Benefit manager definition

Benefit manager means a person who has access to and reviews patient health information, including information related to patient prescription dispensing records, for the purpose of administering a health care program operated by a health benefit plan, including utilization review and determination of coverage issues. The term includes a third-party administrator.
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Benefit manager means a person who performs one or more of
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Benefit manager means a person who performs one or more of the following functions on behalf of a carrier, third-party administrator, or self-insured company:
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Examples of Benefit manager in a sentence

  • Some pharmacies have contracted with the Claims Administrator or with the Claims Administrator's pharmacy Benefit manager to accept a negotiated amount as payment in full for the covered Prescription Drugs that they dispense.

  • Most Plan Participants receive information by accessing the pharmacy section of the Claims Administrator’s website, www.bcbsla.com/pharmacy or request a copy by mail by calling the pharmacy Benefit manager at the telephone number indicated on the Plan Participant’s ID card.

  • Most Members receive information from Us by accessing the pharmacy section of Our website, www.bcbsla.com/pharmacy, or request a copy by mail by calling Our pharmacy Benefit manager at the telephone number identified on Your ID card.

  • Some pharmacies have contracted with Us or with Our pharmacy Benefit manager to accept a negotiated amount as payment in full for the covered Prescription Drugs that they dispense.

  • The Member can view Our Blue Selections Rx Member Guide on Our website at xxx.xxxxxx.xxx or request a copy by mail by calling Our pharmacy Benefit manager at the telephone number indicated on the Member’s ID card.

  • Most Members receive information from Us by accessing the pharmacy section of Our website, www.bcbsla.com/pharmacy, or request a copy by mail by calling Our Pharmacy Benefit manager at the telephone number indicated on the Member’s ID card.

  • Benefit manager contracts with HCFA; benefit manager responsibilities.

  • Most Members receive information from Us by accessing the pharmacy section of Our website, www.bcbsla.com/pharmacy, or request a copy by mail by calling Our pharmacy Benefit manager at the telephone number indicated on Your ID card.

  • The Plan Participant can view the Claims Administrator’s Blue Selections Rx Plan Participant Guide on Our website at www.bcblsa.com or request a copy by mail by calling the Claims Administrator’s pharmacy Benefit manager at the telephone number indicated on the Plan Participant’s ID card.

  • Most Plan Participantsreceive information by accessing the pharmacy section of the Claims Administrator’s website, www.bcbsla.com/pharmacy or request a copy by mail by calling the pharmacy Benefit manager at the telephone number indicated on the Plan Participant’s ID card.


More Definitions of Benefit manager

Benefit manager means the manager designated as the benefit manager of a sustainable business limited liability company under section ‑7.
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Related to Benefit manager

  • Pharmacy benefit manager means a person, business or other

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Pharmacy benefits management means the administration or management of prescription drug

  • Managing Employee means a general manager, business manager, administrator, director, or other individual who exercises operational or managerial control over, or who directly or indirectly conducts the day-to-day operation of an institution, organization, agency or business entity;

  • Benefits Committee means the Employee Benefits Committee of Textron.

  • Health benefits plan means a benefits plan which pays or

  • Medical Benefits Schedule means the Medicare Schedule of Benefits produced by the Department of Health to which all fees and benefits relate for inpatient hospital services.

  • Designated Employer Representative (DER) means a designated school district representative authorized to take immediate action to remove employees from safety-sensitive duties, to make required decisions in the testing and evaluation process, and to receive test results and other communications for the school district.

  • Retirement Committee means a committee consisting of the Company’s Vice President of Human Resources, the Director of HR Operations and the Compensation & Benefits Manager.

  • Retirement board or "board" means the retirement system's governing board provided for in 2-15-1010.

  • Societal benefits charge means a charge imposed by an electric

  • SERP has the meaning assigned thereto in Section 5(c) hereof.

  • Retirement Savings Plan means the Air Products and Chemicals, Inc. Retirement Savings Plan, as amended from time to time, together with any similar, succeeding or substitute plan.

  • Exit Manager the person appointed by each party pursuant to paragraph 3.3 of this Schedule 8 (Exit Arrangements) for managing the Provider’s obligations under Schedule 8 (Exit Arrangements);

  • CME Term SOFR Administrator means CME Group Benchmark Administration Limited as administrator of the forward-looking term Secured Overnight Financing Rate (SOFR) (or a successor administrator).

  • Affected employee means an employee who would be affected by the grant or denial of a variance, or any one of the employee’s authorized representatives, such as the collective bargaining agent.

  • Medical Benefits means the monthly fair market value of benefits provided to the Employee and the Employee’s dependents under the major medical, dental and vision benefit plans sponsored and maintained by the Company, at the level of coverage in effect for such persons immediately prior to the Employee’s termination of employment date. The “monthly fair market value” of such benefits shall be equal to the monthly cost as if such persons elected COBRA continuation coverage at such time at their own expense.

  • Compensation and Benefits Programs means all compensation and benefit plans, policies, and programs of the Debtors, and all amendments and modifications thereto, applicable to the Debtors’ employees, former employees, retirees, and non-employee directors and the employees, former employees and retirees of their subsidiaries, including all savings plans, retirement plans, health care plans, disability plans, and incentive plans, deferred compensation plans, and life, accidental death, and dismemberment insurance plans.

  • Supervisory employee means an employee, regardless of job description, having authority in the interest of the employer to hire, transfer, suspend, lay off, recall, promote, discharge, assign, reward, or discipline other employees, or the responsibility to assign work to and direct them, or to adjust their grievances, or effectively recommend that action, if, in connection with the foregoing functions, the exercise of that authority is not of a merely routine or clerical nature, but requires the use of independent judgment.

  • Termination Compensation means a monthly cash amount equal to one-twelfth ( 1/12th) of the highest amount of the annual cash compensation (including cash bonuses and other cash-based compensation, including for these purposes amounts earned or payable whether or not deferred) received by Executive during any one of the three (3) calendar years immediately preceding the calendar year in which Executive’s Termination Date occurs; provided, that if the cash compensation received by Executive during the Termination Year exceeds the highest amount of the annual cash compensation received by Executive during any one of the immediately preceding three (3) consecutive calendar years, the cash compensation received by Executive during the Termination Year shall be deemed to be Executive’s highest amount of annual cash compensation. In no event shall Executive’s Termination Compensation include equity-based compensation (e.g., income realized as a result of Executive’s exercise of non-qualified stock options or other stock based benefits).

  • Accrued Professional Compensation means, at any given moment, all accrued, contingent and/or unpaid fees and expenses (including, without limitation, success fees) for legal, financial advisory, accounting and other services and reimbursement of expenses that are awardable and allowable under section 328, 330(a) or 331 of the Bankruptcy Code and were rendered before the Effective Date by any Retained Professional in the Chapter 11 Cases, or that are awardable and allowable under section 503 of the Bankruptcy Code, that have not been denied by a Final Order, all to the extent that any such fees and expenses have not been previously paid (regardless of whether a fee application has been filed for any such amount). To the extent that the Bankruptcy Court or any higher court denies or reduces by a Final Order any amount of a Retained Professional’s fees or expenses, then those reduced or denied amounts shall no longer constitute Accrued Professional Compensation.

  • Individual service plan means the written description of services, supports, and activities to be provided to an individual.

  • Retirement Plan means a plan which provides retirement benefits to you and which is not funded wholly by your contributions. The term shall not include a profit-sharing plan, informal salary continuation plan, registered retirement savings plan, stock ownership plan, 401(K) or a non-qualified plan of deferred compensation.

  • Ongoing employee means an employee who has been employed for at least one complete standard measurement period.

  • Planning Director means the Planning Director of the City of Santa Xxxxxx, or his or her designee.

  • Medical Executive Committee or “MEC” means the Executive Committee of the Medical Staff.