Plan Deductible Sample Clauses

The Plan Deductible clause defines the amount a plan participant must pay out-of-pocket for covered services before the insurance plan begins to pay its share. Typically, this deductible applies annually and may differ for individual versus family coverage, or for in-network versus out-of-network services. By establishing a clear threshold for initial participant responsibility, the clause helps manage costs for the insurer and encourages prudent use of healthcare services by participants.
Plan Deductible. Delta Dental shall not be obligated to pay or otherwise discharge, in whole or in part, the first Fifty Dollars ($50) of fees for Classes II and III services rendered an eligible Subscriber or eligible Dependent during the period of each benefit year covered under this Plan. Such deductible shall not exceed three (3) individual deductibles per family per benefit year. Such deductible shall not apply to Class I services rendered an eligible Subscriber or eligible Dependent or to Class IV services rendered an eligible dependent child.
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Plan Deductible. In the event the County implements a change of plan year dates, amounts that employees have accrued toward required deductibles or co- insurances during the partial plan year shall be applied to the deductible required during new plan year.
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Plan Deductible. The Plan Deductible includes Covered Services and Supplies to be paid by you or your Dependent before benefits are payable under this plan. Deductibles are in addition to any Coinsurance. Once the Deductible maximum in The Schedule has been reached, you and your family need not satisfy any further medical deductible for the rest of that year. The Individual Deductible is the amount you are responsible for paying out-of-pocket, each Contract Year, for covered Prescription Drugs Products (as identified in the Supplemental Prescription Drug Rider) and Covered Services and Supplies (as identified in the Group Service Agreement). You must meet your Individual Deductible before the Healthplan begins to pay the cost associated with your coverage. However, when the amount paid by individuals in your Membership Unit to meet their Individual Deductibles equals the Family Deductible amount, all Members in the Membership Unit will be considered to have met their Individual Deductible for that Contract Year. The sum of money paid to the Healthplan by the Group in order for you to receive the Services and Supplies covered by this Agreement. A Physician who practices general medicine, family medicine, internal medicine or pediatrics who, through an agreement with the Healthplan, provides basic health care services to you if you have chosen him as your Primary Care Physician (PCP). Your Primary Care Physician (PCP) also arranges specialized services for you. The Plan that determines and provides or pays its benefits without taking into consideration the existence of any other Plan.
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Plan Deductible. The Plan Deductible is a dollar amount of Usual and Customary Charges for Medically Necessary Covered Medical Services which must be incurred as an out-of-pocket expense by each Insured due to any one Injury or Sickness before benefits are payable for those services. Benefits are not payable for charges applied to the Plan Deductible. The Insured is responsible for payment of the Plan Deductible. The Plan Deductible is shown in the Schedule of Benefits.
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Related to Plan Deductible

  • Deductible An annual deductible of fifty dollars ($50) per person and one hundred fifty dollars ($150) per family applies to State Dental Plan non-preventive services received from in-network providers. An annual deductible of one hundred twenty-five dollars ($125) per person applies to State Dental Plan services received from out of network providers. The deductible must be satisfied before coverage begins.

  • Insurance, Loss Deductible The Customer shall be exempt from, and in no way liable for, any sums of money which may represent a deductible in any insurance policy. The payment of such deductible shall be the sole responsibility of the Contractor providing such insurance. Upon request, the Contractor shall furnish the Customer an insurance certificate proving appropriate coverage is in full force and effect.

  • Self-Insured Retention/Deductibles Certificates of Insurance must indicate the applicable deductible/self-insured retention on each policy. Deductibles or self-insured retentions above $100,000 are subject to approval from OGS, which shall not be unreasonably withheld, conditioned or delayed. Vendor and Contractors shall be solely responsible for all claim expenses and loss payments within the deductible or self-insured retention.

  • Insured Benefits A transferring employee will be covered by the benefit plans at the designated Employer. There will be no break in coverage and/or no waiting period prior to being able to receive benefits so long as the waiting period has already been served, subject to the requirements of the carrier.

  • REFUND OF UNEARNED COMPENSATION The Party of the Second Part agrees to refund the Party of the First Part any compensation received for which no services were rendered. TERMINATION: This contract may be terminated by either party pursuant to law. OTHER CONDITIONS: Any subsequent contracts shall supersede the provisions of this contract. PARTIES: The Fort ▇▇▇▇▇ School District 100, Party of the First Part, and ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Party of the Second Part, agree as follows: