Contracted Fee The term Contracted Fee means the total compensation level that a provider has agreed to accept as payment for vision procedures and services performed on You or Your Dependent, according to Your vision benefit plan.
• any child of Yours who is: • less than 26 years old.
• 26 or more years old, unmarried, and primarily supported by You and incapable of self-sustaining employment by reason of intellectual or physical disabilities. Proof of the child's condition and dependence may be required to be submitted to Us within 31 days after the date the child ceases to qualify above. The term child means a child born to You or a child legally adopted by You. It also includes a stepchild, a foster child, a child for whom You are the legal guardian or a child supported pursuant to a court order imposed on You (including a Qualified Medical Child Support Order). Benefits for a Dependent child will continue until the last day of the calendar month in which the limiting age is reached. Anyone who is eligible as an Employee will not be considered as a Dependent. No one may be considered as a Dependent of more than one Employee.
HCVIS-DFS12
01-24
Copayment The term Copayment means a defined dollar amount a Covered Person is required to pay for certain vision services payable under the plan. The Covered Person is responsible for the payment of any Copayment directly to the provider of the vision service at the time of service or when billed by the provider.
HCVIS-DFS13
01-24
Covered Expenses The term Covered Expenses means that portion of a Vision Provider’s charge that is payable for a service delivered to a Covered Person provided: • Provided by or under the direction of a Vision Provider or other appropriate provider as specifically described; • Identified as payable in this certificate; • The maximum benefit in The Schedule has not been exceeded; and • It is not excluded as described in the section entitled Exclusions.
HCVIS-DFS16
01-24
Effective Date The term Effective Date means the date that coverage for insurance begins under the Policy. See the Certificate cover page for the Effective Date.
HCVIS-DFS18
01-24
Eligibility Waiting Period The term Eligibility Waiting Period means the period of time that an Employee must be in an Eligible Class in order to be eligible for coverage under the Policy.
HCVIS-DFS14
01-24
Covered Person The term Covered Person means a person who is insured for vision coverage under the terms of the Policy and this Certificate.
HCVIS-DFS19
01-24
Eligible Class The term Eligible Class means a group of people who are eligible to enroll for insurance coverage under the Policy as determined by the Employer.
HCVIS-DFS15
01-24
Dependent The term Dependent means: • Your lawful Spouse; and
HCVIS-DFS20
01-24
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