Coverage Type. Contractor will identify whether the type of coverage is “occurrence” or “claims made.” If the type of coverage is “claims made,” which at renewal Contractor changes to “occurrence,” Contractor will carry a twelve (12) month tail. Contractor will not do or permit to be done anything that will invalidate the policies.
Coverage Type. The coverage type codes used on the non-MSP file will be consistent with those used on the MSP file, but not all MSP file coverage types will be relevant. CMS needs supplemental drug coverage on the non-MSP file. If the partner is describing a network (EDI) pharmacy benefit, the coverage type will be U, W, X, or Y. If the partner is describing a non-network pharmacy benefit the coverage type will be V, Z, 4, 5, or 6. Insurer Name- This is the name of the private insurer providing prescription drug coverage. CMS asks for this to facilitate proper billing at point of sale. The ‘D’ record in the Non-MSP Response File will also contain whatever information was provided in the incoming file, i.e. SSN or Medicare ID (HICN or MBI), DOB, Rx ID, etc. The Non-MSP Response File will also contain the Rx Disposition Code and Rx Error Codes that will be contained in the MSP Response record for the same reasons and according to the same rules as described in the MSP File section above. Special Note about the “ID” Disposition Code Partners may see the term “ID” as a value in the Rx Disposition Code field in the D/N Disposition Code field on their Non-MSP Response Files (Field 48). This “ID” Disposition Code is being caused by an identification error at the CMS Medicare Beneficiary Database (the MBD). Response records you get that have an “ID” code in an Rx Disposition Code field are those that have not yet been accepted by the MBD. However, these response records returned to you do include whatever Medicare information the BCRC had received, if any, from the MBD and stored for that beneficiary in the BCRC’s own database. But without a confirmation of acceptance of a record from the MBD, the record’s data can not be considered validated. To confirm acceptance of such records Partners should include them as part of their next quarterly submission. ‘N’ – Non-Reporting Query Record and Response Non-MSP Input Files with an ‘N’ Action Type (that is, a “query only” filing) will require the following minimum data set: Medicare ID (HICN or MBI) or SSN, last name, first initial, date of birth, and sex. All are included as part of the current Non-MSP Input File. In response, CMS will provide the Medicare Part A and B entitlement information it now provides in other non-MSP responses, as well as the new Medicare Part D entitlement information, which is described above in the Non-MSP Response File layout. Note that an ‘N’ Action Type (a “query only” input file) includes and is related...
Coverage Type a scope of medical services, other benefits, or both, that are available to members who meet specific MassHealth eligibility criteria. EOHHS’s current Coverage Types with Members who may be enrolled with the Contractor are: Standard, Family Assistance, CarePlus and CommonHealth. See 130 CMR 450.105 for an explanation of each Coverage Type. Credentialing Criteria – criteria establishing the qualifications of Network Providers. See Section 2.8.H. of this Contract.
Coverage Type a scope of medical services, other benefits, or both, that are available to members who meet specific MassHealth eligibility criteria. EOHHS’s current Coverage Types with Members who may be enrolled with the Contractor are: Standard, Family Assistance, CarePlus and CommonHealth. See 130 CMR 450.105 for an explanation of each Coverage Type. Covered Entity – shall have the meaning given to this term in the Privacy and Security Rules. CP Supports – see Appendix G. Cultural and Linguistic Competence – competence, understanding, and awareness with respect to Culturally and Linguistically Appropriate Services. Culturally and Linguistically Appropriate Services – health care services that are respectful of and responsive to cultural and linguistic needs, and that are characterized by cultural and linguistic competence, as described in the Culturally and Linguistically Appropriate Services (CLAS) standards set forth by the Office of Minority Health of the U.S. Department of Health and Human Services. More detail on CLAS standards may be found here: xxxx://xxxxxxxxxxxxxx.xxx.xxx/assets/pdf/checked/finalreport.pdf Customer Service Center (CSC) Vendor – EOHHS’s enrollment broker that provides Members with a single point of access to a wide range of customer services, including enrolling Members into MCOs and the PCC Plan. DCF – the Massachusetts Department of Children and Families. DDS – the Massachusetts Department of Developmental Services. Department of Mental Health (DMH) – the department within the Massachusetts Executive Office of Health and Human Services designated as the Commonwealth’s mental health authority pursuant to M.G.L. c. 19 and M.G.L. c. 123, et seq. DPH – the Massachusetts Department of Public Health. DTA – the Massachusetts Department of Transitional Assistance. DYS – the Massachusetts Department of Youth Services. Digital Quality Measures (dQMs) – quality measures expressed in a digital format using standardized language and data definitions that enable sharing of the specified measure electronically between systems. dQMs are developed for HEDIS measure reporting. Disability Coordinator – one of the Contractor’s Key Personnel roles, as described in Section 2.5.A. Discharge Planning – the evaluation of an Enrollee’s medical and Behavioral Health care needs and coordination of any other support services in order to arrange for safe and appropriate care and living situation after discharge from one care setting (e.g., acute hospital, inpatient beha...
Coverage Type the level of coverage You purchased and defined on Your Purchase Confirmation. Enhanced coverages such as ADH are described in Section 6.2. 4.12.
Coverage Type. In-Network1 % of Negotiated Fee2 Out-of-Network1 % of R&C Fee3 Type A - Preventive 80% 80% Type B - Basic Restorative 80% 80% Type C - Major Restorative 80% 80% Type D - Orthodontia 50% 50% Deductible Individual $0 $0 Family $0 $0 Annual Maximum Benefit: Per Individual $2000 $2000 Orthodontia Lifetime Maximum - Ortho applies to Child Only Child to age 19 $800 per Person $800 per Person
Coverage Type. Payment Amount Individual $1,250 Individual plus one dependent $1,500 Individual plus two or more dependents $1,750 No payment will be made for a reduction in the number of dependents. The employee's entire contract must be canceled by the employee to qualify for payment.
Coverage Type. Primary Insured Person Only Mobile Device Protection: $500 per Claim;
Coverage Type. Primary Insured Person Only Solely for the purposes of this Section VI, the following terms will have Purchases of: professional advice; boats; motorized vehicles other personal insurance or a statement that no other insurance exists; Mobile Device Protection: $500 per Claim; the meanings so indicated: (including but not limited to airplanes, automobiles, mopeds, i.) provide a third party statement regarding circumstances of the theft 2 Claims Maximum per 12 Month
Coverage Type. Commercial general liability coverage Comprehensive with contract coverage $1,000,000 Automobile liability (non-owned). Bodily Injury and property damage $1,000,000 Worker’s compensation coverage $1,000,000 and waiver of subrogation Inland Marine policy $ 300,000 or higher Covers rented/leased equipment, all risk, including theft - Retail value of equipment Certificate holder must be named as additional insured and loss payee Certificate holder: Mega Machinery 00000 Xxxxxxx 00 Xxxxxxxx, XX 00000 PLEASE NOTE: You are responsible for all uninsured and underinsured losses while equipment is in your care and custody. Your insurance agent can explain this to you. If you have any questions, special requests, or needs, please have your agent call us at 000-000-0000.
