Non-Plan Pharmacy Benefit Payments Sample Clauses

Non-Plan Pharmacy Benefit Payments. In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Insured must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to SHL or its designee. Benefit payments are subject to the limitations and exclusions set forth in the SHL AOC as follows: 1. When any Covered Drug is dispensed, the benefit payment will be subject to SHL’s EME and any applicable tier Copayment and/or Coinsurance. The Insured is responsible for any amounts exceeding SHL’s benefit payment. 2. The Mandatory Generic benefit provision applies when any Brand Name Covered Drug is dispensed and a Generic Covered Drug equivalent is available. The benefit payment is subject to SHL’s EME of the Generic Covered Drug less the applicable tier Copayment and/or Coinsurance. The Insured is responsible for any amounts exceeding SHL’s benefit payment. 3. No benefits are payable if SHL’s EME of the Covered Drug is less than the applicable Copayment and/or Coinsurance.
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Non-Plan Pharmacy Benefit Payments. In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Member must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to HPN or its designee. Benefit payments are subject to the limitations and exclusions set forth in the HPN AOC as follows: 1. When any Covered Drug is dispensed, the benefit payment will be subject to HPN’s EME and any applicable tier Copayment and/or Coinsurance. The Member is responsible for any amounts exceeding HPN’s benefit payment. 2. The Mandatory Generic benefit provision applies when any Brand Name Covered Drug is dispensed and a Generic Covered Drug equivalent is available. The benefit payment is subject to HPN’s EME of the Generic Covered Drug less the applicable tier copayment. The Member is responsible for any amounts exceeding HPN’s benefit payment. 3. No benefits are payable if HPN’s EME of the Covered Drug is less than the applicable Copayment and/or Coinsurance.
Sample 1Sample 2See All (4)
Non-Plan Pharmacy Benefit Payments. In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Insured must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to SHL or its designee. Benefit payments are subject to the limitations and exclusions set forth in the SHL AOC as follows: 1. When any Covered Drug is dispensed, the benefit payment will be subject to SHL’s EME, or the Recognized Amount when applicable, and any applicable tier Copayment and/or Coinsurance. The Insured is responsible for any amounts exceeding SHL’s benefit payment. 2. The Mandatory Generic benefit provision applies when any Brand Name Covered Drug is dispensed and a Generic Covered Drug equivalent is available. The benefit payment is subject to SHL’s EME, or the Recognized Amount when applicable, of the Generic Covered Drug less the applicable tier Copayment and/or Coinsurance. The Insured is responsible for any amounts exceeding SHL’s benefit payment. 3. No benefits are payable if SHL’s EME, or the Recognized Amount when applicable, of the Covered Drug is less than the applicable Copayment and/or Coinsurance.
Sample 1
Non-Plan Pharmacy Benefit Payments. In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Member must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to HPN or its designee. Benefit payments are subject to the limitations and exclusions set forth in the HPN AOC as follows: 1. When any Covered Drug is dispensed, the benefit payment will be subject to HPN’s EME and any applicable tier Copayment and/or Coinsurance. The Member is responsible for any amounts exceeding HPN’s benefit payment.
Sample 1
Non-Plan Pharmacy Benefit Payments. In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Insured must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to SHL or its designee. Benefit payments are subject to the limitations and exclusions set forth in the SHL COC as follows: 1. When any Covered Drug is dispensed, the benefit payment will be subject to SHL’s EME and any applicable Tier I, II, III or IV Copayment and/or Coinsurance. The Insured is responsible for any amounts exceeding SHL’s benefit payment.
Sample 1
Non-Plan Pharmacy Benefit Payments. In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Member must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to HPN or its designee. Benefit payments are subject to the limitations and exclusions set forth in the HPN AOC as follows: 1. When any Covered Drug is dispensed, the benefit payment will be subject to HPN’s EME, or the Recognized Amount when applicable, and any applicable tier Copayment and/or Coinsurance. The Member is responsible for any amounts exceeding HPN’s benefit payment. 2. The Mandatory Generic benefit provision applies when any Brand Name Covered Drug is dispensed and a Generic Covered Drug equivalent is available. The benefit payment is subject to HPN’s EME, or the Recognized Amount when applicable, of the Generic Covered Drug less the applicable tier copayment. The Member is responsible for any amounts exceeding HPN’s benefit payment. 3. No benefits are payable if HPN’s EME, or the Recognized Amount when applicable, of the Covered Drug is less than the applicable Copayment and/or Coinsurance.
Sample 1

Related to Non-Plan Pharmacy 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.

  • 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)

  • Retirement Plans (a) In connection with the individual retirement accounts, simplified employee pension plans, rollover individual retirement plans, educational IRAs and XXXX individual retirement accounts (“XXX Plans”), 403(b) Plans and money purchase and profit sharing plans (“Qualified Plans”) (collectively, the “Retirement Plans”) within the meaning of Section 408 of the Internal Revenue Code of 1986, as amended (the “Code”) sponsored by a Fund for which contributions of the Fund’s shareholders (the “Participants”) are invested solely in Shares of the Fund, Transfer Agent shall provide the following administrative services: (i) Establish a record of types and reasons for distributions (i.e., attainment of eligible withdrawal age, disability, death, return of excess contributions, etc.); (ii) Record method of distribution requested and/or made; (iii) Receive and process designation of beneficiary forms requests; (iv) Examine and process requests for direct transfers between custodians/trustees, transfer and pay over to the successor assets in the account and records pertaining thereto as requested; (v) Prepare any annual reports or returns required to be prepared and/or filed by a custodian of a Retirement Plan, including, but not limited to, an annual fair market value report, Forms 1099R and 5498; and file same with the IRS and provide same to Participant/Beneficiary, as applicable; and (vi) Perform applicable federal withholding and send Participants/Beneficiaries an annual TEFRA notice regarding required federal tax withholding. (b) Transfer Agent shall arrange for PFPC Trust Company to serve as custodian for the Retirement Plans sponsored by a Fund. (c) With respect to the Retirement Plans, Transfer Agent shall provide each Fund with the associated Retirement Plan documents for use by the Fund and Transfer Agent shall be responsible for the maintenance of such documents in compliance with all applicable provisions of the Code and the regulations promulgated thereunder.

  • 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 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.

  • SERP Executive is a participant in the BB&T Corporation Non-Qualified Defined Benefit Plan (the “SERP”). The SERP was formerly known as the Branch Banking and Trust Company Supplemental Executive Retirement Plan. The SERP is a non-qualified, unfunded supplemental retirement plan which provides benefits to or on behalf of selected key management employees. The benefits provided under the SERP supplement the retirement and survivor benefits payable from the Pension Plan. Except in the event the employment of Executive is terminated by the Employer or BB&T for Just Cause and except in the event Executive terminates Executive’s employment for any reason other than Good Reason and such termination does not occur within twelve (12) months after a Change of Control (or, if later, within ninety (90) days after a MOE Revocation), the following special provisions shall apply for purposes of this Agreement: (i) The provisions of the SERP shall be and hereby are incorporated in this Agreement. The SERP, as applied to Executive, may not be terminated, modified or amended without the express written consent of Executive. Thus, any amendment or modification to the SERP or the termination of the SERP shall be ineffective as to Executive unless Executive consents in writing to such termination, modification or amendment. The Supplemental Pension Benefit (as defined in the SERP) of Executive shall not be adversely affected because of any modification, amendment or termination of the SERP. In the event of any conflict between the terms of this Section 1.7.7(i) and the SERP, the provisions of this Section 1.7.7 (i) shall prevail. Executive hereby agrees and consents to Employer’s amendment of the SERP to comply with Section 409A.

  • Survivor Benefits 1. A surviving dependent of a retiree who was eligible to receive a Retiree Medical Grant, as stated above in A through C, and who qualifies for a monthly allowance shall be eligible for fifty (50) percent of the Grant authorized for the retiree. 2. A surviving eligible retiree who qualifies for a monthly retirement allowance who was married to a retiree who was also eligible for a Grant shall receive the survivor benefit described in D.1., above, or his or her own Grant, whichever is greater. Such retiree shall not be eligible for both Grants.

  • Regular Benefits The Executive shall also be entitled to participate in any and all employee benefit plans, medical insurance plans, life insurance plans, disability income plans, retirement plans, bonus incentive plans and other benefit plans from time to time in effect for senior executives of the Employer. Such participation shall be subject to (i) the terms of the applicable plan documents, (ii) generally applicable policies of the Employer and (iii) the discretion of the Board of Directors of the Employer or any administrative or other committee provided for in or contemplated by such plan.

  • Salary Benefits and Bonus Compensation 3.1 BASE SALARY. Effective July 1, 2000, as payment for the services to be rendered by the Employee as provided in Section 1 and subject to the terms and conditions of Section 2, the Employer agrees to pay to the Employee a "Base Salary" at the rate of $180,000 per annum, payable in equal bi-weekly installments. The Base Salary for each calendar year (or proration thereof) beginning January 1, 2001 shall be determined by the Board of Directors of Avocent Corporation upon a recommendation of the Compensation Committee of Avocent Corporation (the "Compensation Committee"), which shall authorize an increase in the Employee's Base Salary in an amount which, at a minimum, shall be equal to the cumulative cost-of-living increment on the Base Salary as reported in the "Consumer Price Index, Huntsville, Alabama, All Items," published by the U.S. Department of Labor (using July 1, 2000, as the base date for computation prorated for any partial year). The Employee's Base Salary shall be reviewed annually by the Board of Directors and the Compensation Committee of Avocent Corporation.

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