sharing expenses Deductible and Coinsurance expense greater than their his or her Individual Out-of-Pocket Maximum. However, as each Member reaches their his or her Individual Out-of-Pocket Maximum, the benefits payable for that Member will increase to one hundred percent (100% %) of the Plan Allowance for the remainder of the Benefit Period, whether or not the Family Out-of-Pocket Maximum has been met. The dollar amount specified shall not include amounts in excess of the Plan Allowance.

Appears in 1 contract

Samples: Individual Comprehensive Major Medical Preferred Provider Qualified High Deductible Health Plan Subscription Agreement

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Network Covered Services. When Members under the same Family Coverage have Incurred $14,300 13,800 in Deductible, Copayment and Coinsurance expenses for Network Covered Services furnished to the Members in one (1) Benefit Period, the benefits payable for claims received by the Plan thereafter for all Members under that same Family Coverage during the remainder of the Benefit Period will increase to one hundred percent (100%) of the Plan Allowance. In the case of family coverageFamily Coverage, no individual Member may contribute cost-sharing expenses expense greater than their Individual Out-of-Pocket Maximum. However, as each Member reaches their Individual Out-of-Pocket Maximum, the benefits payable for that Member will increase to one hundred percent (100% %) of the Plan Allowance for the remainder of the Benefit Period, whether or not the Family Out-of-Pocket Maximum has been met. The dollar amount specified shall not include amounts in excess of the Plan Allowance.

Appears in 1 contract

Samples: Individual Comprehensive Major Medical Preferred Provider Subscription Agreement

Network Covered Services. When Members under the same Family Coverage have Incurred $14,300 13,000 in Deductible, Copayment Deductible and Coinsurance expenses for Network Covered Services furnished to the Members in received during one (1) Benefit Period, the benefits payable for claims received by the Plan thereafter for all Members under that same Family Coverage during the remainder of the Benefit Period will increase to one hundred percent (100%) of the Plan Allowance. In the case of family coverageFamily Coverage, no individual Member may contribute cost-sharing Deductible and Coinsurance expenses greater than their Individual Out-of-Pocket Maximum. However, as each Member reaches their Individual Out-of-Pocket Maximum, the benefits payable for that Member will increase to 100% of the Plan Allowance for the remainder of the Benefit Period, whether or not the Family Out-of-Pocket Maximum has been met. The dollar amount specified shall not include amounts in excess of the Plan Allowance.

Appears in 1 contract

Samples: Individual Comprehensive Major Medical Preferred Provider Qualified High Deductible Health Plan Subscription Agreement

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