Other Coverage definition

Other Coverage means another public or private plan of health insurance or other health benefit arrangement including Medicare, Medicaid or Champus, that provides benefits similar to or exceeding the benefits provided under this Group Contract.
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Other Coverage means any recovery or reimbursement for covered charges available from any other source whatsoever whether that is due to an insurance policy, or other type of coverage. This does not include gifts or donations, but does include, but is not limited to:
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Other Coverage means any other contract or policy under which the COVERED PERSON is enrolled, such as:
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Examples of Other Coverage in a sentence

  • It is extremely important that the value entered in the Other Coverage Code field corresponds to the entry in the Other Payer Amount Paid field.

  • For a third party or Medicare Managed Care Organization (MCO) claim to be successfully captured, the Other Coverage Code field and Other Payer Amount Paid field must be entered.

  • Changes must correspond to coverage changes under the other employer’s plan – for example, this would allow you to revoke your election mid-year if your spouse’s plan offers open enrollment and you actually enroll in your spouse’s plan.d. Loss of Other Coverage Under A Governmental or Educational Institution Plan: If you, your spouse, or dependent lose coverage under any governmental or educational institution health plan, you may make an election to add coverage under youremployer’s plan.

  • When submitting claims with value “3” in the (Other Coverage Code) field 308-C8, the NCPDP reject code or code(s) from the Other Payer(s) must also be entered in field 472- 6E (Other Payer Reject Code).

  • Under such circumstances, the Executive shall make all claims first under the Other Coverage and then, only to the extent not paid or reimbursed by the Other Coverage, under the plans and programs described in Section 6(a)(i) hereof.

  • Special Enrollment Due to Loss of Certain Other Coverage Special Enrollment Rights due to loss of certain other coverage are available only to current Employees, elected officials, officers or directors and their Dependents.

  • Are There Other Coverage Options Besides COBRA Continuation Coverage?Yes.

  • Also, the words "covered building" used throughout this Other Coverage 12.

  • Participating Providers are listed in the Participating Provider directory.Participating Providers agree to accept Blue Shield’s payment, plus the Member’s payment of any applicable Deductibles, Copayments, Coinsur- ance or amounts in excess of specified Benefit maximums as payment-in-full for Covered Ser- vices, except as provided under the Exception for Other Coverage and the Reductions – Third Party Liability sections.

  • In this Condition E., the terms "cost to repair or re- place" and "replacement cost" do not include the increased costs incurred to comply with the en- forcement of any ordinance or law except to the extent that coverage for these increased costs is provided in Other Coverage F.12.


More Definitions of Other Coverage

Other Coverage means comprehensive medical insurance provided by another insurance plan, not the City’s plan.
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Other Coverage means coverage under any of the following:
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Other Coverage means any other contract or policy under which the COVERED PERSON is enrolled, such as: * Group or blanket insurance; * Group plans, other employer plans, individual plans offered on a group basis, or other group prepayment coverage;* Labor management trusteed plans, union welfare plans, employee organization plans, or employee benefit organization plans; * Government programs, such as Medicare, or coverage required or provided by statute; * Any group coverage of a child sponsored by, or provided through, any educational institution; * Group arrangements for members of associations or individuals.
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Other Coverage means any other coverage by means of any individual, entity or program that is, or may be, liable to pay all or part of the medical expenses incurred by a member including, but not limited to, first and third party payers.
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Other Coverage. If an employee who is covered by this provision retires and is able to obtain health care coverage from another source (e.g., other employment), the retiree may choose to drop the City’s health care coverage. However, should the retiree lose his/her alternate coverage for any reason, including voluntary or involuntary separation of employment, upon production of proof-of-loss to the City, such retiree may elect to reenroll under the City’s health coverage. Such coverage shall be restored and recommence immediately following the production of such proof-of-loss. The City shall not prohibit a retiree or surviving spouse or eligible dependent from re-entering the City’s PPO Plan for any reason upon loss of coverage from another program, and the health coverage benefits provided upon return to City coverage will be the same as those the employee was entitled to upon retirement. Hire date on or after July 1, 2016: Employees who are hired on or after July 1, 2016, (or who are promoted from another position in the City in which they were not eligible for retiree health care coverage) will not be eligible for employer paid health care insurance coverage at the time of retirement. For the term of this agreement, the City will annually contribute the actuarial equivalent of the collectively bargained amount into a Retirement Health Reimbursement Account for each bargaining unit member hired on or after July 1, 2016. Effective January 1, 2019, the amount of this contribution is $3,500, as outlined in Appendix F. The account will become available to employees upon their retirement, for reimbursement of eligible medical expenses, or to purchase, at the retiree’s full cost, access to the City health care plan that may be offered at that time.
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Related to Other Coverage

  • Lot coverage means the portion or percentage of the area of a lot upon which buildings are erected.

  • Claims-made coverage means an insurance contract or provision limiting

  • Fraud Coverage During the period prior to the first anniversary of the Cut-Off Date, 2.00% of the aggregate principal balance of the Mortgage Loans as of the Cut-Off Date (the "Initial Fraud Coverage"), reduced by Fraud Losses allocated to the Certificates since the Cut-Off Date; during the period from the first anniversary of the Cut-Off Date to (but not including) the fifth anniversary of the Cut-Off Date, the amount of the Fraud Coverage on the most recent previous anniversary of the Cut-Off Date (calculated in accordance with the second sentence of this paragraph) reduced by Fraud Losses allocated to the Certificates since such anniversary; and during the period on and after the fifth anniversary of the Cut-Off Date, zero. On each anniversary of the Cut-Off Date, the Fraud Coverage shall be reduced to the lesser of (i) on the first, second, third and fourth anniversaries of the Cut-Off Date, 1.00% of the aggregate principal balance of the Mortgage Loans as of the Due Date in the preceding month and (ii) the excess of the Initial Fraud Coverage over cumulative Fraud Losses allocated to the Certificates since the Cut-Off Date. The Fraud Coverage may be reduced upon written confirmation from the Rating Agencies that such reduction will not adversely affect the then current ratings assigned to the Certificates by the Rating Agencies.

  • Errors and Omissions Policy As defined in each of the Servicing Agreements.

  • Errors and Omissions Insurance Policy means an errors and omissions insurance policy maintained by the Master Servicer, the Special Servicer, the Trustee, the Custodian or the Certificate Administrator, as the case may be, in accordance with Section 8.2, Section 9.2 and Section 7.17, respectively.

  • General Liability Insurance Subcontractor shall carry minimum primary General Liability Insurance for the following amounts:

  • Child or covered child means a child (natural, step-child, legally adopted or a minor or disabled child who is dependent on the insured for support and maintenance) who is born to or brought to a marriage or to a civil union established according to Vermont law.

  • Professional liability insurance means insurance against legal liability incident to the practice of a profession and provision of a professional service.

  • Co-insurance means the percentage of the usual, reasonable, customary, and fair market value expense that a covered person must pay.

  • Issuer Covered Person shall have the meaning ascribed to such term in Section 3.1(oo).

  • Coverage or “Covering”) shall mean that the developing, making, using, offering for sale, promoting, selling or importing of a given compound, formulation or product would infringe a Valid Claim of an issued patent in the absence of a license under such Valid Claim. The determination of whether a compound, formulation or product is Covered by a particular Valid Claim shall be made on a country-by-country basis.

  • Liability Insurance means compulsory professional liability errors and omissions insurance required by a governing body;

  • Term Of This Policy means the period from and including the Date of Issuance to and including the date on which (i) all Scheduled Payments have been paid or deemed to be paid within the meaning of Section 4.1 of the Indenture; (ii) any period during which any Scheduled Payment could have been avoided in whole or in part as a preference payment under applicable bankruptcy, insolvency, receivership or similar law shall have expired and (iii) if any proceedings requisite to avoidance as a preference payment have been commenced prior to the occurrence of (i) and (ii), a final and nonappealable order in resolution of each such proceeding has been entered.

  • Impervious cover means a surface composed of material that significantly impedes or prevents natural infiltration of water into soil.

  • Fidelity Insurance means insurance coverage with respect to employee errors, omissions, dishonesty, forgery, theft, disappearance and destruction, robbery and safe burglary, property (other than money and securities) and computer fraud in an aggregate amount acceptable to Seller’s regulators.

  • Insurance Coverage Contractor shall, at Contractor’s sole expense, procure, maintain and keep in force for the duration of this Contract the following insurance conforming to the minimum requirements specified below. Unless specified herein or otherwise agreed to by the City, the required insurance shall be in effect prior to the commencement of work by Contractor and shall continue in force as appropriate until the latter of:

  • Other Insurance means insurance available to any covered person that covers a loss to which this policy applies, other than either primary insurance or insurance specifically purchased by you to be excess of the insurance afforded by this policy.

  • Insurance means (i) all insurance policies covering any or all of the Collateral (regardless of whether the Collateral Agent is the loss payee thereof) and (ii) any key man life insurance policies.

  • Other Contractors means any contractor (other than the entity which executed this Contract or its Subcontractors) who or which has a contract with the City for work on or adjacent to the building or Site of the Work.

  • COBRA Coverage means continuation coverage required under Section 4980B of the Code and Part 6 of Title I of ERISA.

  • Master Policy means a single worker’s compensation insurance policy issued by an insurer authorized to do business in this state to an employee leasing company in the name of the employee leasing company that covers more than one client of the employee leasing company.

  • Family Coverage means coverage for you and your eligible spouse and/or dependents under this Certificate. FREESTANDING FACILITY……means an Outpatient services facility that is not covered under a Hospital's written agreement with Blue Cross and Blue Shield and has its own billing number and written agreement with Blue Cross and Blue Shield to provide services to participants in the benefit program at the time services are rendered. Freestanding Facilities may also be referred to as Outpatient Freestanding Facilities. GROUP POLICY or POLICY.....means the agreement between Blue Cross and Blue Shield and the Group, any addenda, this Certificate, the Group’s application and the Plan, as appropriate, along with any exhibits, appendices, addenda and/or other required information and the individual application(s) of the persons covered under the benefit program. HABILITATIVE SERVICES....means Occupational Therapy, Physical Therapy, Speech Therapy, and other services prescribed by a Physician pursuant to a treatment plan to enhance the ability of a child to function with a Congenital, Genetic, or Early Acquired Disorder. These services may include Physical Therapy and Occupational Therapy, speech language pathology, and other services for a Covered Person with disabilities in a variety of Inpatient and/or Outpatient settings, with coverage as described in the Certificate. HEARING AID.....means any wearable non-disposable, non-experimental instrument or device designed to aid or compensate for impaired human hearing and any parts, attachments, or accessories for the instrument or device, including an ear mold. HEARING CARE PROFESSIONAL. means a person who is a licensed Hearing Aid dispenser, licensed audiologist, or licensed physician operating within the scope of such license. HOME INFUSION THERAPY PROVIDER. means a duly licensed home infusion therapy provider, when operating within the scope of such license. PARTICIPATING HOME INFUSION THERAPY PROVIDER… means a Home Infusion Therapy Provider who has a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide Covered Services to participants in the benefit program at the time Covered Services are rendered. NON-PARTICIPATING HOME INFUSION THERAPY PROVIDER… means a Home Infusion Therapy Provider who does not have a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide Covered Services to participants in the benefit program at the time Covered Services are rendered. HOSPICE CARE PROGRAM PROVIDER.....means an organization duly licensed to provide Hospice Care Program Service, when operating within the scope of such license. PARTICIPATING HOSPICE CARE PROGRAM PROVIDER… means a Hospice Care Program Provider that either: (i) has a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide Covered Services to participants in the benefit program, or; (ii) a Hospice Care Program Provider that has been designated by any Blue Cross and/or Blue Shield Plan as a Participating Provider in the benefit program. NON-PARTICIPATING HOSPICE CARE PROGRAM PROVIDER… means a Hospice Care Program Provider that either:

  • Health Coverage means that if Key Employee elects to continue coverage for himself or his eligible dependents under the Company’s group health plans pursuant to the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended (“COBRA”), during the twelve-month period commencing on the date of Key Employee’s termination of employment from the Company (the “Severance Period”), then throughout the Severance Period the Company shall promptly reimburse Key Employee on a monthly basis for the difference between the amount Key Employee pays to effect and continue such coverage and the employee contribution amount that active senior employees pay for the same or similar coverage under Company’s group health plans. Further, if after the Severance Period Key Employee continues his COBRA coverage and Key Employee’s COBRA coverage terminates at any time during the eighteen-month period commencing on the day immediately following the last day of the Severance Period (the “Extended Coverage Period”), then the Company shall provide Key Employee (and his eligible dependents) with health benefits substantially similar to those provided under its group health plans for active employees for the remainder of the Extended Coverage Period at a cost to Key Employee that is no greater than the cost of COBRA coverage; provided, however, that the Company shall use its reasonable efforts so that such health benefits are provided to Key Employee under one or more insurance policies (or such other manner) so that reimbursement or payment of benefits to Key Employee thereunder shall not result in taxable income to Key Employee. Notwithstanding the preceding provisions of this paragraph, the Company’s obligation to reimburse Key Employee during the Severance Period and to provide health benefits to Key Employee during the Extended Coverage Period shall immediately end if and to the extent Key Employee becomes eligible to receive health plan coverage from a subsequent employer (with Key Employee being obligated hereunder to promptly report such eligibility to the Company).

  • Other Contractor means any party or parties having a direct Contract with the Employer for Work outside the scope of this Contract and shall include any Sub-Contractor of this “Other Contractor”

  • All Risk property insurance on a full replacement cost basis insuring CLEC’s property situated on or within any CenturyLink Premises. CLEC may elect to insure business interruption and contingent business interruption, as it is agreed that CenturyLink has no liability for loss of profit or revenues should an interruption of service occur.

  • Tail risk means a risk that occurs either where the frequency of low probability events is higher than expected under a normal probability distribution or where there are observed events of very significant size or magnitude.