Covered By Another Plan Sample Clauses

The "Covered By Another Plan" clause defines how benefits or coverage are coordinated when an individual is eligible for coverage under more than one insurance plan. Typically, this clause outlines the procedures for determining which plan is primary and which is secondary, and how payments are allocated between the plans to avoid duplication of benefits. Its core practical function is to prevent double payment for the same claim and to ensure that the insured receives the appropriate level of benefits without exceeding the total cost of the covered services.
Covered By Another Plan. The person receiving continuation coverage becomes covered under another group health plan with no pre-existing condition limitation or exclusion. For plan years beginning on or after June 30, 1997, however, a pre-existing exclusion or limitation in the other group health plan will not prevent COBRA continuation coverage from being terminated if the exclusion or limitation does not apply (or is otherwise satisfied) due to the applicable group health plan portability, access and renewability provisions of the Health Insurance Portability and Accessibility Act.
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Related to Covered By Another Plan

  • Period Covered by Request Requests must set forth a specific period, not to exceed 90 days from the date of the request, for which transaction information is sought. The Fund may request transaction information older than 90 days from the date of the request as it deems necessary to investigate compliance with policies established by the Fund for the purpose of eliminating or reducing any dilution of the value of the outstanding shares issued by the Fund.

  • Medical Benefits - Prescription Drugs Administered by a Provider (other than a pharmacist)

  • When You Are Covered by More Than One Insurer A healthcare coverage plan is considered the primary plan and its benefits will be paid first if: • the plan does not use similar COB rules to determine coverage; or • the plan does not have a COB provision; or • The plan has similar the COB rules and is determined to be primary under the order of benefit determination rules described below. Benefits under another plan include all benefits that would be paid if claims had been initially submitted under that plan. The following factors are used to determine which plan is primary and which plan is • if you are the main subscriber or a dependent; • if you are married, which spouse was born earlier in the year; • the length of time each spouse has been covered under the plan; • if a parental custody or divorce decree applies; or • if Medicare is your other coverage then Medicare guidelines will apply. These factors make up the order of benefit determination rules, described in greater detail below:

  • Award Confers No Rights to Continued Employment In no event shall the granting of the Award or its acceptance by the Holder, or any provision of the Agreement or the Plan, give or be deemed to give the Holder any right to continued employment by the Company, any Subsidiary or any affiliate of the Company or affect in any manner the right of the Company, any Subsidiary or any affiliate of the Company to terminate the employment of any person at any time.

  • Covered Benefits Benefits for Bone Mass Measurement for the prevention, diagnosis, and treatment of osteoporosis are covered when requested by a Health Care Provider for a Qualified Individual.