Pediatric Vision Coverage Clause Samples

The Pediatric Vision Coverage clause defines the health insurance benefits provided for vision care services specifically for children, typically under the age of 19. This clause outlines what pediatric vision services are included, such as routine eye exams, prescription glasses, or contact lenses, and may specify frequency limits or cost-sharing requirements. Its core practical function is to ensure that children covered under the policy have access to essential vision care, addressing early detection and correction of vision problems to support healthy development.
Pediatric Vision Coverage. A. When the Member receives a vision examination from a Contracting Vision Provider, the benefit payment is accepted as payment in full. B. When a Member receives frames and spectacle lenses or contact lenses from a Contracting Vision Provider, the Member’s responsibility is as stated below. The benefit payment is as stated in the attached Schedule of Benefits. 1. When the Member receives frames from the display of collection frames (the collection designated by the Vision Care Designee) and basic spectacle lenses from a Contracting Vision Provider, the benefit payment is accepted as payment in full. 2. When the Member receives other frames, non-basic spectacle lenses or contact lenses from a Contracting Vision Provider, the Member is responsible for the cost difference between the Vision Care Designee’s payment and the Contracting Vision Provider’s actual charge. C. When the Member receives Covered Vision Services from a Non-Contracting Vision Provider, the Member is responsible for the cost difference between the Vision Care Designee’s payment and the Non-Contracting Vision Provider’s actual charge. The Vision Care Designee’s payment is stated in the Schedule of Benefits. D. Limited Access Area: If the Member resides in an area that does not have adequate access to a Contracting Vision Provider and the Member receives Vision Care from a Non-Contracting Vision Provider, the Vision Care Designee will pay up to 100% of the Allowed Benefit. The Member is responsible for any difference between the amount billed and the Vision Care Designee’s payment. To determine if the Member resides in a limited access area, the Member must call the Vision Care Designee at the telephone number on the Member’s identification card.
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Pediatric Vision Coverage. 1. When the Member receives a vision examination from a Contracting Vision Provider, the benefit payment is accepted as payment in full. 2. When a Member receives frames and spectacle lenses or contact lenses from a Contracting Vision Provider, the Member’s responsibility is as stated below. The benefit payment is as stated in the attached Schedule of Benefits. a. When the Member receives frames from the display of collection frames (the collection designated by the Vision Care Designee) and basic spectacle lenses from a Contracting Vision Provider, the benefit payment is accepted as payment in full. b. When the Member receives other frames, non-basic spectacle lenses or contact lenses from a Contracting Vision Provider, the Member is responsible for the cost difference between the Vision Care Designee’s payment and the Contracting Vision Provider’s actual charge. 3. When the Member receives Covered Vision Services from a Non-Contracting Vision Provider, the Member is responsible for the cost difference between the Vision Care Designee’s payment and the Non-Contracting Vision Provider’s actual charge. The Vision Care Designee’s payment is stated in the Schedule of Benefits.
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Pediatric Vision Coverage. A. When the Member receives a vision examination from a Contracting Vision Provider, the benefit payment is accepted as payment in full. B. When a Member receives frames and spectacle lenses or contact lenses from a SAMPLE Contracting Vision Provider, the Member’s responsibility is as stated below. The benefit payment is as stated in the attached Schedule of Benefits.
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Related to Pediatric Vision Coverage

  • Vision Coverage A fully employee paid vision benefit will be available beginning January 1, 2021 subject to agreement by the subcommittee of the Joint Labor Management Insurance Committee to the benefit set determined through the state’s Request for Proposal (RFP) process.

  • Vision Care Plan The County agrees to provide a Vision Care Plan for all employees and dependents. The Plan will be the Vision Service Plan - Plan A with benefits at 12/12/24 month intervals with twenty dollar ($20.00) deductible for examinations and twenty dollar ($20.00) deductible for materials. The County will fully pay the monthly premium for employee and dependents and pick up inflationary costs during the term of this agreement.

  • Medical Coverage The Executive shall be entitled to such continuation of health care coverage as is required under, and in accordance with, applicable law or otherwise provided in accordance with the Company’s policies. The Executive shall be notified in writing of the Executive’s rights to continue such coverage after the termination of the Executive’s employment pursuant to this Section 3(d)(iv), provided that the Executive timely complies with the conditions to continue such coverage. The Executive understands and acknowledges that the Executive is responsible to make all payments required for any such continued health care coverage that the Executive may choose to receive.

  • COMPENSATION COVERAGE The Employer shall provide coverage to all employees for injury on the job under the Workers’ Compensation Act of the Province of Alberta, or under an Insured Plan which provides coverage of compensation equal thereto.

  • Health Care Coverage The Company shall continue to provide Executive with medical, dental, vision and mental health care coverage at or equivalent to the level of coverage that the Executive had at the time of the termination of employment (including coverage for the Executive’s dependents to the extent such dependents were covered immediately prior to such termination of employment) for the remainder of the Term of Employment, provided, however that in the event such coverage may no longer be extended to Executive following termination of Executive’s employment either by the terms of the Company’s health care plans or under then applicable law, the Company shall instead reimburse Executive for the amount equivalent to the Company’s cost of substantially equivalent health care coverage to Executive under ERISA Section 601 and thereafter and Section 4980B of the Internal Revenue Code (i.e., COBRA coverage) for a period not to exceed the lesser of (A) 18 months after the termination of Executive’s employment or (B) the remainder of the Term of Employment, and provided further that (1) any such health care coverage or reimbursement for health care coverage shall cease at such time that Executive becomes eligible for health care coverage through another employer and (2) any such reimbursement shall be made no later than the last day of the calendar year following the end of the calendar year with respect to which such coverage or reimbursement is provided. The Company shall have no further obligations to the Executive as a result of termination of employment described in this Section 8(a) except as set forth in Section 12.