Notification of Non Covered Benefit Clause Samples

The Notification of Non Covered Benefit clause requires that parties are informed when a particular benefit or service is not included under a policy or agreement. In practice, this means that if a claim is made for a service that is excluded from coverage, the responsible party must promptly notify the claimant, often specifying the reason for non-coverage and referencing the relevant policy terms. This clause ensures transparency and helps prevent misunderstandings by clearly communicating coverage limitations, allowing parties to make informed decisions and seek alternative solutions if necessary.
Notification of Non Covered Benefit. In accordance with Article XI, Section D.1., the MCO shall provide a Notification of Non Covered Benefit (▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇▇▇▇▇▇▇.▇▇▇/forms/f0/f01283.doc) to the member when a decision is made to: a. Deny a member’s request for a service outside the benefit package; or b. Deny a member's request for payment of a service outside of the benefit package.
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Notification of Non Covered Benefit. In accordance with Article XI, Section D.1, the PO shall provide a Notification of Non Covered Benefit (▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇▇▇▇▇▇▇.▇▇▇/forms/f00950a.docx)to the member when a decision is made to: Deny a member’s request for an excluded service; or Deny a member's request for payment of an excluded service.
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Notification of Non Covered Benefit. In accordance with Article X.D.1., the IHCP shall provide a Notification of Non Covered Benefit (▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇▇▇▇▇▇▇.▇▇▇/forms/f0/f01283.docx) to the member when a decision is made to: Deny a member’s request for a service outside the benefit package; or Deny a member's request for payment of a service outside of the benefit package. Geographic Service Region (GSR) means a county or group of counties for which the MCO has applied and been certified by the Department to provide the Family Care benefit.
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Notification of Non Covered Benefit. In accordance with Article X, Section D.1., the IHCP shall provide a Notification of Non Covered Benefit (▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇▇▇▇▇▇▇.▇▇▇/forms/f0/f01283.doc) to the member when a decision is made to: a. Deny a member’s request for a service outside the benefit package; or b. Deny a member's request for payment of a service outside of the benefit package.
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Related to Notification of Non Covered Benefit

  • Post-Retirement Benefits The present value of the expected cost of post-retirement medical and insurance benefits payable by the Borrower and its Subsidiaries to its employees and former employees, as estimated by the Borrower in accordance with procedures and assumptions deemed reasonable by the Required Lenders is zero.

  • Termination of Benefits Except as provided in Section 2 above or as may be required by law, Executive’s participation in all employee benefit (pension and welfare) and compensation plans of the Company shall cease as of the Termination Date. Nothing contained herein shall limit or otherwise impair Executive’s right to receive pension or similar benefit payments that are vested as of the Termination Date under any applicable tax-qualified pension or other plans, pursuant to the terms of the applicable plan.

  • Transition to Retirement 24.1 An Employee may advise their Employer in writing of their intention to retire within the next five years and participate in a retirement transition arrangement. 24.2 Transition to retirement arrangements may be proposed and, where agreed, implemented as: (a) a flexible working arrangement (see clause 16 (Flexible Working Arrangements)); (b) in writing between the parties; or (c) any combination of the above. 24.3 A transition to retirement arrangement may include but is not limited to: (a) a reduction in their EFT; (b) a job share arrangement; or (c) working in a position at a lower classification or rate of pay. 24.4 The Employer will consider, and not unreasonably refuse, a request by an Employee who wishes to transition to retirement: (a) to use accrued Long Service Leave (LSL) or Annual Leave for the purpose of reducing the number of days worked per week while retaining their previous employment status; or (b) to be appointed to a role which that has a lower hourly rate of pay or hours (post transition role), in which case: (i) the Employer will preserve the accrual of LSL at the time of reduction in salary or hours; and (ii) where LSL is taken or paid out in lieu on termination, the Employee will be paid LSL hours at the applicable classification and grade, and at the preserved hours, prior to the post transition role until the preserved LSL hours are exhausted.