Maximum Eligible Expense definition

Maximum Eligible Expense or “MEE” means the maximum amount considered for payment by this Plan for any covered treatment, service, or supply, subject however, to all Plan annual and lifetime maximum benefit limitations. The following criteria will apply to determination of the Maximum Eligible Expense:
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Examples of Maximum Eligible Expense in a sentence

  • The Plan will adjust the Maximum Eligible Expense for Emergency Services provided in an emergency department of a hospital or in an independent freestanding emergency department, in instances where the billing party, facility, or provider is not a Preferred Provider.

  • The Maximum Eligible Expense for such services will be the Qualifying Payment Amount.

  • The Maximum Eligible Expense, when reduced by any coinsurance amount, will equal the Benefit Period Maximum outlined under Paramedical Services on the Schedule of Benefits.

  • Approximately a third of the respondents (38%) opposed that they found it easy to use E-banking to accomplish their banking tasks compared 38% who concurred while 25% were not sure.

  • The Maximum Eligible Expense for such services will be the median amount the Plan would pay to a Preferred Provider (the “Qualifying Payment Amount” or “QPA”)1.

  • In the case of services other than those described in item (2.) directly above, the Plan will adjust the Maximum Eligible Expense for items and services furnished to a participant by a billing provider that is not a Preferred Provider if the facility where the services are provided is a Preferred Provider.

  • Eligible Expenses will include only the appropriate Maximum Eligible Expense or Procedure Based Limit for those procedures necessary to eliminate oral disease and to replace missing teeth.

  • However, the Maximum Eligible Expense will not be adjusted where the billing provider has satisfied specific notice and consent criteria with respect to the services received.

  • If a cast chrome or acrylic partial denture will restore the dental arch satisfactorily and the Covered Person and the dental service provider elect a more elaborate appliance, Eligible Expenses for the Covered Dental Service performed will be limited to the Maximum Eligible Expense or Procedure Based Limit appropriate to the cast chrome or acrylic denture.

  • The Plan will pay for any eligible services performed Outside the P.P.O. at the 50% co- insurance level subject to the Maximum Eligible Expense for the service the Participant received.

Related to Maximum Eligible Expense

  • Eligible Expense means the lesser of the reasonable, customary, usual, fair market value charge for a covered service or the provider's actual charge.

  • Eligible Expenses means expenses incurred for Medical Services rendered with respect to a Disability.

  • Maximum Basic Grant Amount’ has the same meaning as set out in item 1 of Schedule 1 of HESA;

  • Cumulative EBITDA means, as of any date of determination, EBITDA of the Company from the Existing Notes Issue Date to the end of the Company’s most recently ended full fiscal quarter prior to such date, taken as a single accounting period.

  • Base Year Value means the assessed value of eligible property January 1 preceding the execution of the agreement plus the agreed upon value of eligible property improvements made after January 1 but before the execution of the agreement.

  • Allowable Expense means a necessary, reasonable and customary item of expense for health care, which is:

  • Minimum Disbursement Amount means Twenty-Five Thousand and No/100 Dollars ($25,000).

  • Maximum Distributable Amount means any maximum distributable amount relating to the Issuer and/or the Group (if any) which is determined pursuant to Article 141 of the CRD IV Directive (or, as the case may be, any provision of Danish law transposing or implementing Article 141 of the CRD IV Directive), or any successor provision thereto;

  • Maximum Benefit means the maximum benefit amount of each of the benefits covered under this Policy as stated in the Schedule of Benefits.

  • Eligible Expenditures means expenditures in respect of the reasonable cost of goods, works and services required for the Project and to be financed out of the proceeds of the Loan allocated from time to time to the eligible Categories in accordance with the provisions of Schedule 1 to this Agreement; and

  • Base Period Income Base Period Income" is an amount equal to Executive's "annualized includable compensation" for the "base period" as defined in Sections 280G(d)(1) and (2) of the Code and the regulations adopted thereunder. Generally, Executive's "annualized includable compensation" is the average of Executive's annual taxable income from Company for the "base period," which is the five calendar years prior to the year in which the Change of Control occurs. These concepts are complicated and technical and all of the rules set forth in the applicable regulations apply for purposes of this Agreement.

  • Eligible Expenditure means an expenditure described as eligible in Schedule B or deemed eligible by Canada in accordance with Section 4.2.

  • Maximum Benefit Amount means the maximum amount payable for coverage provided to You as shown in the Schedule of Benefits.

  • Maximum allowable cost means the maximum amount that a pharmacy benefit manager will reimburse a pharmacy for the cost of a drug.

  • Maximum Face Amount means, with respect to any outstanding Letter of Credit, the face amount of such Letter of Credit including all automatic increases provided for in such Letter of Credit, whether or not any such automatic increase has become effective.

  • Quarterly Excess Available Funds Percentage means, with respect to the March 2008 Transfer Date and each Transfer Date thereafter, the percentage equivalent of a fraction the numerator of which is the sum of the Excess Available Funds Percentages with respect to the immediately preceding three Monthly Periods and the denominator of which is three.

  • Maximum Available Amount means, on any date of determination, an amount equal to the lesser of:

  • Annual Deferral Amount means that portion of a Participant's Base Annual Salary and Annual Bonus that a Participant elects to have, and is deferred, in accordance with Article 3, for any one Plan Year. In the event of a Participant's Retirement, Disability (if deferrals cease in accordance with Section 8.1), death or a Termination of Employment prior to the end of a Plan Year, such year's Annual Deferral Amount shall be the actual amount withheld prior to such event.

  • Daily Maximum Cash Amount means, with respect to the conversion of any Note, the quotient obtained by dividing (A) the Specified Dollar Amount applicable to such conversion by (B) forty (40).

  • Cumulative Net Loss Ratio means, as of any Payment Date, the ratio (expressed as a percentage) of (i) the aggregate Principal Balance of Receivables that became Defaulted Receivables plus all the Cram Down Losses (without duplication) which occurred during the period from the Cut-Off Date through the end of the related Collection Period reduced by the amount of Liquidation Proceeds with respect to Defaulted Receivables received during such period which are applied to principal of the Defaulted Receivables to (ii) the Pool Balance as of the Cut-Off Date.

  • Maximum Put Amount means the lesser of (i) Two Hundred Fifty Thousand Dollars ($250,000), or (ii) Two Hundred Fifty percent (250%) of the average of the Dollar Volume for the twenty (20) Trading Days immediately preceding the Put Date.

  • Minimum DSCR means, with respect to a Supplemental Loan, (i) if the Senior Indebtedness bears interest at a fixed rate, 1.25:1, or (ii) if the Senior Indebtedness bears interest at a floating rate, 1.10:1.

  • Minimum Quarterly Distribution means $0.35 per Unit per Quarter (or with respect to the period commencing on the Closing Date and ending on September 30, 2005, it means the product of $0.35 multiplied by a fraction of which the numerator is the number of days in such period and of which the denominator is 92), subject to adjustment in accordance with Section 6.6 and Section 6.9.

  • Payout Period means the time frame during which certain benefits payable hereunder shall be distributed. Payments shall be made in monthly installments commencing on the first day of the month following the occurrence of the event which triggers distribution and continuing for a period of one hundred eighty (180) months. Should the Executive make a Timely Election to receive a lump sum benefit payment, the Executive's Payout Period shall be deemed to be one (1) month.

  • Maximum allowable cost list means a list of drugs for

  • Total Available Amount With respect to any Distribution Date, the sum of the Available Interest and the Available Principal for such Distribution Date and the amount of all cash or other immediately available funds on deposit in the Reserve Account immediately prior to such Distribution Date.