Direct Access. The Contractor shall offer female Enrollees direct access to primary and preventive obstetrics and gynecology services, follow-up care as a result of a primary and preventive visit, and any care related to pregnancy from Participating Providers of her choice, without referral from the PCP as set forth in PHL § 4406- b(1).
Direct Access. The Contractor must provide female Members with direct access to a women’s health specialist within the network for covered care necessary to provide women’s routine and preventive health care services. This is in addition to the Member’s designated source of primary care if that source is not a women’s health specialist.
Direct Access. 4.8.3.1 The Contractor shall provide female Members with direct in-network access to a women’s health specialist for covered care necessary to provide her routine and preventive Health Care services. This is in addition to the Member’s designated source of Primary Care if that Provider is not a women’s health specialist.
4.8.3.2 The Contractor shall have a process in place that ensures that Members determined to need a course of treatment or regular care monitoring have direct access to a specialist as appropriate for the Member’s condition and identified needs. The Medical Director shall be responsible for over-seeing this process.
4.8.3.3 The Contractor shall ensure that Members who are determined to need a course of treatment or regular care monitoring have a treatment plan. This treatment plan shall be developed by the Member’s PCP with Member participation, and in consultation with any specialists caring for the Member. This treatment plan shall be approved in a timely manner by the Medical Director and in accord with any applicable State quality assurance and utilization review standards.
Direct Access. Provided Insured shall give to Reinsurer notice of any claim under the Policy within a reasonable time after notice of the claim is given to or received by Ceder and is pursuing its remedies under the Policy against Ceder unless prevented by law or regulation, then in the event that under the terms of the Policy Insured has sustained a loss or losses which, in the aggregate, exceeds Ceder’s Primary Loss Risk, the liability of Reinsurer under this Agreement shall be extended to and in favor of Insured. Failure to so notify as provided in this paragraph shall not defeat the rights of the Insured hereunder unless Reinsurer shall establish that it was actually prejudiced by the failure, and then only to the extent of the prejudice. Thereafter, if Insured requests payment of Reinsurer’s liability under this Agreement directly to Insured, then this Agreement may be enforced by Insured directly against Reinsurer to the extent of Reinsurer’s liability to Ceder hereunder, without diminution, defense, set off or counterclaim which Reinsurer may have against Ceder. Any defense to liability which Ceder has against Insured shall inure to Reinsurer. Reinsurer agrees that Insured shall have the right to commence a legal action to enforce this Agreement against it in the state in which the land is located or in any state where Reinsurer is qualified to do business, provided that when any service of process is made in any action, a copy is sent by Registered or Certified Mail to Reinsurer at its address set forth in Schedule 1.
Direct Access. Questions of compliance with this provision may be referred to SERB or courts of appropriate jurisdiction for prompt, remedial action not withstanding any other provision of this Agreement.
Direct Access. Questions of compliance with this provision may be referred to SERB or courts of appropriate jurisdiction for prompt, remedial action not withstanding any other provision of this Agreement. Step 1 $25,376 $12.20 Step 2 $25,376 $12.20 Step 3 $25,376 $12.20 Step 4 $25,803.00 $12.41 Step 5 $26,320.00 $12.65 Step 1 $25,813.00 $12.41 Step 2 $26,329.00 $12.66 Step 3 $26,856.00 $12.91 Step 4 $27,393.00 $13.17 Step 5 $27,941.00 $13.43 Step 1 $25,376 $12.20 Step 2 $25,376 $12.20 Step 3 $25,376 $12.20 Step 4 $25,803.00 $12.41 Step 5 $26,320.00 $12.65 Step 1 $28,080.00 $13.50 Step 2 $28,642.00 $13.77 Step 3 $29,214.00 $14.05 Step 4 $29,799.00 $14.33 Step 5 $30,395.00 $14.61 Step 1 $25,376 $12.20 Step 2 $25,376 $12.20 Step 3 $25,376 $12.20 Step 4 $25,803.00 $12.41 Step 5 $26,320.00 $12.65 Step 1 $25,813.00 $12.41 Step 2 $26,329.00 $12.66 Step 3 Step 4 Step 5 $26,856.00 $27,393.00 $27,941.00 $12.91 $13.17 $13.43 Proposed Starting Wage Dollars Per Hour Step 1 $27,448.00 $13.20 Step 2 $27,793.00 $13.36 Step 3 $28,349.00 $13.63 Step 4 $28,916.00 $13.90 Step 5 $29,494.00 $14.18 0-2 yrs. Step 1 $40,394.00 $19.42 3-5 yrs. Step 2 $41,201.00 $19.81 6-8 yrs. Step 3 $42,026.00 $20.20 9-11 yrs. Step 4 $42,866.00 $20.61 12-14 yrs. Step 5 $43,723.00 $21.02 Step 1 $25,376 $12.20 Step 2 $25,376 $12.20 Step 3 $25,376 $12.20 Step 4 $25,803.00 $12.41 Step 5 $26,320.00 $12.65
Direct Access. Implementation Date - The date after Edison’s approval of a completed Direct Access Service Request on which ESP may supply electrical energy services and Billing Services, Metering Services, and/or Meter Reading Services to a Direct Access Customer.
Direct Access. Provider acknowledges that Covered Individuals may obtain covered mammography screening services and influenza vaccinations from a participating provider without a referral and that Covered Individuals who are women may obtain women's routine and preventive Health Services from a participating women's health specialist without a referral.
Direct Access. In cases where the member opts for the third-party solution, an identification is performed at the connection of the member by the ISV. The certification of orders is carried out by the ISV or the Member. Where Members use the services of an ISV, this does not relieve the Member of its obligations and responsibilities under the Rules or this Agreement.
Direct Access. Provider acknowledges that MA Member may obtain covered mammography screening services and influenza vaccinations from a participating provider without a referral and that MA Member who are women may obtain women's routine and preventive Health Services from a participating women's health specialist without a referral.
