Prospective Beneficiary definition
Examples of Prospective Beneficiary in a sentence
Once the Department has determined that an individual is an Eligible Enrollee and after the Eligible Enrollee has selected the Contractor's Plan, such individual shall become a Prospective Beneficiary.
This Plan does not recognize the terms of any prenuptial, post-nuptial or similar agreement as having the effect of either a designation of Prospective Beneficiary or a spousal consent under this Section.
The designation by a married Participant of his/her Spouse to be his/her sole primary Prospective Beneficiary shall not require the consent of his/her Spouse hereunder.
A Prospective Beneficiary shall become a Beneficiary on the effective date of coverage.
The Primary Care Provider or Women's Health Care Provider selected by the Prospective Beneficiary must provide necessary service including providing pregnant women with priority services in an expedient manner in order for such Prospective Beneficiaries to establish a relationship with the Primary Care Provider or Women's Health Care Provider, promoting and ensuring continuity of care, and determining any special needs as early in the pregnancy as possible.
Other than as provided in Section 18.01(b), no Participant, Beneficiary or Alternate Payee shall have the right to alienate, anticipate, commute, pledge, encumber or assign any of the benefits or payments which he/she may expect to receive, contingently or otherwise, under this Plan, except the right to designate a Prospective Beneficiary or Prospective Beneficiaries as hereinabove provided.
Each Participant may at any time, and from time to time, change his/her primary Prospective Beneficiary and/or contingent Prospective Beneficiary designations; provided, however, that if the Participant is married, any such change which does not result in the designation of the Participant's Spouse as his/her primary Prospective Beneficiary shall be invalid unless and until consented to by the Participant's Spouse in the manner described in Section 9.03.
Where the language is other than English, the Contractor shall offer and, if accepted by the Eligible Enrollee, Prospective Beneficiary or Beneficiary, shall supply interpretive services.
If the Department determines that the Contractor has misrepresented or falsified information furnished to an Eligible Enrollee, Prospective Beneficiary, Beneficiary, Provider, the Department or HCFA, the Department may impose a sanction of $1,000.00 to $5,000.00.
If a married Participant is unable to determine the whereabouts of his/her Spouse, such Participant may file with the Plan Administrator an "Affidavit of Missing Spouse," which affidavit may be accepted by the Plan Administrator in lieu of the spousal consent otherwise required by this Section in connection with the designation by the Participant of a non-spousal Prospective Beneficiary.