Right to and Payment of Benefits Sample Clauses

Right to and Payment of Benefits. All rights to the benefits of this contract are available only to you. They may not be transferred or assigned to anyone else. We will not honor any attempted assignment, garnishment, or attachment of any right of this contract. At our option and in accordance with the federal and state law, we may pay the benefits of this contract to the subscriber, member, provider, other carrier, or other party legally entitled to such payment under federal or state medical child support laws, or jointly to any of these. Such payment will discharge our obligation to the extent of the amount paid so that we will not be liable to anyone aggrieved by our choice of payee.
Sample 1Sample 2Sample 3See All (20)
AutoNDA by SimpleDocs
Right to and Payment of Benefits. Benefits of this plan are available only to Members. Except as required by law, we won’t honor any attempted assignment, garnishment or attachment of any right of this plan. In addition, Members may not assign a payee for Claims, payments or any other rights of this plan. At our option only and in accordance with the law, we may pay the benefits of this plan to: • The Subscriber; • A Provider; • Another health insurance carrier; • A Member; • Another party legally entitled under federal or state medical child support laws; or • Jointly to any of the above. Payment to any of the above satisfies our obligation as to payment of benefits. ACCESSING CARE‌ This plan makes available to you sufficient numbers and types of Providers to give you access to all covered services in compliance with applicable Washington State regulations governing access to Providers. Our Provider network includes primary care providers, specialty physicians, Hospitals, and a variety of other types of Providers, who are contracted in writing with us (“In-Network Providers”). Members of this plan may also choose to receive care from Providers who are not contracted with our network (“Out-of-Network Providers”) at any time. This plan’s benefits and your Out-of-Pocket Expenses depend on which Providers you see. With the exception of emergencies, you can control your Out-of-Pocket Expenses by choosing to seek care from In-Network Providers. If you receive care from an Out-of-Network Provider, you are always responsible for and will be billed for any amounts that exceed the Allowed Amount (this is known as “balance billing”).
Sample 1Sample 2Sample 3See All (4)
Right to and Payment of Benefits. Benefits of this plan are available only to Members. Except as required by law, we won’t honor any attempted assignment, garnishment or attachment of any right of this plan. In addition, Members may not assign a payee for Claims, payments or any other rights of this plan. At our option only and in accordance with the law, we may pay the benefits of this plan to:  The Subscriber;  A Provider;  Another health insurance carrier;  A Member;  Another party legally entitled under federal or state medical child support laws; or  Jointly to any of the above. Payment to any of the above satisfies our obligation as to payment of benefits.
Sample 1

Related to Right to and Payment of Benefits

  • Payment of Benefits a) In computing the amount of disability benefits, disability will be considered as starting from the first day of disability; however, an employee must be certified by a medical practitioner for the disability within the first three days of disability. In the event that the employee is not certified within the first three days, disability will be considered as starting two complete days prior to the day that the employee is actually certified by a medical practitioner.

  • Termination of Benefits Except as provided in Section 2 above or as may be required by law, Executive’s participation in all employee benefit (pension and welfare) and compensation plans of the Company shall cease as of the Termination Date. Nothing contained herein shall limit or otherwise impair Executive’s right to receive pension or similar benefit payments that are vested as of the Termination Date under any applicable tax-qualified pension or other plans, pursuant to the terms of the applicable plan.

  • Retention of Benefits Union leave under the following four (4) sections will be unpaid. The Employer will maintain regular pay and xxxx the Union for the costs of the employee’s salary and benefits. If the Union member is part-time or casual, and the leave is greater than their normal work hours, the Employer will pay the employee for the full length of the leave requested by the Union. The Employer will xxxx the Union for these days as noted above. The Union will pay these invoices within twenty-eight (28) days. Union leave is not unpaid leave for the purposes of Article 22.02 [i.e. such leave will not affect the employee’s benefits, seniority or increment anniversary date].

  • Coordination of Benefits The coordination of benefits (COB) provision applies when a Member has health care coverage under more than one plan. Plan is defined below. The order of benefit determination rules govern the order in which each plan will pay a claim for benefits. The plan that pays first is called the primary plan. The primary plan must pay benefits according to its policy terms without regard to the possibility that another plan may cover some expenses. The plan that pays after the primary plan is the secondary plan. In no event will a secondary plan be required to pay an amount in excess of its maximum benefit plus accrued savings. If the Member is covered by more than one health benefit plan, and the Member does not know which is the primary plan, the Member or the Member’s provider should contact any one of the health plans to verify which plan is primary. The health plan the Member contacts is responsible for working with the other plan to determine which is primary and will let the Member know within 30 calendar days. All health plans have timely claim filing requirements. If the Member or the Member’s provider fails to submit the Member’s claim to a secondary health plan within that plan’s claim filing time limit, the plan can deny the claim. If the Member experiences delays in the processing of the claim by the primary health plan, the Member or the Member’s provider will need to submit the claim to the secondary health plan within its claim filing time limit to prevent a denial of the claim. If the Member is covered by more than one health benefit plan, the Member or the Member’s provider should file all the Member’s claims with each plan at the same time. If Medicare is the Member’s primary plan, Medicare may submit the Member’s claims to the Member’s secondary carrier.

  • Duration of Benefits Eligibility for Income Protection benefits will cease upon the earliest of the following dates:

  • Limitation of Benefits (a) Anything in this Agreement to the contrary notwithstanding, in the event it shall be determined that any benefit, payment or distribution by the Company to or for the benefit of the Executive (whether payable or distributable pursuant to the terms of this Agreement or otherwise) (a "Payment") would, if paid, be subject to the excise tax imposed by Section 4999 of the Code (the "Excise Tax"), then the Payment shall be reduced to the extent necessary to avoid the imposition of the Excise Tax. The Executive may select the Payments to be limited or reduced.

  • Explanation of Benefits Contractor shall send each Enrollee an Explanation of Benefits to Enrollees in Plans that issue Explanation of Benefits or similar documents as required by Federal and State laws, rules, and regulations. The Explanation of Benefits and other documents shall be in a form that is consistent with industry standards.

Time is Money Join Law Insider Premium to draft better contracts faster.