Maximum Plan Allowance definition

Maximum Plan Allowance or “MPA” means the total dollar amount allowed for a specific Benefit.
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Maximum Plan Allowance means the amount that a Delta Dental Premier Dentist agrees contractually to accept as full payment for covered procedures. The Maximum Plan Allowance is calculated as a percentile of billed fees.
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Maximum Plan Allowance means the lesser of the following:
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Examples of Maximum Plan Allowance in a sentence

  • ODS will use the Maximum Plan Allowance for the comparable code to price the claim.

  • It is usually a percentage of the Maximum Plan Allowance the Enrollee pays directly to the Dentist for covered Benefits after meeting any applicable deductible.

  • The Maximum Plan Allowance is determined by HDS as to each Covered Benefit.

  • If you go to a non-participating Dentist (not contracted with a Delta Dental plan), DDMO will make payment directly to you based on the applicable Maximum Plan Allowance for the non-participating Dentist.

  • You are not responsible for paying the participating Dentist any amount that exceeds the Delta Dental PPO or Delta Dental Premier Maximum Plan Allowance, whichever is applicable.

  • If the fee is not payable because of a deductible, annual maximum, waiting period or frequency limitation, the dentist may bill up to the Maximum Plan Allowance.

  • If the crown is benefited, the dentist is held to the Maximum Plan Allowance for the service.

  • You or Your means the member.* Services by Non Network providers are subject to the Allowed Amount including the Maximum Plan Allowance for Non Network Providers.

  • Given the limited existing data of the area, additional surveys were required to provide the necessary detail as part of the Pluto project approval.

  • Not all Premier Dentists are PPO Dentists; however, all Premier Dentists agree to accept Delta Dental’s Maximum Plan Allowance for each Single Procedure as payment in full.


More Definitions of Maximum Plan Allowance

Maximum Plan Allowance or “MPA” means the amount we will allow for each covered Benefit based on the lowest of:
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Maximum Plan Allowance. (or MPA) means the maximum amount Delta Dental will reimburse for a covered procedure. Delta Dental establishes the MPA for each procedure through a review of proprietary filed fee data and actual submitted claims. MPAs are set annually to reflect charges based on actual submitted claims from providers in the same geographical area with similar professional standing. The MPA may vary by the type of network Dentist.
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Maximum Plan Allowance means the total dollar amount allowed under the Contract for a specific Benefit. The Maximum Plan Allowance will be reduced by any Deductible and Coinsurance the Subscriber or Covered Dependent is required to pay.
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Maximum Plan Allowance or “UCR” means the amount determined by the applicable Delta Dental Plan as the highest amount allowed for a particular procedure, service, or item for the particular Dentist or service provider. The amount allowed for a particular Dentist or service provider depends on its, his or her participation status (e.g., PPO Dentist, Premier Dentist or Non-Participating Dentist).
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Maximum Plan Allowance means the most that will be allowed for a procedure. Delta Dental reviews the limits twice a year. We may increase or decrease fees for any procedure.
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Maximum Plan Allowance means the lesser of the following: a. In the case of a Participating Delta Dental Premier Dentist:
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Related to Maximum Plan Allowance

  • NOx Allowance means an authorization to emit a specified amount of NOx that is allocated or issued under an emissions trading or marketable permit program of any kind that has been established under the Clean Air Act or a state implementation plan.

  • disability living allowance means a disability living allowance under section 71 of the SSCBA;

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

  • Retirement allowance means the retirement payments to which a member is entitled.

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

  • Tenant Improvement Allowance in the maximum amount of $200.00 per rentable square foot in the Premises, which is included in the Base Rent set forth in the Lease; and

  • training allowance means an allowance (whether by way of periodical grants or otherwise) payable—

  • Maximum Applied Water Allowance (MAWA) means the upper limit of annual applied water for the established landscaped area as specified in Section 492.4. It is based upon the area's reference evapotranspiration, the ET Adjustment Factor, and the size of the landscape area. The Estimated Total Water Use shall not exceed the Maximum Applied Water Allowance. Special Landscape Areas, including recreation areas, areas permanently and solely dedicated to edible plants such as orchards and vegetable gardens, and areas irrigated with recycled water are subject to the MAWA with an ETAF not to exceed 1.0. MAWA = (ETo) (0.62) [(ETAF x LA) + ((1-ETAF) x SLA)]

  • Maximum Premium has the meaning set forth in Section 7.06(b).

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

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

  • Excess Compensation means Compensation in excess of the following Integration Level: (Choose (1) or (2))

  • Disability allowance means monthly payments during

  • emission allowance means a financial instrument as defined in point (11) of Section C of Annex I of Directive [new MiFID].

  • Restoration Threshold means an amount equal to 5% of the outstanding principal amount of the Loan.

  • Annual Addition The sum of the following amounts allocated on behalf of a Participant for a Limitation Year, of (i) all Employer contributions; (ii) all forfeitures; and (iii) all Employee contributions. Except to the extent provided in Treasury regulations, Annual Additions include excess contributions described in Code Section 401(k), excess aggregate contributions described in Code Section 401(m) and excess deferrals described in Code Section 402(g), irrespective of whether the plan distributes or forfeits such excess amounts. Annual Additions also include Excess Amounts reapplied to reduce Employer contributions under Section 3.10. Amounts allocated after March 31, 1984, to an individual medical account (as defined in Code Section 415(l)(2)) included as part of a defined benefit plan maintained by the Employer are Annual Additions. Furthermore, Annual Additions include contributions paid or accrued after December 31, 1985, for taxable years ending after December 31, 1985, attributable to post-retirement medical benefits allocated to the separate account of a key employee (as defined in Code Section 419A(d)(3)) under a welfare benefit fund (as defined in Code Section 419(e)) maintained by the Employer.

  • 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.

  • Annual Additions means the sum credited to a Participant's Accounts for any Limitation Year of (a) "employer" contributions, (b) Employee contributions (except as provided below), (c) Forfeitures, (d) amounts allocated to an individual medical benefit account, as defined in Code §415(l)(2), which is part of a pension or annuity plan maintained by the "employer," (e) amounts derived from contributions paid or accrued which are attributable to post-retirement medical benefits allocated to the separate account of a key employee (as defined in Code §419A(d)(3)) under a welfare benefit fund (as defined in Code §419(e)) maintained by the "employer" and (f) allocations under a simplified employee pension. Except, however, the Compensation percentage limitation referred to in paragraph (e)(5)(ii) below shall not apply to: (1) any contribution for medical benefits (within the meaning of Code §419A(f)(2)) after separation from service which is otherwise treated as an "annual addition," or (2) any amount otherwise treated as an "annual addition" under Code §415(l)(1).

  • Density bonus means a floor area ratio bonus over the otherwise maximum allowable density permitted under the applicable zoning ordinance and land use elements of the general plan of a city, including a charter city, city and county, or county of:

  • 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.

  • Maximum allowable cost list means a list of drugs for

  • Maximum Award means as to any Participant for any Performance Period, $4 million.

  • 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.

  • 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.

  • Total Compensation means the cash and noncash dollar value earned by the executive during the Contractor’s preceding fiscal year and includes the following (for more information see 17 CFR 229.402(c)(2)):

  • Annual Balanced Budget means that, in each Funding Year of the term of this Agreement, the total revenues of the HSP are greater than or equal to the total expenses, from all sources, of the HSP;