Orange County NC Website
Browse       Search
10 <br /> Continuation Coverage means that Plan Coverage that may be available <br /> to a Member upon the occurrence of a "qualifying event" (as defined in <br /> the Consolidated Omnibus Budget Reconciliation Act (P.L. 99-272) . If <br /> available and depending on the qualifying event, Continuation Coverage <br /> may be elected for 18 to 36 months and during such period, an eligible <br /> person who elects such Coverage shall continue to be a Member of the <br /> Group for purposes of this Master Group Contract. <br /> Contract Year means the Effective Term of the Group Contract as stated <br /> on page one of this Contract. <br /> Copayment means a charge expressed as a percentage or fixed dollar <br /> amount, in addition to the premium, which the member is required to pay <br /> for certain Health Services provided under this Contract. The Member is <br /> responsible for the payment of any Copayment directly to the <br /> Participating Physician or Participating Provider when Health Services <br /> are received. <br /> Coverage or Covered means the Health Services paid for by this <br /> Contract. <br /> Crisis Intervention and Evaluation means those Health Services that <br /> are Medically Necessary to provide immediate treatment of acute Mental <br /> Health Conditions on a short-term basis, and to provide appropriate <br /> referral for longer term Mental Health treatment. <br /> Direct Payment Agreement means a Contract issued by the Plan directly <br /> to a Member, which requires the Member to pay the premium either <br /> directly to the Plan or an indemnity carrier designated by the Plan for <br /> that Contract. <br /> 6 <br />