Member Benefit Plan definition

Member Benefit Plan means the applicable Medicaid plan through which a Member is covered. Non-Covered Services means those services which exceed any limit on, or are outside the scope of health care coverage of Member Benefit Plans.
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Examples of Member Benefit Plan in a sentence

  • Creative teaching and learning tries to find solutions to the challenges occurring due to the cultural and socioeconomic diversity of the students.

  • WHEN THE PLAN IS PRIMARY, Your Participating Provider can: • Submit to the insurance company on a secondary basis at Participating Provider’s usual and customary rates, but indicating the out-of-pocket Benefit Plan Copayment for procedures performed.• Accept payment from the secondary insurance company equal to the Member Benefit Plan Copayment.• Only bill the Member if the insurance pays an amount less than the Benefit Plan Copayment.

  • IPA shall implement cash management policies in keeping with sound financial management practices in order to ensure timely and accurate payment to all providers who provide Medically Necessary IPA Services to IPA Members, acknowledging that WellCare is responsible for the final determination of benefit payments to be made under an IPA Member Benefit Plan.

  • IMPORTANT: Always contact ORS with any SSN issues or corrections before taking any action. To ensure you report new employees correctly, review the new e-learning module: New Employee Reporting Process  Use the Member Benefit Plan link on the Employer Reporting website to determine whether the employee is (1) new to the retirement system, (2) a current MPSERS member who is new to your reporting unit, or (3) a MPSERS retiree (if a retirement effective date is displayed).

  • Authorization The number of days or non-routine outpatient visits/units for which benefits have been applied as part of the Member Benefit Plan for payment (formerly known as Certification).

  • Before reporting wages and service for the first time for an employee new to your reporting unit you must check the Member Benefit Plan link on the employer reporting web site to find out if the new employee is already a MPSERS member or is new to the MPSERS system.

  • Follow the information displayed on the Member Benefit Plan screen and report wages and contributions on DTL2 and/or DTL4 records as dictated by the benefit plan displayed for this employee.

  • Further details can be found in the appeals process.Admissions CriteriaThe criteria for admission, published on the school’s website, are as follows: • Students must either have an EHCP or be in the process of gaining one or be a looked after child (with/without an EHCP)• The school admits year 7 to year 13 students.

Related to Member Benefit Plan

  • Seller Benefit Plan means each Employee Benefit Plan sponsored, maintained or contributed to by a Seller or any of its Affiliates or with respect to which a Seller or any of its Affiliates has, or could reasonably be expected to have, any direct or indirect Liability.

  • Seller Benefit Plans has the meaning set forth in Section 4.10(a).

  • Buyer Benefit Plans has the meaning set forth in Section 6.10(f).

  • Purchaser Benefit Plans has the meaning set forth in Section 8.7(d).

  • Non-U.S. Benefit Plan has the meaning set forth in Section 3.20(a).

  • Health benefit plan means a policy, contract, certificate or agreement offered or issued by a health carrier to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services.

  • Parent Benefit Plan means any Employee Benefit Plan maintained by, sponsored by or contributed to by, or obligated to be contributed to by any Parent Group Entity.

  • Qualified Benefit Plan has the meaning set forth in Section 3.20(c).

  • Company Benefit Plan has the meaning specified in Section 4.13(a).

  • Foreign Benefit Plan means any Employee Benefit Plan established, maintained or contributed to outside of the United States of America or which covers any employee working or residing outside of the United States.

  • Welfare Benefit Plan means each welfare benefit plan maintained or contributed to by the Company, including, but not limited to a plan that provides health (including medical and dental), life, accident or disability benefits or insurance, or similar coverage, in which Executive was participating at the time of the Change in Control.

  • Pension Benefit Plan means at any time any employee pension benefit plan (including a Multiple Employer Plan, but not a Multiemployer Plan) which is covered by Title IV of ERISA or is subject to the minimum funding standards under Section 412 of the Code and either (i) is maintained by any member of the Controlled Group for employees of any member of the Controlled Group; or (ii) has at any time within the preceding five years been maintained by any entity which was at such time a member of the Controlled Group for employees of any entity which was at such time a member of the Controlled Group.

  • Company Employee Benefit Plan means each Employee Benefit Plan that is maintained, sponsored or contributed to (or required to be contributed to) by any of the Group Companies or under or with respect to which any of the Group Companies has any Liability.

  • Parent Benefit Plans has the meaning set forth in Section 5.07(b).

  • Benefit Plan means any of (a) an “employee benefit plan” (as defined in ERISA) that is subject to Title I of ERISA, (b) a “plan” as defined in and subject to Section 4975 of the Code or (c) any Person whose assets include (for purposes of ERISA Section 3(42) or otherwise for purposes of Title I of ERISA or Section 4975 of the Code) the assets of any such “employee benefit plan” or “plan”.

  • Company Benefit Plans has the meaning set forth in Section 3.16(a).

  • Company Employee Plan means any plan, program, policy, practice, contract, agreement or other arrangement providing for compensation, severance, termination pay, deferred compensation, performance awards, stock or stock-related awards, fringe benefits or other employee benefits or remuneration of any kind, whether written or unwritten or otherwise, funded or unfunded, including without limitation, each "employee benefit plan," within the meaning of Section 3(3) of ERISA which is or has been maintained, contributed to, or required to be contributed to, by the Company or any Affiliate for the benefit of any Employee, or with respect to which the Company or any Affiliate has or may have any liability or obligation;

  • Defined Benefit Plan means each Benefit Plan which is subject to Part 3 of Title I of ERISA, Section 412 of the Code or Title IV of ERISA.

  • Company Plan means all Plans of which the Company or an ERISA Affiliate of the Company is or was a Plan Sponsor, or to which the Company or an ERISA Affiliate of the Company otherwise contributes or has contributed, or in which the Company or an ERISA Affiliate of the Company otherwise participates or has participated. All references to Plans are to Company Plans unless the context requires otherwise.

  • Basic health benefit plan means any plan offered to an individual, a small group,

  • Compensation and Benefit Plans has the meaning set forth in Section 5.03(m).

  • Employee Welfare Benefit Plan has the meaning set forth in ERISA Section 3(1).

  • Parent Employee Plan means any plan, program, policy, practice, contract, agreement or other arrangement providing for compensation, severance, termination pay, performance awards, stock or stock-related awards, fringe benefits or other employee benefits or remuneration of any kind, whether written or unwritten or otherwise, funded or unfunded, including without limitation, each "EMPLOYEE BENEFIT PLAN," within the meaning of Section 3(3) of ERISA which is maintained, contributed to, or required to be contributed to, by Parent or any Affiliate for the benefit of any Parent Employee;

  • Foreign Benefit Arrangement any employee benefit arrangement mandated by non-US law that is maintained or contributed to by any Group Member or any ERISA Affiliate.

  • Canadian Benefit Plan means any plan, fund, program or policy, whether oral or written, formal or informal, funded or unfunded, insured or uninsured, providing employee benefits, including medical, hospital care, dental, sickness, accident, disability, life insurance, pension, retirement or savings benefits, under which any Loan Party has any liability with respect to any of its employees or former employees employed in Canada, and includes any Canadian Pension Plan.

  • Employee Pension Benefit Plan has the meaning set forth in ERISA Section 3(2).