Conducting administrative hearings Sample Clauses

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Conducting administrative hearings. Reviewing findings concerning the eligibility of EPA employees for security clearances.

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• Hearing Aids Any active employee who is insured under any one of the 9 District sponsored medical plans may request reimbursement for the costs of 10 hearing aids. The maximum amount of reimbursement shall not exceed one 11 thousand dollars ($1,000) within any three (3) year period. The cost of 12 hardware, fitting tests, and other tests related to the hearing aids purchased 13 shall be included for reimbursement purposes. 14

• Claims Administration An employee will be required to comply with any and all rules and regulations and/or limitations established by the carrier or applicable third party administrator and contained in the policy, and employees and their dependents shall look solely to such carrier or third party administration for the adjudication of the payment of any and all benefits claims.

• Administrative Appeals An administrative appeal is a request for us to reconsider a full or partial denial of payment for covered healthcare services for the following reasons: • the services were excluded from coverage; • we determined that you were not eligible for coverage; • you or your provider did not follow BCBSRI’s requirements; or • a limitation on an otherwise covered benefit exists. You are not required to file a complaint (as described above), before filing an administrative appeal. If you call our Customer Service Department, a Customer Service Representative will try to resolve your concern. If the issue is not resolved to your satisfaction, you may file a verbal or written administrative appeal with our Grievance and Appeals Unit. If you request an administrative appeal, you must do so within one hundred eighty (180) days of receiving a denial of payment for covered healthcare services. The Grievance and Appeals Unit will conduct a thorough review of your administrative appeal and respond within: • thirty (30) calendar days for a prospective review; and • sixty (60) calendar days for a retrospective review. The letter will provide you with information regarding our determination.

• Health and Safety Representative Meetings 13.1 A health and safety representative will be allowed reasonable paid time during working hours to attend occupational health and safety matters, including meetings affecting employees they represent, providing that the Representative informs their manager.

• Office of Inspector General Investigative Findings Expert Review In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government Code, Section 531.102(m-1)(2) is applicable to this Contract, Contractor affirms that it possesses the necessary occupational licenses and experience.

• Joint Remediation Committee If the Sellers (acting reasonably) determine that the Purchasers have committed a Major Default, then, at the election of the Sellers, within three (3) Business Days of the Sellers providing the Purchasers written notice of such determination, the Sellers and the Purchasers shall establish a joint remediation committee of designated executives from the Sellers and the Purchasers (“Joint Remediation Committee”) consisting of three (3) members of each of the Sellers and the Purchasers. The Joint Remediation Committee shall be responsible for overseeing the development of a mutually agreeable plan in accordance with subsection 3 below to either (i) remediate any breaches giving rise to the Major Default to the extent such breaches can be remediated and/or (ii) prevent similar breaches from recurring in the future (clauses (i) and (ii), a “Corrective Action Plan”). Each member of the Joint Remediation Committee shall have sufficient authority on the part of his or her respective party to make decisions relating to matters reviewed by the Joint Remediation Committee, and shall be approved by the other party (such approval not to be unreasonably delayed, conditioned or withheld). The Joint Remediation Committee shall have access to Purchaser Personnel that are primarily responsible for the area of the business relationship (such as information technology, data security or regulatory) where the breaches giving rise to the Major Default arise (such Purchaser Personnel, collectively, the “Subject Matter Experts”). The Sellers and the Purchasers shall cause their respective members on the Joint Remediation Committee to, and the Purchasers shall cause the Subject Matter Experts to, act in good faith in connection with the development of the Corrective Action Plan.

• Contractor Hearing Board 1. If there is evidence that the Contractor may be subject to debarment, the Department will notify the Contractor in writing of the evidence which is the basis for the proposed debarment and will advise the Contractor of the scheduled date for a debarment hearing before the Contractor Hearing Board. 2. The Contractor Hearing Board will conduct a hearing where evidence on the proposed debarment is presented. The Contractor and/or the Contractor’s representative shall be given an opportunity to submit evidence at that hearing. After the hearing, the Contractor Hearing Board shall prepare a tentative proposed decision, which shall contain a recommendation regarding whether the Contractor should be debarred, and, if so, the appropriate length of time of the debarment. The Contractor and the Department shall be provided an opportunity to object to the tentative proposed decision prior to its presentation to the Board of Supervisors. 3. After consideration of any objections, or if no objections are submitted, a record of the hearing, the proposed decision, and any other recommendation of the Contractor Hearing Board shall be presented to the Board of Supervisors. The Board of Supervisors shall have the right to modify, deny, or adopt the proposed decision and recommendation of the Contractor Hearing Board. 4. If a Contractor has been debarred for a period longer than five (5) years, that Contractor may after the debarment has been in effect for at least five (5) years, submit a written request for review of the debarment determination to reduce the period of debarment or terminate the debarment. The County may, in its discretion, reduce the period of debarment or terminate the debarment if it finds that the Contractor has adequately demonstrated one or more of the following: (1) elimination of the grounds for which the debarment was imposed; (2) a bona fide change in ownership or management; (3) material evidence discovered after debarment was imposed; or (4) any other reason that is in the best interests of the County. 5. The Contractor Hearing Board will consider a request for review of a debarment determination only where (1) the Contractor has been debarred for a period longer than five (5) years; (2) the debarment has been in effect for at least five (5) years; and (3) the request is in writing, states one or more of the grounds for reduction of the debarment period or termination of the debarment, and includes supporting documentation. Upon receiving an appropriate request, the Contractor Hearing Board will provide notice of the hearing on the request. At the hearing, the Contractor Hearing Board shall conduct a hearing where evidence on the proposed reduction of debarment period or termination of debarment is presented. This hearing shall be conducted and the request for review decided by the Contractor Hearing Board pursuant to the same procedures as for a debarment hearing. 6. The Contractor Hearing Board’s proposed decision shall contain a recommendation on the request to reduce the period of debarment or terminate the debarment. The Contractor Hearing Board shall present its proposed decision and recommendation to the Board of Supervisors. The Board of Supervisors shall have the right to modify, deny, or adopt the proposed decision and recommendation of the Contractor Hearing Board.

• Settlement Administration 5.1. The Settlement Administrator shall, under the supervision of the Court, administer the relief provided by this Settlement Agreement by processing Claim Forms in a rational, responsive, cost effective, and timely manner. The Settlement Administrator shall maintain reasonably detailed records of its activities under this Settlement Agreement. The Settlement Administrator shall maintain all such records as are required by applicable law in accordance with its normal business practices and such records will be made available to Class Counsel and Defendants’ Counsel upon request. The Settlement Administrator shall also provide reports and other information to the Court as the Court may require. The Settlement Administrator shall provide Class Counsel and Defendants’ Counsel with information concerning Notice, administration, and implementation of the Settlement Agreement. Should the Court request, the Parties, in conjunction with the Settlement Administrator, shall submit a timely report to the Court summarizing the work performed by the Settlement Administrator, including a report of all amounts paid to each Settlement Class Member on account of Approved Claims. Without limiting the foregoing, the Settlement Administrator shall: (a) Forward to Defendants’ Counsel, with copies to Class Counsel, all documents and other materials received in connection with the administration of the Settlement Agreement within thirty (30) days after the date on which all Claim Forms have been finally approved or disallowed per the terms of the Settlement Agreement; (b) Receive requests for exclusion and other requests from the Settlement Class and promptly provide a copy of such requests to Class Counsel and Defendants’ Counsel upon receipt (“the Opt-Out List”). If the Settlement Administrator receives any exclusion forms or other requests from the Settlement Class after the Objection/Exclusion Deadline, the Settlement Administrator shall promptly provide copies thereof to Class Counsel and Defendants’ Counsel; (c) Provide weekly reports to Class Counsel and Defendants’ Counsel, including without limitation, reports regarding the number of Claim Forms received, the number determined to be rejected, the number of Approved Claims, and the number of calls to be paid per Settlement Class Member; and (d) Make available for inspection by Class Counsel or Defendants’ Counsel the Claim Forms, any documentation or other evidence submitted in support thereof, and any correspondence received by the Settlement Administrator at any time upon reasonable notice. 5.2. The Settlement Administrator shall employ reasonable procedures to screen claims for abuse or fraud, including without limitation, by cross-referencing the information provided on the Claim Form against the Class List, and by reviewing the evidentiary proof submitted by Settlement Class Members. The Settlement Administrator shall reject a Claim Form, or any part of a claim for a payment reflected therein, where there is evidence of abuse or fraud. The Settlement Administrator shall also reject a Claim Form that does not contain all requested information necessary to screen the claim for fraud or abuse, after giving the claimant a reasonable opportunity of no greater than twenty-one (21) days to provide any requested missing information. The Settlement Administrator shall notify the claimant regarding the missing information via email, telephone call or direct mail, whichever is the most practical based on the information provided in the Claim Form. The validation of all Claim Forms by the Settlement Administrator shall occur no later than fourteen (14) days after the Effective Date and the Settlement Administrator shall give notice of such validation to counsel on that date. 5.3. Defendants and the Class Representatives will have the right to challenge the number of calls received by each Settlement Class Member that are eligible for payment. All challenges will be presented to the Special Master who will make a binding determination as to the number of calls received by each Settlement Class Member entitled to receive payment on account of an Approved Claim. To effectuate such challenge, the party making the challenge must provide email notice to the Settlement Administrator, Special Master and opposing counsel informing them of the claim(s) that party seeks to challenge and the factual basis for that challenge within thirty (30) days of the Settlement Administrator’s validation of all Claim Forms as an Approved Claims determination of the number of calls entitled to a pro rata payment, and notice of the validation. Challenges must be made to individual or designated groups of Claim Forms; so-called “blanket” or “mass” challenges to all Claim Forms without differentiation will not be allowed. 5.4. For Settlement Class Members that submit a Claim Form indicating that they received three (3) calls or fewer, the presumption of three (3) calls can be rebutted by Defendants’ challenges. All other Settlement Class Members will have the ultimate burden if their Claim Form is challenged to demonstrate the number of calls, greater than one (1), that they received. 5.5. In the event of a challenge, the Settlement Administrator shall notify each Settlement Class Member via email, telephone call or direct mail, whichever is the most practical based on the information provided in the Claim Form, that (i) the Settlement Class Member must within thirty (30) days either submit supplemental documentation to prove each call claimed or schedule a telephonic hearing with the Special Master where the Settlement Class Member must testify as to the basis for each separate call claimed, (ii) the Settlement Class Member has the burden of proving the specific number of calls received, and (iii) that the Settlement Class Member will still receive a payment on account of an Approved Claim regardless of the outcome of the challenge. Following the Claims Deadline, but in no event later than one hundred eighty (180) days after Final Judgment, the Special Master will make a determination regarding the claims under challenge, including the number of calls received by the Settlement Class Member (1) based on the information already submitted, and (2) by requiring additional information in the form of (i) either supplemental documentation to prove each call claimed or testimony before the Special Master as to the basis for each separate call claimed. The Special Master’s determination regarding the claims under challenge shall be final and binding on the Parties. If the challenged Settlement Class Member does not timely submit the supplemental documentation or testify before the Special Master, the Special Master shall sustain the Defendants’ challenge and the Settlement Class Member will have an Approved Claim for one (1) call. If the challenged Settlement Class Member does timely submit the supplemental documentation or testify before the Special Master, the Special Master will then, in his sole discretion, make a determination as to the number of calls for which the Settlement Class member can recover. To the extent the Special Master sustains Defendants’ challenge, the Settlement Class member will be permitted to recover for at least one (1) call.

• Search, Enquiry, Investigation, Examination And Verification a. The Property is sold on an “as is where is basis” subject to all the necessary inspection, search (including but not limited to the status of title), enquiry (including but not limited to the terms of consent to transfer and/or assignment and outstanding charges), investigation, examination and verification of which the Purchaser is already advised to conduct prior to the auction and which the Purchaser warrants to the Assignee has been conducted by the Purchaser’s independent legal advisors at the time of execution of the Memorandum. b. The intending bidder or the Purchaser is responsible at own costs and expenses to make and shall be deemed to have carried out own search, enquiry, investigation, examination and verification on all liabilities and encumbrances affecting the Property, the title particulars as well as the accuracy and correctness of the particulars and information provided. c. The Purchaser shall be deemed to purchase the Property in all respects subject thereto and shall also be deemed to have full knowledge of the state and condition of the Property regardless of whether or not the said search, enquiry, investigation, examination and verification have been conducted. d. The Purchaser shall be deemed to have read, understood and accepted these Conditions of Sale prior to the auction and to have knowledge of all matters which would have been disclosed thereby and the Purchaser expressly warrants to the Assignee that the Purchaser has sought independent legal advice on all matters pertaining to this sale and has been advised by his/her/its independent legal advisor of the effect of all the Conditions of Sale. e. Neither the Assignee nor the Auctioneer shall be required or bound to inform the Purchaser of any such matters whether known to them or not and the Purchaser shall raise no enquiry, requisition or objection thereon or thereto.

• Function of Joint Health and Safety Committee All incidents involving aggression or violence shall be brought to the attention of the Joint Health and Safety Committee. The Employer agrees that the Joint Health and Safety Committee shall concern itself with all matters relating to violence to staff.