Additional Benefits and Premiums Sample Clauses
The 'Additional Benefits and Premiums' clause defines the terms under which extra benefits or services, beyond the standard agreement, may be provided and the corresponding premiums or fees that apply. This clause typically outlines what constitutes an additional benefit, how such benefits are requested or approved, and the method for calculating or invoicing any extra premiums. Its core function is to ensure both parties have a clear understanding of the costs and entitlements associated with enhancements to the original agreement, thereby preventing disputes over unexpected charges or unapproved services.
Additional Benefits and Premiums. The SNP MCO will notify the STATE of proposed changes with the understanding that the STATE will not share this information. The process of notification is as follows:
(1) Prior to the submission of the initial annual Medicare Advantage bids to CMS, the MCO/SNP will consult with the STATE about any changes in proposed Plan Benefit Packages (PBPs), including proposed changes in current benefits or additional premiums the SNP is expecting to request to have approved through the bid; and
(2) Notify the STATE of the status of final changes to benefits or premium levels, on or before September 1st of each Contract Year.