Claims and Appeals; Financial Responsibility for Self-Insured Benefits and Claims Sample Clauses

Claims and Appeals; Financial Responsibility for Self-Insured Benefits and Claims. (A) The applicable Claims fiduciary under the LSC Group Benefits Plan shall be solely responsible for the adjudication of any Claim, and any appeal of any Claim, (whether for eligibility or benefits) submitted under the LSC Group Benefits Plan. The members of LSC’s “controlled group” (as defined in Section 414(b) of the Code) shall bear sole financial responsibility for any Claim for (1) eligibility under the LSC Group Benefits Plan and (2) self-insured benefits of the sort covered by the LSC Group Benefits Plan on July 1, 2016, incurred by an LSC Employee (or his or her dependents or beneficiaries) if the date of service, or date of claimed eligibility, which is the subject of such Claim was on or after July 1, 2016. (B) The applicable Claims fiduciary under the Donnelley Financial Group Benefits Plan shall be solely responsible for the adjudication of any Claim, and any appeal of any Claim, (whether for eligibility or benefits) submitted under the Donnelley Financial Group Benefits Plan. The members of Donnelley Financial’s “controlled group” (as defined in Section 414(b) of the Code) shall bear sole financial responsibility for any Claim for (1) eligibility under the Donnelley Financial Group Benefits Plan and (2) self-insured benefits of the sort covered by the Donnelley Financial Group Benefits Plan on July 1, 2016, incurred by a Donnelley Financial Employee (or his or her dependents or beneficiaries) if the date of service, or date of claimed eligibility, which is the subject of such Claim was on or after July 1, 2016. (C) The applicable Claims fiduciary under the XX Xxxxxxxxx Group Benefits Plan shall be solely responsible for the adjudication of any Claim, and any appeal of any Claim, (whether for eligibility or benefits) submitted under the XX Xxxxxxxxx Group Benefits Plan. The members of RRD’s “controlled group” (as defined in Section 414(b) of the Code) shall bear sole financial responsibility for any Claim for (1) eligibility under the XX Xxxxxxxxx Group Benefits Plan or (2) self-insured benefits of the sort covered by the XX Xxxxxxxxx Group Benefits Plan on July 1, 2016, incurred by (x) a RRD Employee (or his or her dependents or beneficiaries) if, with respect to clauses (1) and (2) of this Subsection (C), the date of service, or date of claimed eligibility, which is the subject of such Claim was on or after July 1, 2016, and (y) an LSC Employee, Former LSC Employee, Donnelley Financial Employee, Former Donnelley Financial Employee, RRD Emplo...
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Related to Claims and Appeals; Financial Responsibility for Self-Insured Benefits and Claims

  • General Responsibilities of the Parties 1. The Parties will work together in a spirit of cooperation and partnership, with the responsibilities and accountabilities set out in this Agreement, to implement the Programme Documents in full in a timely, efficient, and effective, manner. 2. The Parties agree to carry out their respective responsibilities in accordance with the provisions of this Agreement, including the Programme Documents. 3. The Parties shall keep each other informed of all relevant activities pertaining to the implementation of the Programme Documents, and shall hold consultations when either Party considers it appropriate, including any circumstance that may affect the achievement of the results of the Programme and the Programme Documents. 4. The Parties shall fulfill their commitments with the fullest regard for the terms and conditions of this Agreement and the principles of the United Nations.

  • PROFESSIONAL RESPONSIBILITY (APPLIES TO RNS ONLY 19.01 The parties agree that resident care is enhanced if concerns relating to professional practice and workload are resolved in a timely and effective manner, as set out below; In the event that the Home assigns a number of residents or a workload to an individual employee or group of employees, such that she or they have cause to believe that she or they are being asked to perform more work than is consistent with proper resident care, she or they shall: i) At the time the workload issue occurs, discuss the issue within the Home to develop strategies to meet resident care needs using current resources. If necessary, using established lines of communication, seek immediate assistance from an individual(s) identified by the Home who has responsibility for timely resolution of workload issues. ii) Failing resolution at the time of occurrence of the workload issue, complain in writing to the Union-Management Committee within twenty (20) calendar days of the alleged improper assignment. The chairperson of the Union-Management Committee shall convene a meeting of the Union-Management Committee within twenty (20) calendar days of the filing of the complaint. The Union-Management Committee shall hear and attempt to resolve the complaint to the satisfaction of both parties. The Employer will provide a written response to the Union, with a copy to the ONA representation within ten (10) calendar days. iii) Prior to the complaint being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the complaint and recommendations to the Director of Resident Care and/or the Administrator. iv) At any time during this process, the parties may agree to the use of a mediator to assist in the resolution of the Professional Practice issues. v) Any settlement arrived at under 19.01 (a) i) – iii) shall be signed by the parties. vi) Failing resolution of the complaint within twenty (20) calendar days of the meeting of the Union-Management Committee, the complaint shall be forwarded to an independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Home and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chairperson. vii) The Independent Assessment Committee shall set a date to conduct a hearing into the complaint, within twenty (20) calendar days of its appointment, and shall be empowered to investigate as is necessary to properly assess the merits of the complaint. The Independent Assessment Committee shall report its findings, in writing, to the parties within twenty (20) calendar days following completion of its hearing. (b) i) The list of Independent Assessment Committee Chairpersons is attached as Appendix “B”. The members of the panel shall sit in rotation as agreed by the parties. If a panel member is unable to sit within the time limit stipulated, the panel member next scheduled to sit will be appointed by the parties.

  • INSURANCE AND PROOF OF FINANCIAL RESPONSIBILITY Contractor understands and agrees that financial responsibility for claims or damages to any person, or to Contractor’s employees and agents, shall rest with the Contractor. Contractor and its subcontractors shall effect and maintain any insurance coverage, including, but not limited to, Workers’ Compensation, Employers’ Liability, General Liability, Contractual Liability, Automobile Liability and Umbrella Liability to support such financial obligations. The indemnification obligation, however, shall not be reduced in any way by existence or non-existence, limitation, amount or type of damages, compensation, or benefits payable under Workers’ Compensation laws or other insurance provisions. The minimum limits of insurance required of the Contractor by MPS shall be: Workers’ Compensation Statutory Limits Employers’ Liability $100,000 per occurrence General Liability $1,000,000 per occurrence/$2,000,000 aggregate Auto Liability $1,000,000 per occurrence Umbrella (excess) Liability $1,000,000 per occurrence The Milwaukee Board of School Directors shall be named as an additional insured under Contractor’s and subcontractors’ general liability insurance and umbrella liability insurance. Evidence of all required insurances of Contractor shall be submitted electronically to MPS via its third party vendor, EXIGIS Risk Management Services. Waivers and exceptions to the above limits will be in the sole discretion of MPS and shall be recorded in the EXIGIS system, which records are incorporated into this Contract by reference. The certificate of insurance or policies of insurance evidencing all coverages shall include a statement that MPS shall be afforded a thirty (30) day written notice of cancellation, non-renewal or material change by any of Contractor’s insurers providing the coverages required by MPS for the duration of this Contract.

  • Personal Responsibility The Participant and his/her parent(s) or legal guardian(s) certify that Participant has no physical or mental condition that precludes him/her from participating in the Activities and that he/she is not participating against medical advice.

  • Mutual Responsibilities It is recognized by this Agreement to be the duty of the Company to explain fully the terms of this Agreement to all its officers, foremen and others engaged in a supervisory capacity and it is recognized to be the duty of the Union to explain fully to its members, its and their responsibilities and obligations under this Agreement.

  • ’ Compensation and Employer’s Liability Workers’ Compensation limits as required by the Labor Code of the State of California. Employer’s Liability limits of $1,000,000 per accident for bodily injury or disease.

  • General Responsibilities Issuer hereby engages Distributor to act as exclusive distributor of the shares of each class of the Funds. The Funds subject to this Agreement as of the date hereof are identified on SCHEDULE A, which may be amended from time to time in accordance with Section 11 below. Sales of a Fund's shares shall be made only to investors residing in those states in which such Fund is registered. After effectiveness of each Fund’s registration statement, Distributor will hold itself available to receive, as agent for the Fund, and will receive by mail, telex, telephone, or such other method as may be agreed upon between Distributor and Issuer, orders for the purchase of Fund shares, and will accept or reject such orders on behalf of the Fund in accordance with the provisions of the applicable Fund’s prospectus. Distributor will be available to transmit orders, as promptly as possible after it accepts such orders, to the Fund’s transfer agent for processing at the shares’ net asset value next determined in accordance with the prospectuses.

  • Delegation of Responsibilities The Adviser may carry out any of its obligations under this Agreement by employing, subject to supervision by the Adviser, one or more Sub-Adviser(s) who are registered as investment advisers pursuant to the Investment Advisers Act of 1940 ("Sub-Advisers"). Each Sub-Adviser's employment will be evidenced by a separate written agreement approved by the Board and, if required under the 1940 Act, by the shareholders of the Fund (unless the Commission or its staff has given authorization or issued an interpretation dispensing with the requirement of shareholder approval). The Adviser shall not be liable hereunder for any act or omission of any Sub-Adviser, except for failure to exercise good faith in the employment of the Sub-Adviser and for failure to exercise appropriate supervision of such Sub-Adviser, and as may otherwise be agreed in writing. The Adviser shall be solely responsible for compensating any Sub-Adviser for services rendered under any Sub-Advisory Agreement. The Adviser may, from time to time and at any time, terminate any Sub-Adviser and reassume the responsibilities assigned to such Sub-Adviser with respect to any Fund without obtaining the approval of the shareholders of the Fund.

  • Complaints and Compensation If you have a complaint of any kind, please be sure to let us know. We will do our utmost to resolve the issue. You can put your complaint in writing to us at:

  • Employer Responsibility The Employer accepts its responsibility to insure equal opportunity in all aspects of employment for all qualified persons regardless of race, creed, religion, color, national origin, age, disability, reliance on public assistance, sex, marital status, sexual orientation/affectional preference, or any other class or group distinction, as set forth by state or federal anti-discrimination laws, or in Board policy.

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