Primary enrollee definition

Primary enrollee means a person who is responsible for making payments for participation in a health care plan or an enrollee whose employment or other status is the basis of eligibility for enrollment in a health care plan.
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Primary enrollee means an Employee who is enrolled hereunder. Prospective Rating Method shall mean the rating method where Delta Dental is at risk for claims cost versus premium. Protected Health Information, (PHI) shall mean information related to an Enrollee‘s health status or Treatment received, that is individually identifiable by reference to the Enrollee. Records shall mean the data collected by Delta Dental regarding claims administration. Retention Rating Method shall mean the rating method where Delta Dental is at risk for losses, but surpluses are refunded to the purchaser. Services shall mean the Treatments set forth in Schedule A and any applicable Riders to Schedule A, which Schedule and Riders are incorporated herein and made part hereof by reference, the provisions, conditions, limitations and exclusions contained in Schedule A, performed by a Dentist or under his/her supervision and direction and when necessary, customary and reasonable, as determined by Delta Dental, using standards of generally accepted dental practice. Single Procedure shall mean a dental procedure to which a separate procedure number is assigned by Delta Dental. Treatment shall mean a caring for or dealing with an oral condition.
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Primary enrollee means a person who is responsible for making payments for participation in a
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Examples of Primary enrollee in a sentence

  • Persons eligible for enrollment as Enrollees shall be: Primary Enrollee Only Primary Enrollee and One Dependent Primary Enrollee and All Dependents x Primary Enrollee and Specified Dependents Specified Dependent (only) (All) Dependents (only) All members of a defined group must be enrolled by the Company as Enrollees.


More Definitions of Primary enrollee

Primary enrollee means a person who is responsible
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Related to Primary enrollee

  • Enrollee means any person entitled to health care services from a carrier.

  • primary carer means the person who has responsibility for the care of the Child. Only one person can be the Child’s Primary Carer on a particular day.

  • Primary care provider (PCP) means, for the purpose of this plan, professional providers that are family practitioners, internists, and pediatricians. For the purpose of this plan, gynecologists, obstetricians, nurse practitioners, and physician assistants may be credentialed as PCPs. To find a PCP or check that your provider is a PCP, please use the “Find a Doctor” tool on our website or call Customer Service.

  • HMO means any health maintenance organization, managed care organization, any Person doing business as a health maintenance organization or managed care organization, or any Person required to qualify or be licensed as a health maintenance organization or managed care organization under applicable federal or state law (including, without limitation, HMO Regulations).

  • DSHS means the Department of State Health Services.

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79