Level of Coverage definition

Level of Coverage or “Metal Tier” means one of four standardized actuarial values and the catastrophic level of coverage as defined in 42 USC Section 18022(d) and (e), Sections 1367.008(a) and (c)(1) and 1367.009 of the Health and Safety Code, and Sections 10112.295(a) and (c)(1) and 10112.297 of the Insurance Code.
Level of Coverage means a bronze, silver, gold, or platinum level as determined under 45 CFR 156.140.
Level of Coverage or “Metal Tier” means one of four standardized actuarial values and the catastrophic level of coverage as defined in 42 USC Section 18022(d) and (e), Sections

Examples of Level of Coverage in a sentence

  • Effective January 1, 2017, employees electing Individual Coverage only under any of these plans will pay 10% of total premium cost through payroll deduction; employees electing any other Level of Coverage will pay 20% of total premium cost through payroll deduction.

  • Continued Summary of Medical Benefits See Important Note from First Page Type of Service Section Level of Coverage Benefit Limit Network Provider Non-Network Provider Physical/ Occupational Therapy Inpatient, Outpatient, or in a doctor’s/ therapist’s office 3.26 After deductible 100% coverage.

  • Continued Summary of Medical Benefits See Important Note from First Page Type of Service Section Level of Coverage Benefit Limit Network Provider Non-Network Provider Emergency Room Services 3.11 See Section 8.0 – definition of Emergency.

  • Continued Summary of Medical Benefits See Important Note from First Page Type of Service Section Level of Coverage Benefit Limit Network Provider Non-Network Provider Ambulance 3.1 • Ground 3.1 After deductible 100% coverage.

  • Carrier will ensure that each of its QHPs complies with the Benefit Design Standards required by the ACA (Section 1302), including the Cost-Sharing limits, actuarial value requirements, and EHBs. Carrier may offer Catastrophic QHPs, which are exempt from the actuarial Level of Coverage requirement, as long as they meet other statutory provisions related to QHP design.

  • SUMMARY GRP (09-10) Summary of Benefits Continued Summary of Medical Benefits See Important Note from First Page Type of Service Section Benefit Limit Level of Coverage Network Provider Non-Network Provider Deductible The deductible applies to both network and non-network services separately.

  • See Important Note from First Page Type of Service Section Benefit Limit Level of Coverage Network Pharmacy Non-Network Pharmacy • when purchased at a Mail Order Pharmacy 3.29 Glucometers, Test Strips, Lancet and Lancet Devices, and Miscellaneous Supplies (including calibration fluid).

  • The 2018 and 2019 monthly health flex allowance amounts are: Level of Coverage 2018 Rates Effective December 2018 for 2019 Rates Employee Only $539 $550 Employee Only "Grandfathered" *with no cash back option $790 $790 Employee Plus One $1,066 $1,088 Family $1,442 $1,472 Employees hired prior to September 1, 2008 that are grandfathered in and elect employee only medical coverage will receive the health flex allowance listed above for employee only “grandfathered” coverage.

  • Level of Coverage 37 24.6. Free Health Department Services 37 24.7. Retirement 37 24.8. Retirement Contributions 38 24.9. Retirement Conditions 38 Article 25- Miscellaneous Provisions 39 25.0. Assignment Exchange .

  • Carrier shall ensure that each of its QHPs complies with the Benefit Design Standards, including the Cost-Sharing limits, EHBs, and, except for Catastrophic QHPs, Level of Coverage requirements.


More Definitions of Level of Coverage

Level of Coverage has the meaning set forth in §1302 of the Affordable Care Act, and applicable regulatory guidance.
Level of Coverage means one of four standardized actuarial value levels as defined in 42 U.S.C. 18022.
Level of Coverage or “Metal Tier” means one of four standardized actuarial values of Plan coverage (bronze, silver, gold, or platinum), as defined by section 1302(d) (1) of the ACA.
Level of Coverage means the board's rating of a qualified health plan on the basis of the actuarial value of essential benefits provided under the plan, pursuant to regulations issued by the federal secretary of health and human services;