In-Network Annual Maximum Sample Clauses

In-Network Annual Maximum. This Policy has an in-network annual maximum for in-network non-orthodontic benefits described in the Adult Dental Care section of this Policy. There is no annual maximum for the in-network pediatric dental essential health benefit. When Members receiving adult dental care or additional pediatric dental care have met the in-network annual maximum for non-orthodontic in-network Covered Services in the Schedule of Benefits section of this Policy, no more benefits will be payable for that Member for the remainder of that Plan Year. If you have other than individual coverage, the individual in-network annual maximum for adult dental care benefits applies to each person covered under this Policy. Once a person within a family meets the individual in-network annual maximum for adult dental care, no more benefits for services will be payable for that person. If other than individual coverage applies, when persons in the same family covered under this Policy have collectively met the family in-network annual maximum for benefits described in the Adult Dental Care section of this Policy, no more benefits will be payable for the family for the rest of that Plan Year.
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In-Network Annual Maximum. This Contract has an in-network and out-of-network annual maximum for in-network and out- of-network benefits described in the Adult Dental Care section of this Contract. There is no annual maximum for the in-network and out-of-network pediatric dental essential health benefit. When Members receiving adult dental care have met the in-network and out-of- network annual maximum for in-network Covered Services in the Schedule of Benefits section of this Contract, no more benefits will be payable for that Member for the remainder of that Plan Year. If You have other than individual coverage, the individual in-network annual maximum for adult dental care benefits applies to each person covered under this Contract. Once a person within a family meets the individual in-network annual maximum for adult dental care, no more benefits for services will be payable for that person.
Sample 1

Related to In-Network Annual Maximum

  • Annual maximums State Dental Plan coverage is subject to a one thousand dollar ($1,000) annual maximum benefit payable (excluding orthodontia) per person. "Annual" means per insurance year.

  • Lifetime maximums and non-prescription out-of-pocket maximums Coverage under Advantage is not subject to a per person lifetime maximum. In the first and second years of the contract, coverage under Advantage is subject to a plan year, non-prescription drug, out-of-pocket maximum of one thousand seven hundred dollars ($1,700) per person or three thousand four hundred dollars ($3,400) per family for members whose primary care clinic is in Cost Level 1 or Cost Level 2; two thousand four hundred dollars ($2,400) per person or four thousand eight hundred dollars ($4,800) per family for members whose primary care clinic is in Cost Level 3; and three thousand six hundred dollars ($3,600) per person or seven thousand two hundred dollars ($7,200) per family for members whose primary care clinic is in Cost Level 4.

  • Orthodontia lifetime maximum Orthodontia benefits are subject to a three thousand dollar ($3,000) lifetime maximum benefit.

  • Cashing out of Annual Leave (a) Annual leave credited to an employee may be cashed out by agreement, subject to the following conditions: (refer to section 93 of the Act)

  • Mileage Measurement Where required, the mileage measurement for LIS rate elements is determined in the same manner as the mileage measurement for V&H methodology as outlined in NECA Tariff No. 4.

  • Evaluation Cycle: Annual Orientation A) At the start of each school year, the superintendent, principal or designee shall conduct a meeting for Educators and Evaluators focused substantially on educator evaluation. The superintendent, principal or designee shall:

  • Unbundled Network Terminating Wire (UNTW) 2.8.3.1 UNTW is unshielded twisted copper wiring that is used to extend circuits from an intra-building network cable terminal or from a building entrance terminal to an individual End User’s point of demarcation. It is the final portion of the Loop that in multi-subscriber configurations represents the point at which the network branches out to serve individual subscribers.

  • Copayments and annual out-of-pocket maximums For the first and second year of the contract: Tier 1 copayment: Fourteen dollar ($14) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five dollar ($25) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty dollar ($50) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight hundred dollars ($800) per person or one thousand six hundred dollars ($1,600) per family.

  • Cashing out annual leave Annual leave may be cashed out by agreement between the Company and an Employee, subject to the following conditions: ▪ An Employee must elect in writing to cash out annual leave; ▪ An Employee must not cash out more than two (2) weeks annual leave in each twelve (12) month period; ▪ The Company must agree to the Employee cashing out their annual leave.

  • Shortfall of Annual Working Hours There shall be no pay back for shortfall of annual working hours in the shift systems determined in this Agreement.

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