Coverage Agreement definition

Coverage Agreement means any agreement, program or certificate entered into, issued or agreed to by Company or Payor, under which Company or Payor furnishes administrative services or other services in support of a health care program for an individual or group of individuals, and which may include access to one or more of Company’s provider networks or vendor arrangements, except those excluded by Health Plan.
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Coverage Agreement means the entire coverage agreement issued for the coverage period shown on the Information Pages.
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Coverage Agreement means any agreement, program or certificate entered into, issued or agreed to by a Payor, under which the Payor arranges for the delivery of health care services to Covered Persons through one or more network(s) of providers or other vendor arrangements.
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Examples of Coverage Agreement in a sentence

  • A Company is only responsible for performing its respective obligations hereunder with respect to a particular Product, Coverage Agreement, Payor Contract, Covered Service or Covered Person.

  • Any Cost-Sharing Amounts that the Covered Person is responsible to pay under the Coverage Agreement will be subtracted from the Allowed Amount in determining the amount to be paid.

  • Subject to the terms of this Agreement, Payor shall pay or arrange for payment of each Clean Claim received from a Contracted Provider for Covered Services provided to a Covered Person in accordance with the applicable Compensation Amount less any applicable copayments, cost-sharing or other amounts that are the Covered Person’s financial responsibility under the applicable Coverage Agreement.

  • This provision shall not prohibit collection of any applicable copayments, cost-sharing or other amounts that are the Covered Person’s financial responsibility under the applicable Coverage Agreement.


More Definitions of Coverage Agreement

Coverage Agreement means a written agreement between two neighboring ambulance service providers that each will cover the other’s 9−1−1 area when the other knows in advance that it will be unable to do so.
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Coverage Agreement means any agreement, program or certificate entered into, issued or agreed to by Company or Payor, under which Company or Payor furnishes administrative services or other services in support of a health care program for an individual or group of individuals, and which may include access to one or more of Company’s provider networks or vendor arrangements, except those excluded by Carolina Complete.
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Coverage Agreement. Unless the context requires otherwise, any use of the term “Coverage Agreement” will include its endorsements and the Fund Member’s CCS.
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Coverage Agreement means the coverage document(s) established by the Board of Directors and intended to address the general claim operations of the Agency.
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Coverage Agreement means a written agreement between two neighboring ambulance service providers that each
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Coverage Agreement means an agreement between an employer and the Administration Corporation pursuant to which the employer consents to provide benefits under this Plan to a particular class of its employees;
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Coverage Agreement means the agreement between the CIS Trust and a Member describing the terms and conditions of coverage provided in consideration of the Contribution received from the Member. A separate Coverage Agreement shall exist for each Line of Coverage made available by the Board of Trustees.
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