be approved for its stated purpose by Medicare. A Facility is not a Birthing Center, for the purpose of this Contract, if it is part of a Hospital. BOARD. The Board of Directors of the New Jersey Small Employer Health Benefits Program. CALENDAR YEAR. Each successive twelve-month period starting on January 1 and ending on December 31. CASH DEDUCTIBLE or DEDUCTIBLE. The amount of Covered Charges that a [Member] must pay before this Contract pays any benefits for such charges. Cash Deductible does not include Coinsurance, Copayments, and Non-Covered Services and Supplies and Non-Covered Charges. See the Cash Deductible section of this Contract for details. CHURCH PLAN. Has the same meaning given that term under Title I, section 3 of Pub.L.93-406, the “Employee Retirement Income Security Act of 1974” COINSURANCE. The percentage of Covered Services or Supplies or the percentage of Covered Charges, as applicable, that must be paid by a [Member]. Coinsurance does not include the Cash Deductible, Copayments, or Non-Covered Services and Supplies and Non-Covered Charges. [COMPLEX IMAGING SERVICES. Any of the following services: Computed Tomography (CT), Computed Tomography Angiography (CTA), Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiogram (MRA), Magnetic Resonance Spectroscopy (MRS) Positron Emission Tomography (PET), Nuclear Medicine including Nuclear Cardiology.] CONTRACT. This contract, including the application and any riders, amendments or endorsements, between the Contractholder and Us. CONTRACTHOLDER. Employer or organization which purchased this Contract. COPAYMENT. A specified dollar amount which [Member] must pay for certain Covered Services or Supplies or Covered Charges. NOTE: The Emergency Room Copayment, if applicable, must be paid in addition to any other Copayments, Cash Deductible, and Coinsurance.
be approved for its stated purpose by Medicare. A Facility is not a Birthing Center, for the purpose of this Contract, if it is part of a Hospital. BOARD. The Board of Directors of the New Jersey Small Employer Health Benefits Program. CALENDAR YEAR. Each successive twelve-month period starting on January 1 and ending on December 31. CASH DEDUCTIBLE or DEDUCTIBLE. The amount of Covered Charges that a [Member] must pay before this Contract pays any benefits for such charges. Cash Deductible does not include Coinsurance, Copayments, and Non-Covered Services and Supplies and Non-Covered Charges. See the Cash Deductible section of this Contract for details. CHURCH PLAN. Has the same meaning given that term under Title I, section 3 of Pub.L.93-406, the “Employee Retirement Income Security Act of 1974” COINSURANCE. The percentage of Covered Services or Supplies or the percentage of Covered Charges, as applicable, that must be paid by a [Member]. Coinsurance does not include the Cash Deductible, Copayments, or Non-Covered Services and Supplies and Non-Covered Charges. [COMPLEX IMAGING SERVICES. Any of the following services: Computed Tomography (CT), Computed Tomography Angiography (CTA), Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiogram (MRA), Magnetic Resonance Spectroscopy (MRS) Positron Emission Tomography (PET), Nuclear Medicine including Nuclear Cardiology.] CONTRACT. This contract, including the application and any riders, amendments or endorsements, between the Contractholder and Us. CONTRACTHOLDER. Employer or organization which purchased this Contract. COPAYMENT. A specified dollar amount which [Member] must pay for certain Covered Services or Supplies or Covered Charges. NOTE: The Emergency Room Copayment, if applicable, must be paid in addition to any other Copayments, Cash Deductible, and Coinsurance.
hmopos_contract.docx