Covered Benefits and Services The Contractor shall provide to its Hoosier Healthwise members, at a minimum, all benefits and services deemed “medically reasonable and necessary” and covered by the IHCP, and included in the Indiana Administrative Code and under the Contract with the State. A covered service is considered medically necessary if it meets the definition as set forth in 405 IAC 5-2-17. The Contractor shall deliver covered services sufficient in amount, duration or scope to reasonably expect that provision of such services would achieve the purpose of the furnished services. Costs for these services are the basis of the Contractor’s capitation rate and are, therefore, the responsibility of the Contractor. Coverage may not be arbitrarily denied or reduced and is subject to certain limitations in accordance with CFR 438.210(a)(4), which specifies when Contractors may place appropriate limits on services: On the basis of criteria applied under the State plan, such as medical necessity; or For the purpose of utilization control, provided the services furnished are sufficient in amount, duration or scope to reasonably be expected to achieve the purpose for which the services are furnished.
Labour Flexibility (i) An employer may direct an employee to carry out such duties as are reasonable and within the limits of the employee's skill, competence and training consistent with employee's classification, grouping and/or career stream provided that such duties are not designed to promote deskilling.
Individual Flexibility Arrangement The Employer and an Employee may agree to make an individual flexibility arrangement to vary the effect of the terms of this Agreement if:
Workplace Flexibility Where, for bona fide operational reasons the Employer schedules employees to work Saturday or Sunday, the following criteria shall apply:
Individual Flexibility Arrangements 7.1 An Employer and Employee covered by the Agreement may agree to make an individual flexibility arrangement to vary the effect of terms of the Agreement if:
Job Benefits and Protection The District shall insure the following provisions:
RDO Flexibility The application of this clause is dependent upon consultation and agreement between the parties provided that agreement will not be unreasonably withheld.
AGREEMENT FLEXIBILITY 7.1 Notwithstanding any other provision of this Agreement, an employer and an individual employee may agree to vary the application of certain terms of this agreement to meet the genuine individual needs of the employer and the individual employee. The terms the employer and the individual employee may agree to vary the application of are those concerning:
Operational Flexibility Each designated airline may, on any or all flights and at its option:
Workplace Safety Insurance Benefits (WSIB) Top Up Benefits If the employee is in a class of employees that, on August 31, 2012, was entitled to use unused sick leave credits for the purpose of topping up benefits received under the Workplace Safety and Insurance Act, 1997;