Curriculum U The Academy Trust must provide for the teaching of religious education and a daily act of collective worship at the Academy.
Value-Based Programs If you receive covered healthcare services under a Value-Based Program inside a Host Blue’s service area, you will not be responsible for paying any of the Provider Incentives, risk-sharing, and/or Care Coordinator Fees that are a part of such an arrangement, except when a Host Blue passes these fees to us through average pricing or fee schedule adjustments. The following defined terms only apply to the BlueCard section only: • Care Coordinator Fee is a fixed amount paid by us to providers periodically for Care Coordination under a Value-Based Program. • Care Coordination is organized, information-driven patient care activities intended to facilitate the appropriate responses to an enrolled member’s healthcare needs across the continuum of care. • Value-Based Program (VBP) is an outcomes-based payment arrangement and/or a coordinated care model facilitated with one or more local providers that is evaluated against cost and quality metrics/factors and is reflected in provider payment. • Provider Incentive is an additional amount of compensation paid to a healthcare provider by us, based on the provider’s compliance with agreed-upon procedural and/or outcome measures for a particular group of covered persons. Federal or state laws or regulations may require a surcharge, tax or other fee that applies to insured accounts. If applicable, we will include any such surcharge, tax or other fee as part of the claim charge passed on to you. • Enrolled Member Liability Calculation When covered healthcare services are provided outside of BCBSRI service area by nonparticipating providers, the amount an enrolled member pays for such services will generally be based on either the Host Blue’s nonparticipating provider local payment or the pricing arrangements required by applicable law. In these situations, the enrolled member may be responsible for the difference between the amount that the nonparticipating provider bills and the payment BCBSRI will make for the covered services as set forth in this paragraph. Federal or state law, as applicable, will govern payments, including but not limited to, emergency services, air ambulance services, and certain covered healthcare services rendered by a nonparticipating provider. • Exceptions In some exception cases, BCBSRI may pay claims from nonparticipating healthcare providers outside of BCBSRI service area based on the provider’s billed charge. This may occur in situations where an enrolled member did not have reasonable access to a participating provider, as determined by BCBSRI. In other exception cases, BCBSRI may pay such claims based on the payment BCBSRI would pay to a local nonparticipating provider (as described in the above subsection “How Non-network Providers Are Paid”). This may occur where the Host Blue’s corresponding payment would be more than BCBSRI in-service area nonparticipating provider payment. BCBSRI may choose to negotiate a payment with such a provider on an exception basis. Unless otherwise stated, in any of these exception situations, the enrolled member may be responsible for the difference between the amount that the nonparticipating healthcare provider bills and payment BCBSRI will make for the covered services as set forth in this paragraph. Blue Cross Blue Shield Global® Core If you are outside the United States (hereinafter “BlueCard service area”), you may be able to take advantage of the Blue Cross Blue Shield Global Core when accessing covered healthcare services. The Blue Cross Blue Shield Global Core is unlike the BlueCard Program available in the BlueCard service area in certain ways. For instance, although the Blue Cross Blue Shield Global Core assists you with accessing a network of inpatient, outpatient and professional providers, the network is not served by a Host Blue. As such, when you receive care from providers outside the BlueCard service area, you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services. • Inpatient Services: In most cases, if you contact the service center for assistance, hospitals will not require you to pay for covered inpatient services, except for your cost-share amounts/deductibles, coinsurance, etc. In such cases, the hospital will submit your claims to the service center to begin claims processing. However, if you paid in full at the time of service, you must submit a claim to receive reimbursement for covered healthcare services. • Outpatient Services: Physicians, urgent care centers and other outpatient providers located outside the BlueCard service area will typically require you to pay in full at the time of service. You must submit a claim to obtain reimbursement for covered healthcare services. Preauthorization may be required for outpatient services. • Submitting a Blue Cross Blue Shield Global Core Claim: When you pay for covered healthcare services outside the BlueCard service area, you must submit a claim to obtain reimbursement. For institutional and professional claims, you should complete a Blue Cross Blue Shield Global Core claim form and send the claim form with the provider’s itemized bill(s) to the service center (the address is on the form) to initiate claims processing. Following the instructions on the claim form will help ensure timely processing of your claim. The claim form is available from BCBSRI, the service center or online at xxx.xxxxxxxxxxxxxx.xxx. If you need assistance with your claim submission, you should call the service center at 0.000.000.XXXX (2583) or call collect at 0.000.000.0000, 24 hours a day, seven days a week.
Target Population TREATMENT FOR ADULT (TRA) Target Population
Unbundled Channelization (Multiplexing) 5.7.1 To the extent NewPhone is purchasing DS1 or DS3 or STS-1 Dedicated Transport pursuant to this Agreement, Unbundled Channelization (UC) provides the optional multiplexing capability that will allow a DS1 (1.544 Mbps) or DS3 (44.736 Mbps) or STS-1 (51.84 Mbps) Network Elements to be multiplexed or channelized at a BellSouth central office. Channelization can be accomplished through the use of a multiplexer or a digital cross-connect system at the discretion of BellSouth. Once UC has been installed, NewPhone may request channel activation on a channelized facility and BellSouth shall connect the requested facilities via COCIs. The COCI must be compatible with the lower capacity facility and ordered with the lower capacity facility. This service is available as defined in NECA 4.
5.7.2 BellSouth shall make available the following channelization systems and interfaces:
5.7.2.1 DS1 Channelization System: channelizes a DS1 signal into a maximum of twenty- four (24)
Research Plan The Parties recognize that the Research Plan describes the collaborative research and development activities they will undertake and that interim research goals set forth in the Research Plan are good faith guidelines. Should events occur that require modification of these goals, then by mutual agreement the Parties can modify them through an amendment, according to Paragraph 13.6.
Performance Indicators The HSP’s delivery of the Services will be measured by the following Indicators, Targets and where applicable Performance Standards. In the following table: INDICATOR CATEGORY INDICATOR P=Performance Indicator E=Explanatory Indicator M=Monitoring Indicator 2022/23 Organizational Health and Financial Indicators Debt Service Coverage Ratio (P) 1 ≥1 Total Margin (P) 0 ≥0 Coordination and Access Indicators Percent Resident Days – Long Stay (E) n/a n/a Wait Time from Home and Community Care Support Services (HCCSS) Determination of Eligibility to LTC Home Response (M) n/a n/a Long-Term Care Home Refusal Rate (E) n/a n/a Quality and Resident Safety Indicators Percentage of Residents Who Fell in the Last 30 days (M) n/a n/a Percentage of Residents Whose Pressure Ulcer Worsened (M) n/a n/a Percentage of Residents on Antipsychotics Without a Diagnosis of Psychosis (M) n/a n/a Percentage of Residents in Daily Physical Restraints (M) n/a n/a
Power Factor Design Criteria Developer shall design the Large Generating Facility to maintain an effective power delivery at demonstrated maximum net capability at the Point of Interconnection at a power factor within the range established by the Connecting Transmission Owner on a comparable basis, until NYISO has established different requirements that apply to all generators in the New York Control Area on a comparable basis. The Developer shall design and maintain the plant auxiliary systems to operate safely throughout the entire real and reactive power design range. The Connecting Transmission Owner shall not unreasonably restrict or condition the reactive power production or absorption of the Large Generating Facility in accordance with Good Utility Practice.
Extra Trips a. Bus Drivers may be absent from driving part and/or all of their regular bus routes to take an extra trip. This will include Kindergarten route, shuttles, and noon Xxxxx Drivers. For Pay purposes the extra trip begins at the end of the driver's regular route.
b. Regular Drivers desiring to take trips shall sign up at first Bus Drivers' Meeting held either prior to or on the opening day of school. Any Driver may join or remove themselves from the list at any time. All extra trips (Educational and Athletic/Group) shall be posted on one (1) list.
c. Eligible Drivers shall be offered trips at a monthly field trip meeting on a seniority rotating basis. Between monthly meetings, trips shall be offered by phone or radio, on a seniority basis.
d. If a Driver cancels a trip they agreed to drive, the trip will be offered to the next driver (who does not have a trip assigned) on a seniority basis from the canceled trip list.
e. Drivers may not exchange trips.
f. Drivers taking a group trip which involves an admission price and/or parking fee shall be covered by the group sponsoring the trip.
g. In the event none of the eligible Drivers on the seniority rotation list are available to take a trip, the Drivers on the as-needed list will be asked. If no regular Drivers are available, then a Sub will be asked. If no Regular or Sub Drivers can take a trip, the Transportation Supervisor will appoint a Driver, starting with the least senior Driver on the DO WANT trips list.
h. The Board may use the radio to contact Drivers for trips. Drivers must make the decision to drive or not to drive the offered trip within two (2) hours.
i. If at all possible, the trips will be scheduled around two (2) weeks in advance.
j. If a Driver shows up for a trip, and has not been notified the trip has been canceled, or a coach/advisor transports students, the Driver will be paid for two (2) regular hours and the driver will not be charged for the trip.
k. If a Driver's trip date is changed, the scheduled Driver will stay on the trip. If the trip is canceled completely, the driver will be inserted next up the seniority rotation. The inserted driver shall not be taken out of rotation for forthcoming trips.
l. If an Athletic Trip is canceled mid-event, the driver will be paid for the actual number of hours on duty; if rescheduled, the rescheduled event will be a new trip on the rotation list and the driver will be paid for the actual number of hours on duty.
m. If a driver is on the insert list and already has a trip on the same day as a newly offered trip, the driver will stay on the insert list until a trip is offered for a day the driver is not already schedule to drive an extra trip.
n. Any driver who cancels an extra trip two (2) or more times in a given month shall be skipped in the next rotation.
o. Pay for extra trips will begin after the driver’s regular route time and will be at the driver’s regular rate of pay for up to two and one-half (2.5) hours for driver time and pre-trip. The remaining portion of the route will be at the Step 0 base rate.
p. Overnight trips shall be considered special trips with reimbursement determined on an individual basis.
q. Drivers on Leaves of Absences are not eligible for extra trips.
r. Drivers are not eligible for extra trips on days on which they have called in and are off.
Curriculum Development This includes the analysis and coordination of textual materials; constant review of current literature in the field, some of which are selected for the college library collection, the preparation of selective, descriptive materials such as outlines and syllabi; conferring with other faculty and administration on curricular problems; and, the attendance and participation in inter and intra-college conferences and advisory committees.
Field Trips Orange COUNTY funds may not be used to support any overnight and/or out of Central Florida travel, unless approved by the COUNTY’S Manager of the CCC or designee in advance. The AGENCY must have on file for field trip(s) that each participant, adult or minor, must have a signed release of liability form releasing the COUNTY from any liability. If the participant is a minor, the release must be signed by a parent/guardian. Central Florida is defined as Orange, Osceola, Seminole, Brevard, Lake, Polk, and Volusia Counties.
