STOP LOSS PROVISION Sample Clauses

STOP LOSS PROVISION. An integral part of the Trust will be a “specific” and “aggregate” stop loss reinsurance for the first year of operation under the self-insured model. The Trust Board may discontinue the aggregate level in subsequent years upon review of the annual renewal and any actuarial recommendations from the District’s benefits consultant and TUSD’s Chief Financial Officer. Stop loss coverage will be provided by an authorized carrier licensed to execute contracts in the State of Arizona.

STOP LOSS PROVISION. The applicable Stop Loss contract will be delivered as a separate document. BCBSNE will have the right to inspect and audit all eligibility records and procedures of THE GROUP, and require, upon request, proof of a Covered Person’s eligibility. BCBSNE shall have no liability to THE GROUP or any Covered Person as a consequence of inaccurate eligibility information.

STOP LOSS PROVISION. An integral part of the Trust will be an aggregate stop loss and specific stop loss insurance. Stop loss coverage will be provided by an authorized carrier licensed to execute contracts in the State of Idaho, pursuant to the requirements of Idaho Code §41-4104.

STOP LOSS PROVISION. A. If Stop Loss coverage is selected, the[The applicable Stop Loss contract will be delivered as a separate document. BCBSNE will have the right to inspect and audit all eligibility records and procedures of THE GROUP, and require, upon request, proof of a Covered Person’s eligibility. BCBSNE shall have no liability to THE GROUP or any Covered Person as a consequence of inaccurate eligibility information.] B. [THE GROUP will make payments to BCBSNE required under this Agreement regardless of any stop loss insurance coverage that may cover such claims and regardless of the existence of any pending stop loss insurance reimbursement that has not been paid to THE GROUP. BCBSNE is not responsible for compliance with any terms and conditions contained within THE GROUP’s stop loss insurance contract. THE GROUP releases and holds BCBSNE harmless for denials of claims submitted to THE GROUP's stop loss insurance carrier.] C. [If THE GROUP has obtained stop loss insurance through one of BCBSNE’s preferred stop loss vendors and BCBSNE has identified that a member has exceeded the specific stop loss deductible, BCBSNE will not request reimbursement from THE GROUP for that member’s claims above the specific stop loss deductible, provided that THE GROUP has executed a valid assignment of benefits with BCBSNE and the stop loss vendor, and the Member’s claims are covered under THE GROUP’s stop loss policy. Notwithstanding the foregoing, BCBSNE is not responsible for the payment of claims that are denied or disputed by THE GROUP’s stop loss carrier and THE GROUP agrees to hold BCBSNE harmless for denials of claims submitted to THE GROUP's stop loss insurance carrier.]

STOP LOSS PROVISION. A. THE GROUP will make payments to BCBSNE required under this Agreement regardless of any stop loss insurance coverage that may cover such claims and regardless of the existence of any pending stop loss insurance reimbursement that has not been paid to THE GROUP. BCBSNE is not responsible for compliance with any terms and conditions contained within THE GROUP’s stop loss insurance contract. THE GROUP releases and holds BCBSNE harmless for denials of claims submitted to THE GROUP's stop loss insurance carrier. B. If THE GROUP has obtained stop loss insurance through one of BCBSNE’s preferred stop loss vendors and BCBSNE has identified that a member has exceeded the specific stop loss deductible, BCBSNE will not request reimbursement from THE GROUP for that member’s claims above the specific stop loss deductible, provided that THE GROUP has executed a valid assignment of benefits with BCBSNE and the stop loss vendor, and the Member’s claims are covered under THE GROUP’s stop loss policy. Notwithstanding the foregoing, BCBSNE is not responsible for the payment of claims that are denied or disputed by THE GROUP’s stop loss carrier and THE GROUP agrees to hold BCBSNE harmless for denials of claims submitted to THE GROUP's stop loss insurance carrier.

STOP LOSS PROVISION. A Series of the Trust will cease trading and liquidate all positions if the Net Asset Value of such Series of the Trust declines by more than fifty percent (50%) from either such Series initial Net Asset Value or the Series Net Asset Value on the first day of the then-current calendar year, after adjusting in each case for distributions, redemptions and additional contributions to capital.