Affordable Care Act The Affordable Care Act requires a Contractor, if Contractor is an applicable large employer under the ACA, to provide healthcare coverage for its employees who provide services for the State and work for 30 or more hours per week. This coverage must also cover the eligible employee’s dependents under the age of 26. The coverage must (a) meet the minimum essential coverage, minimum value, and affordability requirements of the employer responsibility provisions under Section 4980H of the Code (ACA), and (b) otherwise satisfy the requirements of the Code § 4980H (ACA).
Home Health Care This plan covers the following home care services when provided by a certified home healthcare agency: • nursing services; • services of a home health aide; • visits from a social worker; • medical supplies; and • physical, occupational and speech therapy.
Health Care Operations “Health Care Operations” shall have the same meaning as the term “health care operations” in 45 CFR §164.501.
COVERED HEALTHCARE SERVICES This section describes covered healthcare services. This plan covers services only if they meet all of the following requirements: • Listed as a covered healthcare service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered healthcare service under this plan. • Medically necessary, consistent with our medical policies and related guidelines at the time the services are provided. • Not listed in Exclusions Section. • Received while a member is enrolled in the plan. • Consistent with applicable state or federal law. We review medical necessity in accordance with our medical policies and related guidelines. Our medical policies can be found on our website. Our medical policies are written to help administer benefits for the purpose of claims payment. They are made available to you for informational purposes and are subject to change. Medical policies are not meant to be used as a guide for your medical treatment. Your medical treatment remains a decision made by you with your physician. If you have questions about our medical policies, please call Customer Service. When a new service or drug becomes available, when possible, we will review it within six (6) months of one of the events described below to determine whether the new service or drug will be covered: • the assignment of an American Medical Association (AMA) Current Procedural Terminology (CPT) code in the annual CPT publication; • final Food and Drug Administration (FDA) approval; • the assignment of processing codes other than CPT codes or approval by governing or regulatory bodies other than the FDA; • submission to us of a claim meeting the criteria above; and • generally, the first date an FDA approved prescription drug is available in pharmacies (for prescription drug coverage only). During the review period, new services and drugs are not covered. For all covered healthcare services, please see the Summary of Medical Benefits and the Summary of Pharmacy Benefits to determine the amount that you pay and any benefit limits.
HEALTH CARE PLANS Notwithstanding the references to the Pacific Blue Cross Plans in this article, the parties agree that Employers, who are not currently providing benefits under the Pacific Blue Cross Plans may continue to provide the benefits through another carrier providing that the overall level of benefits is comparable to the level of benefits under the Pacific Blue Cross Plans.
Family Care and Medical Leave An unpaid Family Care and Medical Leave shall be granted, to the extent of and subject to the restrictions as set forth below, to an employee who has been employed for at least twelve (12) months and who has served for 130 workdays during the twelve (12) months immediately preceding the effective date of the leave. For purposes of this Section, furlough days and days worked during off-basis time shall count as "workdays". Family Care and Medical Leave absences of twenty (20) consecutive working days or less can be granted by the immediate administrator or designee. Leaves of twenty (20) or more consecutive working days can be granted only by submission of a formal leave application to the Personnel Commission.
Affordable Housing Owner shall set aside and reserve ten percent (10%) of the total multifamily residential units located in the Project as affordable housing units consistent with the terms set forth herein, for Income Eligible Residents earning in the aggregate no more than sixty percent (60%) of AMI. The published income limits will be adjusted by household size. The income limits will be adjusted annually according to the HUD published limits. To that end, no fewer than the number of multifamily units in the Project set forth in the table below shall, pursuant to the terms and conditions of a Land Use Restriction Agreement (i.e., the “XXXX”) in substantially the form attached hereto as “Attachment 1” to this Schedule P and incorporated herein by reference. Capitalized terms used but not defined in this Schedule but which are defined in the XXXX shall have the same meaning herein as therein. Each Phase of the Project shall have no few than the number of Affordable Housing Units allocated to it in in the table below. The table is as follows: PHASES AFFORDABLE HOUSING UNITS ALLOCATED TO PHASE PHASE 1 446 PHASE 2 300 PHASE 3 240 986 PRO FORMA TOTAL MULTIFAMILY UNITS IN THE PROJECT 10% 99 TOTAL AFFORDABLE UNITS Each such Affordable Unit in a Phase will be made available for a period of time not less than twenty (20) years following the date on which the last multifamily building of a Phase receives a permanent certificate of occupancy (each, an “Affordable Housing Compliance Period”), to Income Eligible Residents as defined in the XXXX. Such requirements shall be referred to with respect to each Phase as the “Affordable Housing Requirements.” The foregoing Affordable Housing Requirements will be set forth in the XXXX in such form as is consistent with the then applicable practices of ACC for similar affordable housing transactions, provided that such form does not alter the Affordable Housing Requirements set forth in this Agreement, permits transferability and release consistent with Section 12.4 hereof, and does not increase the obligations of Owner, its successors and assigns. The current form of XXXX is attached “Attachment 1” to this Schedule P. Upon approval of a subsequent form of XXXX by ACC and review and approval by the Owner consistent with the foregoing, the subsequent form of the XXXX may be affixed hereto as “Attachment 1” to this Schedule P without further amendment to this Agreement. The XXXX shall be recorded in the Athens-Xxxxxx County land records in customary fashion upon the submission of the initial and Requisition and shall be recorded only against the applicable parcel on which such units are constructed. The Affordable Housing Requirements are part of this Agreement, and the failure by Owner to comply with same shall be an Event of Default under this Agreement. The Affordable Housing Requirements shall terminate with respect to each such Phase of the Project, respectively, upon conclusion of the Affordable Housing Compliance Period for such Phase as set forth in the applicable XXXX. For purposes of compliance with O.C.G.A. §44-5-60, the parties understand and agree that no XXXX will have a period greater than 20 years, but that this Agreement shall automatically terminate upon the expiration of a XXXX if simultaneously therewith Owner does not enter into a new, replacement XXXX that extends for the lesser of 20 years or the period necessary that the 20 year Affordability Housing Requirements are satisfied on a cumulative basis.
Health Promotion and Health Education Both parties to this Agreement recognize the value and importance of health promotion and health education programs. Such programs can assist employees and their dependents to maintain and enhance their health, and to make appropriate use of the health care system. To work toward these goals:
Extended Health Care Plan The Employer shall pay the monthly premium for regular employees entitled to coverage under a mutually acceptable extended health care plan.
Health Care Compliance Neither the Company nor any Affiliate has, prior to the Effective Time and in any material respect, violated any of the health care continuation requirements of COBRA, the requirements of FMLA, the requirements of the Health Insurance Portability and Accountability Act of 1996, the requirements of the Women's Health and Cancer Rights Act of 1998, the requirements of the Newborns' and Mothers' Health Protection Act of 1996, or any amendment to each such act, or any similar provisions of state law applicable to its Employees.
