covered service

covered service

Covered health care service Managed care
1. A health care service to which a policy holder is entitled under the terms of a contract.
2. A service by a primary care provider in a managed care organization, which is not referred to a specialist.
3. Any medically necessary service, drugs or supplies–eg medical transportation services, which are covered under, and which plan members are entitled to receive under, a group benefits agreement. Cf Noncovered service.
References in periodicals archive ?
The ERISA Advisory Committee recommended last September that the DOL force PBMs to provide health plans with some of the same information that "covered service providers" to pension plans have to provide.
regulation, covered service providers had to provide plan committees-in their role as the responsible plan fiduciary-with disclosures about services, status and compensation.
THE JULY 1 COMPLIANCE DATE FOR THE DEPARTMENT of Labor's (DOL) final 408(b)(2) fee disclosure rule has finally arrived, and even though the final rule was a long time coming, covered service providers have been ramping up their compliance efforts for months.
"This guidance will help both plan administrators and covered service providers comply with their obligations under the department's new fee-transparency rules, so that workers who make their own investment decisions in retirement plans will have the information they need to make informed investment choices," said Assistant Secretary of Labor for EBSA Phyllis C.
Specifically, providers wanted to know how the Department of Labor would treat instances in which plan fiduciaries request information from covered service providers who believe the information is not specifically required under the fee disclosure rule and therefore don't want to provide it.
The first looming deadline is July 1, when "covered service providers" (defined as any retirement plan vendor that receives $1,000 or more going forward for services to a plan paid for from plan assets) must comply with fee disclosure regulations by providing specific plan information in writing to your company, including:
The second reporting is a disclosure of fees and expenses that must be made to each ERISA plan by each covered service provider.
If the test, procedure or surgery sounds unusual or you are unsure if it's a covered service, seek assistance from a Tricare service center near you.
23, 2010, must have an internal appeals process that allows consumers to appeal whenever the plan denies a claim for a covered service or rescinds coverage.
It covers more than 45,000 sq ft, including covered service bays of 28,000 sq ft, accommodating service and body shop facilities.
It also reviews the changes to military family protections, including job-protected leave rights who ae the spouse, child, parent or next of kin of a covered service member.
Environmental remediation services should also be included as a specified covered service. These services are conducted by numerous companies across several industries and do not add value to other products or services; they are generally conducted to comply with environmental laws or regulations imposed by statute or a governmental agency.