Special Coverage. If You suffer an Injury as a result of any of the covered activities of Benefit 25 during Your Overseas Journey, shall within twelve (12) consecutive months result in any of the covered events for Benefit 19, We will pay the amount stated in the Schedule of Benefits:
1. Aerial Activities 2. Bungee Jump 3. Hang Gliding 4. Parachuting 5. Paragliding 6. Hot Air Ballooning 7. Abseiling 8. Scuba Diving 9. Windsurfing/Surfing 10. Winter Sport 11. Mountaineering above three thousand (3,000) meters 12.
Special Coverage. Tenant shall carry “Builder’s All Risk” insurance in an amount approved by Landlord covering the construction of the Tenant Improvements, and such other insurance as Landlord may require. Such insurance shall be in amounts and shall include such extended coverage endorsements as may be reasonably required by Landlord including, but not limited to, the requirement that all of Tenant’s Parties shall carry excess liability and Products and Completed Operation Coverage insurance, each in amounts not less than $1,000,000 per incident, $2,000,000 in aggregate, and in form and with companies as are required to be carried by Tenant as set forth in the Lease.
Special Coverage. 11.3.9.1 In order to obtain services under Special Coverage, an Enrollee must register, as provided in Section 7.7.6 of this Contract. Registration is a form of utilization control, to determine whether the Enrollee’s health condition warrants Access to the expanded services included in Special Coverage.
11.3.9.2 In addition, as noted in Section 7.7.12 of this Contract, some individual Special Coverage services require Prior Authorization for an Enrollee who has registered under Special Coverage.
Special Coverage. 7.7.1 The Special Coverage benefit is designed to provide services for Enrollees with special health care needs caused by serious illness.
7.7.2 The Contractor shall provide to ASES the strategy implemented for the identification of populations with special health care needs in order to identify any ongoing special conditions of Enrollees that require a treatment plan and regular care monitoring by appropriate health care professionals.
7.7.3 The Contractor shall implement a system for screening Enrollees for Special Coverage and registering Enrollees who qualify. The Contractor shall design a form to be used by Providers in submitting a registration for Special Coverage.
7.7.4 The registration system for Special Coverage shall emphasize speedy processing of the registration.
7.7.5 Once a Provider supplies all the required information for the Contractor to process a registration, Special Coverage shall take effect retroactively as of the date the Provider reaches a diagnosis, including documentation of test results, for any condition included in Special Coverage. In case information is submitted to Contractor after diagnosis was reached, coverage can be made retroactive up to sixty (60) Calendar Days before the date on which Provider submitted the registration request.
7.7.6 According to the timeframes specified in Attachment 12 to this Contract, the Contractor shall submit to ASES for approval proposed protocols to be established for Special Coverage and any subsequent changes to the proposed protocols for Special Coverage must be previously approved in writing by ASES. The proposed protocols must be established for, at a minimum, the following:
7.7.6.1 Registration procedures;
7.7.6.2 Formats established for registration forms;
7.7.6.3 Forms of notices to be issued to the Enrollee and to the Provider to inform them of the Contractor’s decision concerning Special Coverage;
7.7.6.4 Protocols for the development of treatment plan;
7.7.6.5 Provisions for ensuring that Enrollees with Special Coverage have timely access to specialists appropriate for the Enrollee’s condition and identified needs; and
7.7.6.6 A summary of the Contractor’s strategy for the identification of populations with special health care needs.
7.7.7 The protocols shall emphasize both the need for a speedy determination and the need for screening evaluations to be conducted by competent Health Care Professionals with appropriate expertise.
7.7.8 The Contractor shall complete, monitor, and ...
Special Coverage. Tenant shall carry “Builder’s All Risk” insurance in an amount approved by Landlord covering the construction of Tenant Improvements, and such other insurance as Landlord may require, it being understood and agreed that Tenant Improvements shall be insured by Tenant pursuant to Section 14 of the Lease immediately upon completion thereof. Such insurance shall be in amounts and shall include such extended coverage endorsements as may be reasonably required by Landlord including, but not limited to, the requirement that all of Tenant’s Agents shall carry excess liability and Products and Completed Operation Coverage insurance, each in amounts not less than $2,000,000.00 per incident, $5,000,000.00 in aggregate, and in form and with companies as are approved by Landlord.
Special Coverage. Tenant’s Contractor, or in the case of a construction management contract Tenant’s Major Subcontractors shall carry “Builder’s All Risk” insurance in an amount approved by Landlord covering the construction of the Tenant Improvements, and such other insurance as Landlord may require. Such insurance shall be in amounts and shall include such extended coverage endorsements including the requirement that all of Tenant’s Parties shall carry excess liability and Products and Completed Operation Coverage insurance, each in amounts not less than $1,000,000 per incident, $2,000,000 in aggregate, and in form and with companies as are required to be carried by Tenant as set forth in the Lease.
Special Coverage. Treatment for the following conditions after confirmed laboratory results and established diagnostic: ü HIV Positive factor and/or Acquired Immunodeficiency Syndrome (AIDS) – Ambulatory and hospitalization services are included. No referral or pre-authorization from the Health Care Organization or the primary care physician is required for beneficiary’s visits and treatment at the Health Department’s Regional Immunology Clinics. ü Tuberculosis ü Leprosy ü Lupus ü Cystic Fibrosis ü Cancer ü Hemophilia ü Special needs children, including the prescribed conditions in the Special Needs Children Diagnostic Manual by the Health Department, Health Protection and Promotion auxiliary Secretary, Habilitation Division (“the manual”) which is part of this document, except: ° Asthma and diabetes, which are included in the “Disease Management Program” ° Mental Disorders; and ° Mental Retardation, behavioral manifestations will be managed by mental health providers within the Basic Coverage, with the exception of a catastrophic disease. The Insurance Company must seek the Administration’s authorization for any other special condition not included in the manual for which the primary care physician or medical group solicit special coverage activation. Said request must contain the total economical impact of the inclusion. The Administration will consult with the Health Department and issue a decision which will be binding between the parties. § Scleroderma § Multiple Sclerosis § Services for treatment of conditions resulting from self-inflicted damage or as a result of a felony by a beneficiary or negligence. § Chronic renal disease in levels three (3), four (4) and five (5). (Levels 1 and 2 are included in the Basic Coverage.) The following is a description of chronic renal disease stages3:
Special Coverage. Tenant shall carry "Builder's All Risk" insurance in an amount approved by Landlord covering the construction of the Tenant Improvements, and such other insurance as Landlord may require, it being understood and agreed that the Tenant Improvements shall be insured by Landlord pursuant to Article 14 of this Lease upon completion thereof. Tenant's policy of Builder's All Risk insurance shall be in amounts and shall include such extended coverage endorsements as may be reasonably required by Landlord including, but not limited to, the requirement that all of Tenant's Agents shall carry Excess Liability and Products and Completed Operation Coverage insurance, each in amounts not less than $1,000,000 per incident, $2,000,000 in aggregate, and in form and with companies as are required to be carried by Tenant as set forth in Article 14 of this Lease.
Special Coverage. SRO: Disclose central kitchens as separate personal property by square footage and value of the kitchen service equipment (disclose receipts if applicable). Recreation/Community Special coverage required if not included in the building and business personal Rooms: property limits. Day Care Facilities: Special coverage required if run separately. The day care center will be required to have separate insurance with limits not less than the limits applicable above and said policy shall name the owner and the Department as an insured.
Special Coverage. Subtenant shall carry "Builder's All Risk" insurance in a reasonable amount approved by Sublandlord and Landlord covering the construction of the Improvements, and such other insurance as Sublandlord and Landlord may reasonably require, it being understood and agreed that the Improvements shall be insured by Subtenant pursuant to the Sublease immediately upon completion thereof. Such insurance shall be in amounts and shall include such extended coverage endorsements as may be reasonably required by Sublandlord and Landlord including, but not limited to, the requirement that all of Subtenant's Agents shall carry excess liability and Products and Completed Operation Coverage insurance, each in amounts not less than $500,000 per incident, $1,000,000 in aggregate, and in form and with companies as are required to be carried by Subtenant as set forth in the Sublease.
