Your Benefits Clause Samples
The "Your Benefits" clause defines the specific rights, services, or advantages that a party is entitled to receive under the agreement. It typically outlines what the beneficiary can expect, such as access to certain products, services, or support, and may detail any conditions or limitations associated with these benefits. By clearly specifying what is provided, this clause ensures both parties have a mutual understanding of entitlements, reducing the risk of disputes and setting clear expectations.
Your Benefits. This section describes the Benefits your plan covers. They are listed in alphabetical order so they are easy to find. Blue Shield provides coverage for Medically Necessary services and supplies only. Experimental or Investigational services and supplies are not covered. All Benefits are subject to: • Your Cost Share; • Any Benefit maximums; • The provisions of the medical management section; and • The terms, conditions, limitations, and exclusions of this Evidence of Coverage. You can receive many outpatient Benefits in a variety of settings, including your home, a Physician’s office, an urgent care center, an Ambulatory Surgery Center, or a Hospital. Blue Shield’s medical management help your provider ensure that your care is provided safely and effectively in a setting that is appropriate to your needs. Your Cost Share for outpatient Benefits may vary depending on where you receive them. See the Exclusions and limitations section for more information about Benefit exclusions and limitations. See the Summary of Benefits section for your Cost Share for Covered Services.
Your Benefits. This section describes the Benefits your plan covers. They are listed in alphabetical order so they are easy to find. Blue Shield provides coverage for Medically Necessary services and supplies only. Experimental or Investigational services and supplies are not covered. All Benefits are subject to: • Your Cost Share; • Any Benefit maximums; • The provisions of the Medical Management Programs; and • The terms, conditions, limitations, and exclusions of this Evidence of Coverage. You can receive many outpatient Benefits in a variety of settings, including your home, a Physician’s office, an urgent care center, an Ambulatory Surgery Center, or a Hospital. Blue Shield’s Medical Management Programs work with your provider to ensure that your care is provided safely and effectively in a setting that is appropriate to your needs. Your Cost Share for outpatient Benefits may vary depending on where you receive them. See the Exclusions and limitations section for more information about Benefit exclusions and limitations.
Your Benefits. The benefits described in this section are covered only when:
Your Benefits. On the date of service, we will collect your deductible, co-pay, and payment for any uncovered services as well as the patient’s portion as determined by insurance. We accept cash, check, debit card, and credit cards for MasterCard and Visa.
Your Benefits for Cancer and Serious Diseases
A. About Your Agreement
Your Benefits. (to the extent permitted by applicable law and the terms of any applicable plans, in each case as if you continued as an active employee or, if the Company is not able to provide any such Benefit to you, the economic equivalent thereof) until the expiration of the scheduled term; and
Your Benefits. You also authorize and direct Self Regional Healthcare to apply any overpayment to other Self Regional Healthcare affiliate accounts of yours, your spouse, or your dependent children.
Your Benefits. We will bill your insurance company as a courtesy, but you are still ultimately responsible for payment of all services you receive. If your insurance company does not respond within 30 days we will follow up with an inquiry on your behalf. If, however, your insurance does not respond within 60 days of claim submission, a statement will be sent to you. You should call your insurance to question why the claim is not paid. Our office will assist you only after you have contacted your insurance.
Your Benefits. While employed by Talecris, you will be entitled to participate in all benefit plans in which employees of Talecris are generally eligible to participate within the terms of those plans. Some of the benefit plans that will be provided include health plans, disability, and life insurance plans; profit sharing, options and a 401(k) savings plan. For the purpose of benefits eligibility, your prior service with Bayer will be honored. Until the Closing, you will continue your current level of participation in your medical, dental, vision, and prescription drug plans; short-term disability plan; flexible spending accounts; and life insurance. Following the Closing, the plans will be replaced with new Talecris plans. These new plans will be implemented as soon as practicable and you will receive separate communication associated with those plans. The Pension Plan and Retiree Medical Plan will remain obligations of Bayer and will not be replaced by Talecris. The current Talecris holiday and vacation schedule is the same as the Bayer holiday and vacation schedule. You will be “grandfathered” at your current level of vacation benefits.
Your Benefits. Loss, or loss of use, of each Arm or Leg Loss, or loss of use, of each Hand; Loss of each Foot; Loss of Sight in each Eye Loss of Speech Loss of Thumb and Index Finger on the Same Hand Loss of Hearing in Each Ear (No more than of the amount for which you are insured under your Accidental Death and Dismemberment benefit will be paid for all losses which result from any one accident.)