Local Authority Central Spend Equivalent Funding representing a proportion of the LA Education Budget money which the LA would be able to retain, from the non- delegated elements of the Schools Budget and the relevant items in the LA Budget, if the Academy were a maintained school. The proportion which this funding will represent will be based on the elements of the LA's Section 251 Budget Return which are relevant to that Academy.
Eye Exam This plan covers one (1) routine or annual eye exam, per plan year, for a member’s visual acuity. Additional eye exams are covered during the plan year when there is an underlying medical condition, such as conjunctivitis. Pediatric Vision Hardware for Members Under Age Nineteen (19) This plan covers vision hardware for members until the last day of the month in which they turn nineteen (19). Covered Vision Hardware This plan covers vision hardware purchased from a network provider up to the benefit limits shown below. See the Summary of Medical Benefits for the amount you pay.
Games The Private Party shall not be entitled to introduce any arcade type amusement or gaming machines into the Restaurant Facility without the prior written approval of SANParks.
Crossing Picket Lines The Company will not expect an employee to cross a picket line, including a picket line at a customer site, if to do so would place the employee's life, limb or personal property in jeopardy.
Lottery The lottery shall be conducted as set forth in the Application, and shall be designed in such a manner that it gives a parent or any other legal guardian a reasonable opportunity to participate in the lottery. If the number of applicants for admission exceeds the capacity stated in the Charter for any grade, building, or program, the Organizer must conduct a random lottery for enrollment, giving each timely applicant an equal chance of admission, with the following exceptions:
Eye Exams Limited to one (1) routine examination per year for which no copay applies.
Sub-Loop In locations where SBC-AMERITECH has deployed: (1) Digital Loop Carrier systems and an uninterrupted copper loop is replaced with a fiber segment or shared copper in the distribution section of the loop; (2) Digital Added Main Line (“DAML”) technology to derive multiple voice-grade POTS circuits from a single copper pair; or (3) entirely fiber optic facilities to the end user, SBC-AMERITECH will make the following options available to CLEC:
Sports related devices, services and medications used to affect performance primarily in sports- related activities; all expenses related to physical conditioning programs such as athletic training, bodybuilding, exercise, fitness, flexibility, and diversion or general motivation.
Orlando, FL; Ft Lauderdale, FL; Charlotte-Gastonia-Rock Hill, NC; Greensboro-Winston Salem-High Point, NC; Nashville, TN; and New Orleans, LA, and BellSouth has provided non- discriminatory cost based access to the Enhanced Extended Link (EEL) throughout Density Zone 1 as determined by NECA Tariff No. 4 as in effect on January 1, 1999.
How Non-network Providers Are Paid If you receive care from a non-network provider, you are responsible for paying all charges for the services you received. You may submit a claim for reimbursement of the payments you made. For the limited circumstances listed below, your copayment and deductible will apply at the network level of benefits: • emergency care (emergency room, urgent care and ambulance services); • we specifically approve the use of a non-network provider for covered healthcare services, see Network Authorization in Section 5 for details; • covered healthcare services are rendered by a non-network provider at a network facility outside of your control; • otherwise, as required by law. For those circumstances where we cover services from a non-network provider, we reimburse you or the non-network provider, less any copayments and deductibles, up to the lesser of: • our allowance; • the non-network provider’s charge; or • the benefit limit. You are responsible for the deductible, if one applies, and the copayment, as well as any amount over the benefit limit that applies to the service you received. You are liable for the difference between the amount that the non-network provider bills and the payment we make for covered healthcare services. Generally, we send reimbursement to you, but we reserve the right to reimburse a non-network provider directly. We reimburse non-network provider services using the same guidelines we use to pay network providers. Generally, our payment for non-network provider services will not be more than the amount we pay for network provider services. If an allowance for a specific covered healthcare service cannot be determined by reference to a fee schedule, reimbursement will be based upon a calculation that reasonably represents the amount paid to network providers. For emergency services, we reimburse non- network providers, in accordance with R.I. Gen. Laws § 27-18-76, the greater of our allowance, our usual guidelines for paying non-network providers, or the amount that would be paid under Medicare, less any copayments or deductibles. Payments we make to you are personal. You cannot transfer or assign any of your right to receive payments under this agreement to another person or organization, unless the R.I. General Law §27-20-49 (Dental Insurance assignment of benefits) applies. For information about network authorization requests to seek covered healthcare services from a non-network provider when the covered healthcare service cannot be provided by a network provider, please see Network Authorization in Section 5.
