Annual Benefit Maximum definition

Annual Benefit Maximum means an amount specified in the Schedule of Benefits which is the maximum amount that Health Plan is obligated to pay on behalf of a Subscriber for Covered Services of a particular type or category provided to a Subscriber in a given benefit or calendar year, as indicated in your Schedule of Benefits.
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Annual Benefit Maximum means an amount specified in the Schedule of Benefits which is the maximum amount that ACN is obligated to pay on behalf of a Member for Covered Services of a particular type or category provided to a Member in a given calendar year benefit/ or calendar year, as indicated in your Schedule of Benefits.
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Examples of Annual Benefit Maximum in a sentence

  • Calculation of Annual Benefit Maximum LimitsEach visit to an OptumHealth Participating Provider, as described below, requires a Copayment by the Member.

  • Please refer to the Summary Dental Benefits and Covered Services chart for the dental services that are applied to the Annual Benefit Maximum.

  • This Annual Benefit Maximum applies to each Covered Person per Benefit Year.

  • The Annual Benefit Maximum is the total dollar amount that the Plan will pay for dental services rendered during any one (1) Benefit Year.

  • You cannot transfer all or any portion of your Annual Benefit Maximum from person to person or year to year.

  • Preventive services are not subject to the Annual Benefit Maximum.

  • Refer to Medicare.gov for complete details.Chiropractic and Acupuncture Schedule of BenefitsOffered by ACN Group of California, Inc.BENEFIT PLAN:$15 Copayment per visit20 visits combined Annual Benefit Maximum for Acupuncture and/or Chiropractic Services CLAIMS DETERMINATION PERIOD:Calendar YearYour Group makes available to you and your eligible dependents a complementary health benefits program for chiropractic and acupuncture.

  • Eligible applicants include not-for- profit institutions and for-profit firms, state and local governments, federally recognized Indian Tribes, and colleges and universities located in the United States.

  • Aggregate Annual Benefit Maximum means the maximum amount of benefits to which you are annually entitled under the program for all covered services combined.

  • Treatment received which is not the direct result of an Accidental Injury will be subject to the Annual Benefit Maximum.

Related to Annual Benefit Maximum

  • Annual Benefit Limit means the maximum amount of benefits paid by the Company to the Policy Holder in a Policy Year irrespective of whether any limits of any benefit items stated in the Benefit Schedule have been reached. The Annual Benefit Limit is counted afresh in a new Policy Year.

  • Lifetime Benefit Limit means the maximum amount of benefits paid by the Company to the Policy Holder cumulatively since the inception of these Terms and Benefits, irrespective whether any limits of any benefit items stated in the Benefit Schedule have been reached or whether the Annual Benefit Limit in a Policy Year has been reached.

  • Benefit year means the period of twelve consecutive months, July 1 through June 30, as established by an employer in which an employee shall accrue and use earned sick leave as provided pursuant to N.J.S.A. 34:11D-2, provided that once the starting date of the benefit year is established by the employer it shall not be changed unless the employer notifies the Commissioner of Labor and Workforce Development of the change in accordance with regulations promulgated pursuant to the Act. The Commissioner shall impose a benefit year on any employer the Commissioner determines is changing the benefit year at times or in ways that prevent the accrual or use of earned sick leave by an employee.