Common use of Appeal Hearing Clause in Contracts

Appeal Hearing. A. The Appeal Hearing will be conducted in the following manner: 1. Representatives of the employee and the Board of Trustees shall select an arbitrator as the hearing officer. The District and CSEA shall each obtain/maintain a list of five arbitrator(s) from the American Arbitration Association or the California Mediation and Conciliation Board. Selection shall be made by mutual agreement or by alternately striking one name from the list until only one name remains. The arbitrator shall be considered the designee of the Board of Trustees to conduct the hearing and report findings, conclusions, and recommendations to the Board of Trustees. 2. The District and the employee shall each have their right to compel attendance of any other employees of the District to testify, to cross examine all witnesses, to present such exhibits and/or other evidence as may be ruled relevant to the case. Technical rules of evidence shall not apply. 3. The employee shall have a right to appear in person on his/her own behalf with designees or representation provided by CSEA as the exclusive representative as he/she requests to represent his/her defense. An employee may provide outside counsel by signing a B. Counsel/representatives for the respective parties shall exchange witness lists at least five (5) working days prior to the hearing. C. The hearing shall be held at the earliest convenient date, considering the established schedule of the arbitrator and the availability of counsel and witnesses. The parties shall be notified of the date, time and place of the hearing. D. In arriving at a decision or proposed decision, the arbitrator may consider the records of any prior personnel action proceeding against the employee in which another personnel action was sustained and any records contained in the employee’s personnel files within the last two (2) years, if the records were introduced into evidence at the hearing. E. The recommendation of the arbitrator shall be submitted to the Board of Trustees and shall be in writing, summarizing the facts, setting forth findings and making a recommended decision. A copy shall be served by registered/certified regular U.S. Mail upon the appellant and appellant’s representative/counsel. F. The proposed decision of the arbitrator shall be considered by the Board of Trustees, which shall thereafter render a final decision on the matter. The Board of Trustees may accept or reject the decision. However, if the decision of the Board of Trustees is different from that of the arbitrator, the decision will not be based on any facts other than those presented to the arbitrator. A statement of the Board of Trustees reasons for rendering a different decision will be included in the final decision. A copy of the decision shall be delivered to the employee and his/her designated representative personally or by registered mail, postage prepaid, and delivered to the employee’s last known address. The decision of the Board of Trustees shall be final.

Appeal Hearing. A. The Appeal Hearing will be conducted in the following manner: 1. Representatives Upon receipt of a written appeal by the Grievance Appeal Committee, HMO shall provide the Member filing the appeal with the procedures governing appeals before the Grievance Appeal Committee. The Member shall be notified of the employee and Member’s right to have an uninvolved HMO representative available to assist the Board of Trustees shall select an arbitrator as Member in understanding the hearing officer. The District and CSEA shall each obtain/maintain a list of five arbitrator(s) from the American Arbitration Association or the California Mediation and Conciliation Board. Selection shall be made by mutual agreement or by alternately striking one name from the list until only one name remains. The arbitrator shall be considered the designee of the Board of Trustees to conduct the hearing and report findings, conclusions, and recommendations to the Board of Trusteesappeal process. 2. The District and Grievance Appeal Committee shall be established by the employee shall each have their right to compel attendance Board of any other employees Directors of the District to testify, to cross examine all witnesses, to present such exhibits and/or other evidence as may HMO and shall be ruled relevant to the casecomprised of three members. Technical rules of evidence The Grievance Appeal Committee shall not applyinclude any person previously involved with the grievance. An HMO Medical Director may serve as a member of the Committee if the Medical Director was not previously involved with the grievance. 3. The employee Grievance Appeal Committee shall have hold appeal hearings in HMO offices on a right certain day each month to appear consider all appeals filed seven business days or more in advance of the hearing day. In the event a Member is unable to attend the hearing on the scheduled hearing day, the Member may request that their appeal be heard on the next scheduled hearing day. If no scheduled hearing day is suitable for the Member, the hearing will be scheduled for the following month. 4. The Member may attend the appeal hearing to question designated HMO representatives and others familiar with the Member’s grievance appeal and to discuss their case. The Member may choose to be assisted or represented by a person on his/her own behalf of the Member’s choice, and may submit written material to support their grievance appeal. The Member may bring a Physician or other expert(s) to discuss the Member’s grievance. HMO may also present persons familiar with designees or representation provided by CSEA as the exclusive representative as he/she requests Member’s grievance appeal. The person the Member chooses to represent his/her defensethem may discuss the case and question persons familiar with the Member’s grievance appeal. An employee If the Member chooses to be assisted or represented by a person of the Member’s choice to discuss the Member’s case, then the HMO may provide outside counsel by signing a B. Counsel/representatives for also be represented. The Grievance Appeal Committee may initiate discussions with the respective parties shall exchange witness lists at least five (5) working days prior to HMO, the hearingMember and other persons familiar with the Member’s grievance appeal. C. 5. The appeal hearing shall be held at the earliest convenient date, considering the established schedule of the arbitrator and the availability of counsel and witnessesinformal. The parties Grievance Appeal Committee shall be notified not apply formal rules of the date, time and place of the hearing. D. In arriving at a decision evidence in reviewing documentation or proposed decision, the arbitrator may consider the records of any prior personnel action proceeding against the employee in which another personnel action was sustained and any records contained in the employee’s personnel files within the last two (2) years, if the records were introduced into evidence accepting testimony at the hearing. The Chair of the Grievance Appeal Committee shall have the right to exclude redundant testimony or excessive argument by any party or witness. E. The recommendation 6. A written record of the arbitrator appeal hearing shall be submitted made by stenographic transcription. All testimony shall be under oath. 7. Before the record is closed, the Chair of the Grievance Appeal Committee shall ask both the Member and the HMO representative (or their counsel) whether there is any additional evidence or argument which the party wishes to present to the Board Grievance Appeal Committee. Once all evidence and arguments have been received, the record of Trustees the appeal hearing shall be closed. The deliberations of the Grievance Appeal Committee shall be confidential and shall not be in writing, summarizing the facts, setting forth findings and making a recommended decision. A copy shall be served by registered/certified regular U.S. Mail upon the appellant and appellant’s representative/counseltranscribed. F. 8. The proposed Grievance Appeal Committee shall render a written decision within 30 working days of the arbitrator shall be considered by conclusion of the Board of Trustees, which shall thereafter render a final decision on the matterappeal hearing. The Board of Trustees may accept or reject the decision. However, if the decision of the Board of Trustees is different from that of the arbitrator, the decision will not be based on any facts other than those presented to the arbitrator. A shall contain: a. a statement of the Board of Trustees reasons for rendering a different decision will be included in the final decision. A copy Grievance Appeal Committee’s understanding of the nature of the grievance and the material facts related thereto; and b. the Grievance Appeal Committee’s decision shall be delivered and rationale; and c. a summary of the evidence, including necessary documents supporting the decision; and x. a statement of the Member’s right to appeal to the employee Department of Insurance, with the phone number and his/her designated representative personally or by registered mail, postage prepaid, and delivered to the employee’s last known address. The decision complete address of the Board Department of Trustees shall be finalInsurance.

Appeal Hearing. A. The Appeal Hearing will be conducted in the following manner: 1. Representatives Upon receipt of a written appeal by a Member to the Grievance Appeal Committee or upon request by a Member for review of non-certifications by HMO, HMO shall provide the Member filing the appeal with the procedures governing appeals before the Grievance Appeal Committee. The Member shall be notified of the employee and Member’s right to have an uninvolved HMO representative available to assist the Board of Trustees shall select an arbitrator as Member in understanding the hearing officer. The District and CSEA shall each obtain/maintain a list of five arbitrator(s) from the American Arbitration Association or the California Mediation and Conciliation Board. Selection shall be made by mutual agreement or by alternately striking one name from the list until only one name remains. The arbitrator shall be considered the designee of the Board of Trustees to conduct the hearing and report findings, conclusions, and recommendations to the Board of Trusteesappeal process. 2. The District and the Grievance Appeal Committee shall be comprised of three members, one of whom shall be a non-employee shall each have their right to compel attendance of any other employees Subscriber of the District to testify, to cross examine all witnesses, to present such exhibits and/or other evidence as may be ruled relevant to the caseHMO. Technical rules of evidence The Grievance Appeal Committee shall not applyinclude any person previously involved with the grievance. An HMO Medical Director may serve as a member of the Committee if the Medical Director was not previously involved with the grievance. 3. The employee Grievance Appeal Committee shall hold appeal hearings in HMO offices on a certain day each month to consider all appeals filed seven business days or more in advance of the hearing day. In the event a Member is unable to attend the hearing on the scheduled hearing day, the Member may request that their appeal be heard on the next scheduled hearing day. If no scheduled hearing day is suitable for the Member, the hearing will be scheduled for the following month. 4. The Member shall have a the right to appear attend the appeal hearing, either in person or via telephone conference call, question the representative of HMO designated to appear at the hearing and any other witnesses, and present their case. The Member shall also have the right to be assisted or represented by a person of the Member’s choice, and submit written material in support of their grievance. The Member may bring a Physician or other expert(s) to testify on his/her own behalf with designees or representation provided by CSEA as the exclusive representative as he/she requests Member’s behalf. HMO shall also have the right to represent his/her defensepresent witnesses. An employee may provide outside counsel by signing a B. Counsel/representatives Counsel for the respective parties Member may present the Member’s case and question witnesses; if the Member is so represented, HMO may be similarly represented by counsel. The Grievance Appeal Committee shall exchange witness lists at least five (5) working days prior have the right to question the hearingHMO representative, the Member and any other witnesses. C. 5. The appeal hearing shall be held at the earliest convenient date, considering the established schedule of the arbitrator and the availability of counsel and witnessesinformal. The parties Grievance Appeal Committee shall be notified not apply formal rules of the date, time and place of the hearing. D. In arriving at a decision evidence in reviewing documentation or proposed decision, the arbitrator may consider the records of any prior personnel action proceeding against the employee in which another personnel action was sustained and any records contained in the employee’s personnel files within the last two (2) years, if the records were introduced into evidence accepting testimony at the hearing. The Chair of the Grievance Appeal Committee shall have the right to exclude redundant testimony or excessive argument by any party or witness. E. The recommendation 6. A written record of the arbitrator appeal hearing shall be submitted made by stenographic transcription. All testimony shall be under oath. 7. Before the record is closed, the Chair of the Grievance Appeal Committee shall ask both the Member and the HMO representative (or their counsel) whether there is any additional evidence or argument which the party wishes to present to the Board Grievance Appeal Committee. Once all evidence and arguments have been received, the record of Trustees the appeal hearing shall be closed. The deliberations of the Grievance Appeal Committee shall be confidential and shall not be in writing, summarizing the facts, setting forth findings and making a recommended decision. A copy shall be served by registered/certified regular U.S. Mail upon the appellant and appellant’s representative/counseltranscribed. F. 8. The proposed Grievance Appeal Committee shall render a written decision within 30 working days of the arbitrator shall be considered by conclusion of the Board of Trustees, which shall thereafter render a final decision on the matterappeal hearing. The Board of Trustees may accept or reject the decision. However, if the decision of the Board of Trustees is different from that of the arbitrator, the decision will not be based on any facts other than those presented to the arbitrator. A shall contain: a. a statement of the Board of Trustees reasons for rendering a different decision will be included in the final decision. A copy Grievance Appeal Committee’s understanding of the nature of the grievance and the material facts related thereto; and b. the Grievance Appeal Committee’s decision shall be delivered and rationale; and c. a summary of the evidence, including necessary document supporting the decision; and x. a statement of the Member’s right to appeal to the employee Department of Insurance, with the phone number and his/her designated representative personally or by registered mail, postage prepaid, and delivered to the employee’s last known address. The decision complete address of the Board Department of Trustees shall be finalInsurance.

Appeal Hearing. A. The Appeal Hearing will be conducted in the following manner: 1. Representatives of the employee and the Board of Trustees shall select an arbitrator as the hearing officer. The District and CSEA shall each obtain/maintain a list of five arbitrator(s) from the American Arbitration Association or the California Mediation and Conciliation Board. Selection shall be made by mutual agreement or by alternately striking one name from the list until only one name remains. The arbitrator shall be considered the designee of the Board of Trustees to conduct the hearing and report findings, conclusions, and recommendations to the Board of Trustees. 2. The District and the employee shall each have their right to compel attendance of any other employees of the District to testify, to cross examine all witnesses, to present such exhibits and/or other evidence as may be ruled relevant to the case. Technical rules of evidence shall not apply. 3. The employee shall have a right to appear in person on his/her own behalf with designees or representation provided by CSEA as the exclusive representative as he/she requests to represent his/her defense. An employee may provide outside counsel by signing a B. Counsel/representatives for the respective parties shall exchange witness lists at least five (5) working days prior to the hearing. C. The hearing shall be held at the earliest convenient date, considering the established schedule of the arbitrator and the availability of counsel and witnesses. The parties shall be notified of the date, time and place of the hearing. D. In arriving at a decision or proposed decision, the arbitrator may consider the records of any prior personnel action proceeding against the employee in which another personnel action was sustained and any records contained in the employee’s personnel files within the last two (2) years, if the records were introduced into evidence at the hearing. E. The recommendation of the arbitrator shall be submitted to the Board of Trustees and shall be in writing, summarizing the facts, setting forth findings and making a recommended decision. A copy shall be served by registered/certified regular U.S. Mail upon the appellant and appellant’s representative/counsel. F. The proposed decision of the arbitrator shall be considered by the Board of Trustees, which shall thereafter render a final decision on the matter. The Board of Trustees may accept or reject the decision. However, if the decision of the Board of Trustees is different from that of the arbitrator, the decision will not be based on any facts other than those presented to the arbitrator. A statement of the Board of Trustees reasons for rendering a different decision will be included in the final decision. A copy of the decision shall be delivered to the employee and his/her designated representative personally or by my registered mail, postage prepaid, and delivered to the employee’s last known address. The decision of the Board of Trustees shall be final.

Appeal Hearing. ‌ A. The Appeal Hearing will be conducted in the following manner: 1. Representatives of the employee and the Board of Trustees shall select an arbitrator as the hearing officer. The District and CSEA shall each obtain/maintain a list of five arbitrator(s) from the American Arbitration Association or the California Mediation and Conciliation Board. Selection shall be made by mutual agreement or by alternately striking one name from the list until only one name remains. The arbitrator shall be considered the designee of the Board of Trustees to conduct the hearing and report findings, conclusions, and recommendations to the Board of Trustees. 2. The District and the employee shall each have their right to compel attendance of any other employees of the District to testify, to cross examine all witnesses, to present such exhibits and/or other evidence as may be ruled relevant to the case. Technical rules of evidence shall not apply. 3. The employee shall have a right to appear in person on his/her own behalf with designees or representation provided by CSEA as the exclusive representative as he/she requests to represent his/her defense. An employee may provide outside counsel by signing a B. Counsel/representatives for the respective parties shall exchange witness lists at least five (5) working days prior to the hearing. C. The hearing shall be held at the earliest convenient date, considering the established schedule of the arbitrator and the availability of counsel and witnesses. The parties shall be notified of the date, time and place of the hearing. D. In arriving at a decision or proposed decision, the arbitrator may consider the records of any prior personnel action proceeding against the employee in which another personnel action was sustained and any records contained in the employee’s personnel files within the last two (2) years, if the records were introduced into evidence at the hearing. E. The recommendation of the arbitrator shall be submitted to the Board of Trustees and shall be in writing, summarizing the facts, setting forth findings and making a recommended decision. A copy shall be served by registered/certified regular U.S. Mail upon the appellant and appellant’s representative/counsel. F. The proposed decision of the arbitrator shall be considered by the Board of Trustees, which shall thereafter render a final decision on the matter. The Board of Trustees may accept or reject the decision. However, if the decision of the Board of Trustees is different from that of the arbitrator, the decision will not be based on any facts other than those presented to the arbitrator. A statement of the Board of Trustees reasons for rendering a different decision will be included in the final decision. A copy of the decision shall be delivered to the employee and his/her designated representative personally or by registered mail, postage prepaid, and delivered to the employee’s last known address. The decision of the Board of Trustees shall be final.

Appeal Hearing. A. The Appeal Hearing will be conducted in the following manner: 1. Representatives Upon receipt of a written appeal by the Grievance Appeal Committee, HMO shall provide the Member filing the appeal with the procedures governing appeals before the Grievance Appeal Committee. The Member shall be notified of the employee and Member’s right to have an uninvolved HMO representative available to assist the Board of Trustees shall select an arbitrator as Member in understanding the hearing officer. The District and CSEA shall each obtain/maintain a list of five arbitrator(s) from the American Arbitration Association or the California Mediation and Conciliation Board. Selection shall be made by mutual agreement or by alternately striking one name from the list until only one name remains. The arbitrator shall be considered the designee of the Board of Trustees to conduct the hearing and report findings, conclusions, and recommendations to the Board of Trusteesappeal process. 2. The District and Grievance Appeal Committee shall be established by the employee shall each have their right to compel attendance Board of any other employees Directors of the District to testify, to cross examine all witnesses, to present such exhibits and/or other evidence as may HMO and shall be ruled relevant to the casecomprised of 3 individuals. Technical rules of evidence The Grievance Appeal Committee shall not applyinclude any person previously involved with the grievance. An HMO Medical Director may serve as a member of the Committee if the Medical Director was not previously involved with the grievance. 3. The employee Grievance Appeal Committee shall hold appeal hearings in HMO offices on a certain day each month to consider all appeals filed 7 business days or more in advance of the hearing day. In the event a Member is unable to attend the hearing on the scheduled hearing day, the Member may request that their appeal be heard on the next scheduled hearing day. If no scheduled hearing day is suitable for the Member, the hearing will be scheduled for the following month. 4. The Member shall have a the right to attend the appeal hearing, question the representative of HMO designated to appear at the hearing and any other witnesses, and present their case. The Member shall also have the right to be assisted or represented by a person of the Member’s choice, and submit written material in person support of their grievance. The Member may bring a Physician or other expert(s) to testify on his/her own behalf with designees or representation provided by CSEA as the exclusive representative as he/she requests Member’s behalf. HMO shall also have the right to represent his/her defensepresent witnesses. An employee may provide outside counsel by signing a B. Counsel/representatives Counsel for the respective parties Member may present the Member’s case and question witnesses; if the Member is so represented, HMO may be similarly represented by counsel. The Grievance Appeal Committee shall exchange witness lists at least five (5) working days prior have the right to question the hearingHMO representative, the Member and any other witnesses. C. 5. The appeal hearing shall be held at the earliest convenient date, considering the established schedule of the arbitrator and the availability of counsel and witnessesinformal. The parties Grievance Appeal Committee shall be notified not apply formal rules of the date, time and place of the hearing. D. In arriving at a decision evidence in reviewing documentation or proposed decision, the arbitrator may consider the records of any prior personnel action proceeding against the employee in which another personnel action was sustained and any records contained in the employee’s personnel files within the last two (2) years, if the records were introduced into evidence accepting testimony at the hearing. The Chair of the Grievance Appeal Committee shall have the right to exclude redundant testimony or excessive argument by any party or witness. E. The recommendation 6. A written record of the arbitrator appeal hearing shall be submitted made. 7. Before the appeal hearing is closed, the Chair of the Grievance Appeal Committee shall ask both the Member and the HMO representative (or their counsel) whether there is any additional evidence or argument which the party wishes to present to the Board Grievance Appeal Committee. Once all evidence and arguments have been received, the appeal hearing shall be closed. The deliberations of Trustees the Grievance Appeal Committee shall be confidential and shall not be in writing, summarizing the facts, setting forth findings and making a recommended decision. A copy shall be served by registered/certified regular U.S. Mail upon the appellant and appellant’s representative/counseltranscribed. F. 8. The proposed Grievance Appeal Committee shall render a written decision within 30 working days of the arbitrator shall be considered by conclusion of the Board of Trustees, which shall thereafter render a final decision on the matterappeal hearing. The Board of Trustees may accept or reject the decision. However, if the decision of the Board of Trustees is different from that of the arbitrator, the decision will not be based on any facts other than those presented to the arbitrator. A shall contain: a. a statement of the Board of Trustees reasons for rendering a different decision will be included in the final decision. A copy Grievance Appeal Committee’s understanding of the nature of the grievance and the material facts related thereto; and b. the Grievance Appeal Committee’s decision shall be delivered and rationale; and c. a summary of the evidence, including necessary document supporting the decision; and x. a statement of the Member’s right to appeal to the employee Department of Insurance, with the phone number and his/her designated representative personally or by registered mail, postage prepaid, and delivered to the employee’s last known address. The decision complete address of the Board Department of Trustees shall be finalInsurance.