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Office Visit Copayments Sample Clauses

Office Visit Copayments. In each year of the Agreement, the level of the office visit copayment applicable to an employee and dependents is based upon whether the employee has completed the on-line Health Assessment during open enrollment and has agreed to opt-in for health coaching.
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Office Visit Copayments. In 2020, the level of the office visit copayment applicable to an employee and dependents is based upon whether the employee has completed the on-line Health Assessment during open enrollment and has agreed to opt-in for health coaching. In 2021, employees will receive a $70 first-dollar credit to their individual deductible (regardless of whether the employee is enrolled in single or family coverage), conditional upon completion of qualifying activities in the State of Wellbeing program by the deadline. (The $70 employee individual deductible credit replaces the copayment reduction.)
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Office Visit Copayments. In each year of the Agreement, the level of the office visit copayment applicable to an employee and dependents is based upon whether the employee has completed the on-line Health Assessment during open enrollment, and has agreed to opt-in for health coaching. Services received from, or authorized by, a primary care physician within the primary care clinic. Under Advantage, the health care services outlined in the benefits charts above shall be received from, or authorized by a primary care physician within the primary care clinic. Preventive care, as outlined in the Summary of Benefits, is covered at one hundred (100%) percent for services received from or authorized by the primary care clinic. The primary care clinic shall be selected from approved clinics in accordance with the Advantage administrative procedures. Unless otherwise specified in 6A2, services not received from, or authorized by, a primary care physician within the primary care clinic may not be covered. Unless the individual has a referral from his/her primary care clinic, there are no benefits for services received from providers in Benefit Levels that are different from that of the primary care clinic in which the individual has enrolled.
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Office Visit Copayments. In each year of the Agreement, the level of the office visit copayment applicable to an ASF Member and dependents is based upon whether the ASF Member has completed the on-line Health Assessment during open enrollment, and has agreed to opt in for health coaching.
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Office Visit Copayments. In each year of the Agreement, the level of the office visit 3 copayment applicable to an employee teacher and dependents is based upon whether 4 the employee teacher has completed the on-line Health Assessment during open 5 enrollment, and has agreed to opt-in for health coaching.
Sample 1
Office Visit Copayments. In each year of the Agreement, the level of the office visit copayment applicable to an employee and dependents is based upon whether
Sample 1
Office Visit Copayments. In 2020, the level of the office visit copayment applicable to an ASF Member and dependents is based upon whether the ASF Member has completed the on-line Health Assessment during open enrollment, and has agreed to opt in for health coaching. In 2021, ASF Members will receive a seventy dollar ($70) first- dollar credit to their individual deductible (regardless of whether the employee is enrolled in single or family coverage), conditional upon completion of qualifying activities in the State of Wellbeing Program by the deadline. (The seventy dollar ($70) ASF individual deductible credit replaces the copayment reduction).
Sample 1

Related to Office Visit Copayments

  • Copayments Effective January 1, 2020, the State Dental Plan will cover allowable charges for the following services subject to the copayments and coverage limits stated. Higher out-of-pocket costs apply to services obtained from dental care providers not in the State Dental Plan network. Services provided through the State Dental Plan are subject to the State Dental Plan's managed care procedures and principles, including standards of dental necessity and appropriate practice. The plan shall cover general cleaning two (2) times per plan year and special cleanings (root or deep cleaning) as prescribed by the dentist. Diagnostic/Preventive 100% 50% after deductible Fillings 80% after deductible 50% after deductible Endodontics 80% after deductible 50% after deductible Periodontics 80% after deductible 50% after deductible Oral Surgery 80% after deductible 50% after deductible Crowns 80% after deductible 50% after deductible Implants 80% after deductible 50% after deductible Prosthetics 80% after deductible 50% after deductible Prosthetic Repairs 80% after deductible 50% after deductible Orthodontics 80% after deductible 50% after deductible

  • Copayment A fixed amount You pay directly to a Provider for a Covered Service when You receive the service. The amount can vary by the type of Covered Service. Cost-Sharing: Amounts You must pay for Covered Services, expressed as Copayments, Deductibles and/or Coinsurance. Cover, Covered or Covered Services: The Medically Necessary services paid for, arranged, or authorized for You by Us under the terms and conditions of this Contract. Deductible: The amount You owe before We begin to pay for Covered Services. The Deductible applies before any Copayments or Coinsurance are applied. The Deductible may not apply to all Covered Services. You may also have a Deductible that applies to a specific Covered Service that You owe before We begin to pay for a particular Covered Service. Dependents: The Subscriber’s Spouse and Children. Emergency Dental Care: Emergency dental treatment required to alleviate pain and suffering caused by dental disease or trauma. Refer to the Pediatric Dental Care and Adult Dental Care sections of this Contract for details.

Most Referenced Clauses

Most Referenced Definitions