Plan Members definition
Examples of Plan Members in a sentence
Each Plan Member shall only be redeemed by the Company pursuant to this Section 4.4 to the extent necessary in order to avoid the assets of the Company constituting assets of the Plan Member for the purposes of the applicable Plan Governing Law and the Manager shall cause any such redemption to be made among all Plan Members with respect to which the basis for redemption is applicable in a manner determined by the Manager in its sole discretion.
Under the Preferred Provider Plan, Members may receive benefits for a particular service under either the In-Network component or the Out-of-Network component.
As a result of this change, the following benefit plans were discontinued: ⚫ BadgerCare Plus Benchmark Plan⚫ BadgerCare Plus Core Plan⚫ BadgerCare Plus Basic Plan Members who are enrolled in the Benchmark Plan or the Core Plan who met new income limits for BadgerCare Plus eligibility were automatically transitioned into the BadgerCare Plus Standard Plan on April 1, 2014.
Plan Members are responsible for the remaining 40%, the amount billed over any Reasonable Charges, and all charges for non-covered services.
Plan Members are responsible for the remaining 40% and all charges in excess of the Allowable Amount, plus all charges for non-covered services.NOTE: Regardless of the reason (medical or otherwise), referrals by Preferred Providers to Non- Preferred Providers will be reimbursed at the Non-Preferred Provider level.
If the Health Plan Member continues to refuse the recommended treatment or procedure, the State of Florida may terminate the Health Plan Member's coverage under this Plan.
PresRN is a no-cost service for Presbyterian Health Plan Members.
Participating Providers maintain the physician/patient relationship with Health Plan Members and are solely responsible for the recommendation and selection of all Medical Services which Participating Providers render to their patients who are Health Plan Members.
The State of Florida, as Plan Administrator, has the discretionary authority to (1) make decisions regarding the interpretation or application of Plan provisions (2) determine the rights, eligibility, and benefits of Health Plan Members and beneficiaries under the Plan, and (3) review Claims under the Plan.
From time to time the Union will survey the Insurance Carriers in the marketplace to ensure that the rates are very competitive and to secure the best deal possible for the Pension Plan Members at NO COST to the Plan Members.