Provisions of Coverage Sample Clauses
The "Provisions of Coverage" clause defines the specific terms, conditions, and scope under which an insurance policy or service agreement provides protection or benefits. It typically outlines what is included and excluded from coverage, the duration of coverage, and any limitations or requirements that must be met for a claim to be valid. For example, it may specify covered events, eligible beneficiaries, and necessary documentation for claims. This clause ensures that both parties clearly understand the extent of protection offered, thereby reducing disputes and clarifying expectations regarding the policy or agreement.
Provisions of Coverage. Provision of the health care insurance program shall be detailed in master policies and contracts agreed upon by the Board and the Association and shall include:
a. Hospital room and board and miscellaneous costs.
b. Out-patient benefits.
c. Laboratory fees, diagnostic expenses, and therapy treatments.
d. Maternity costs.
Provisions of Coverage. Provisions of the health care insurance program shall include:
a. Blue Cross
b. Blue Shield
c. Major Medical
▇. ▇▇▇▇▇ "J" In the event of a change of insurance carrier, the Association shall be notified of such change as soon as practicable.
Provisions of Coverage. The provisions of the insurance programs shall be detailed in master policies and contracts agreed upon by the Board and Association and shall provide benefits for the following services:
1. Hospitalization
2. Surgical
3. Out-Patient
4. Major Medical
5. Prescription
6. Dental (2003-04 $1,500 per person cap) (2004-05 $1,500 per person cap) (2005-06 $1,500 per person cap) Copies of such policies and contracts shall be made available to Association members.
Provisions of Coverage. Provisions of health care insurance program shall be detailed in master policies and contracts and shall include:
a. Hospital room and board and miscellaneous costs
b. Out-patient benefits
c. Laboratory fees, diagnostic expenses and therapy treatments
d. Maternity costs
e. Surgical costs
f. Major Medical coverage, lifetime maximum unlimited
g. Co-pay for office visits: $10.00 per visit h. Prescription Coverage co-pay - $10.00 generic; $20.00 preferred brand on drug plan list and $35.00 for non preferred name brand drugs not listed. Mail order prescriptions are subject to the same co-pays for each category.
i. Employees will not have the ability to submit prescription drug co-pays for reimbursement through Major Medical.
j. Deductibles of $300.00 for single coverage and $600.00 for family coverage k. Out of network coverage percentage of 70%/30%
Provisions of Coverage. The district shall provide full family coverage as follows. The following coverage is based upon the usual customary and reasonable fee concept.
Provisions of Coverage. The District shall provide a full family coverage prescription plan without charge to the employee but with a co-payment charge of $5.00 for generic drug prescriptions and $7.00 for brand name drug prescriptions. The District shall continue to provide without charge to the employee, the Maintenance Drug program outlined in 26:3-3 with a co-payment charge of $3.00.
Provisions of Coverage. The Board agrees to provide dental coverage for all eligible Association Members and dependents, in accordance with the provisions as agreed to by the Teacher's Association unit of the Union County Vocational-Technical Schools.
Provisions of Coverage. Provisions of the health-care insurance program shall be detailed in master policies and contracts agree upon by the District and the Association and shall include:
26:1 1.1 Hospital room and board and miscellaneous costs. 26:1-1.2 Out-patient benefits.
26:1 1.3 Laboratory fees, diagnostic expenses, and therapy treatments. 26:1-1.4 Maternity costs. 26:1-1.5 Surgical costs. 26:1-1.6 Major-medical coverage 26:1-1.7 Emergency room coverage
Provisions of Coverage. Provisions of the health care insurance program shall be detailed in master policies and contracts agreed upon by the Board and ALSS and shall include:
a. Hospital room and board, and miscellaneous costs
b. Out-patient benefits
c. Laboratory fees, diagnostic expenses, and therapy treatments
d. Maternity costs e. Surgical cost
Provisions of Coverage. The School Employees’ Health Benefits Program offers four (4) categories of health plans: Category 1: NJDirect 10, NJDirect 15, Aetna HMO, Cigna HealthCare HMO Category 2: NJDirect1525, Aetna1525, Cigna1525 Category 3: NJ Direct2030, Aetna2030, Cigna2030 Category 4: NJ Direct HD1500, Aetna HD1500, Cigna HD1500 In the event of a change of insurance carrier, the Association shall be notified of such change as soon as practicable.