Eligible Member definition

Eligible Member means an employee who is enrolled in one of the designated benefits plans for which you offer participation in the wellness incentive program prior to the end of the first six months of the policy year and who remains enrolled in one of the designated benefits plans at the end of the policy year. Eligible Member also means the employee’s dependents to the extent that dependents are eligible to participate in the Blue Cross and Blue Shield wellness incentive program.) To qualify for a group wellness incentive award, you must meet the following program participation conditions: • You are a group eligible to offer the program as determined by Blue Cross and Blue Shield; and • You elect to offer the Blue Cross and Blue Shield wellness incentive program to your Members who are eligible to participate in the program at the start of your policy year and you continue the program for eligible Members through the end of the policy year; and • At least 20% of your Members who are eligible for the program must participate in the program during the policy year in which you offer the wellness incentive program; and • This Agreement is not be terminated before the end of the policy year in which you offer the wellness incentive program. When you offer a Blue Cross and Blue Shield wellness incentive program, Blue Cross and Blue Shield will determine if you qualify for a group incentive award within 90 days after the end of the policy year. Your group wellness incentive award will be calculated as a percentage of the total medical insurance premium you paid for the policy year for benefits plans for which you offer wellness incentive program participation, excluding any premium payments that are received by Blue Cross and Blue Shield after the end of the policy year. The percentage used to calculate your wellness incentive award will vary depending on how many of your eligible Members participate in the program during the policy year as follows: 1.25% when 20% to 49% of eligible Members participate; or 2.5% when 50% to 79% of eligible Members participate; or 7.5% when 80% to 100% of eligible Members participate. For the purpose of calculating your group wellness incentive award, an eligible Member who earns his or her individual maximum member wellness incentive payment in the policy year is considered to have participated in the program for that policy year. If you qualify for a group incentive award, Blue Cross and Blue Shield will issue the incentive amount to you (by m...

Eligible Member means an individual eligible for Medicaid pursuant to rule 441—75.1(249A) et seq. and who qualifies for and is participating in the department’s HIPP program prescribed under rule 441—75.21(249A).

Eligible Member means a person who is—

Examples of Eligible Member in a sentence

• Effective January 1, 2020, Cost Sharing Obligations include co-insurance provided during a Dual Eligible Member’s Medicare-covered stay in a skilled nursing facility when the Dual Eligible Member is enrolled in a MA Dual SNP that is contracted with HHSC and receives Medicaid services under the State’s fee-for-service model.

• In order for an Internal Hiring Eligible Claimant, as defined in Section V(M)(1), to participate in this equitable remedy, an Internal Hiring Eligible Member must provide an Executed Claim Form along with supporting documentation that establishes that they meet each of the requirements set forth in Section V(M)(1) with the submission of their Claim Form.

• Effective January 1, 2020, Cost Sharing Obligations include co-insurance provided during a Dual Eligible Member's Medicare-covered stay in a skilled nursing facility when the Dual Eligible Member is enrolled in a MA Health Plan that is contracted with HHSC and receives Medicaid services under the State’s fee-for-service model.

• HHSC will pay the MA Health Plan a per Dual Eligible Member monthly capitated payment in exchange for the MA Health Plan’s payment of Cost Sharing Obligations to healthcare service providers.

• An Eligible Member wishing to participate in the Program may elect to retire on July 1 or January 1 of any calendar year (last day of work, June 30 or December 31 respectively).

More Definitions of Eligible Member

Eligible Member means a member who holds an eligible position.

Eligible Member means a member who has attained fifty-five years of age with at least twenty-two years of membership service.

Eligible Member has the meaning given to that term in the Pledge Agreement.

Eligible Member means any Class A Member or Class B Member of National Rural as described in National Rural’s Bylaws currently in effect.

Eligible Member means an active member of the Plan or a Plan member who is receiving benefits under the Long Term Disability Program established by A.R.S. Title 38, Chapter 5, Article 2.1.

Eligible Member means the member/employee who has met the eligibility requirements as specified in this Policy to participate in insurance under this Policy;

Eligible Member means a policyholder whose policy is in force as of the record date or member as defined under the bylaws or articles of incorporation of the reorganizing insurer. Unless otherwise provided in the reorganization plan, a person insured under a certificate issued under a group policy is not an eligible member.