Election of Medicare Hospice Benefit Sample Clauses

Election of Medicare Hospice Benefit. As in Medicare Advantage, if, after Enrollment, an Enrollee elects to receive the Medicare hospice benefit, the Enrollee will remain in the Contractor’s MMP, but will obtain the hospice service through the Medicare FFS benefit and the Contractor would no longer receive Medicare Parts A & B component of the capitated payment for that Enrollee. Medicare hospice services and all other Original Medicare Parts A & B services would be paid for under Medicare FFS. The Contractor and providers of hospice services would be required to coordinate these services with the rest of the Enrollee’s care, including with Medicaid and Part D benefits and any additional Flexible Benefits and supplemental benefits offered by the Contractor. The Contractor will continue to receive a Medicare Part D capitated payment, for which no changes would occur. Medicaid services and payments for hospice Enrollees must comply with the Section 1115(a) demonstration requirements.
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Election of Medicare Hospice Benefit. As in Medicare Advantage, if an Enrollee elects to receive the Medicare hospice benefit when enrolled in the MMIP, the Enrollee will remain in the MMIP, but will obtain the hospice service through the Medicare FFS benefit and the MMIP would no longer receive Medicare Part C payment for that Enrollee. Medicare hospice services and hospice drugs and all other Original Medicare services would be paid for under Medicare fee-for-service. MMIPs and providers of hospice services would be required to coordinate these services with the rest of the Enrollee’s care, including with Medicaid and Part D benefits and any additional benefits offered under the MMIPs. MMIPs would continue to receive Medicare Part D payment for all non-hospice covered drugs, as well as payment for Medicaid services.
Sample 1
Election of Medicare Hospice Benefit. As in Medicare Advantage, if, after enrollment, an Enrollee elects to receive the Medicare hospice benefit, the Enrollee will remain in the MMP, but will obtain the hospice service through the Medicare FFS benefit and the MMP would no longer receive Medicare Part C payment for that Enrollee. Medicare hospice services and all other Original Medicare services would be paid for under Medicare FFS. MMPs and providers of hospice services would be required to coordinate these services with the rest of the Enrollee’s care, including with Medicaid and Part D benefits and any additional benefits offered under the MMPs. MMPs would continue to receive Medicare Part D payment, for which no changes would occur. Medicaid services and payments for hospice Enrollees must comply with the ICI Demonstration 1115(a) demonstration requirements.
Sample 1
Election of Medicare Hospice Benefit. As in Medicare Advantage, if, after enrollment, a Participant elects to receive the Medicare hospice benefit, the Participant will remain in the FIDA-IDD Plan, but will obtain the hospice service through the Medicare FFS benefit and the FIDA-IDD Plan would no longer receive Medicare Part C payment for that Participant. Medicare hospice services and all other Original Medicare services would be paid for under Medicare Fee-for-Service. The FIDA-IDD Plan and providers of hospice services would be required to coordinate these services with the rest of the Participant’s care, including with Medicaid and Part D benefits and any additional benefits offered under the FIDA-IDD Plan. The FIDA-IDD Plan would continue to receive Medicare Part D payment, for which no changes would occur. Medicaid services and payments for hospice Participants must comply with the OPWDD Comprehensive Section 1915(c) waiver requirements.
Sample 1
Election of Medicare Hospice Benefit. As in Medicare Advantage, if, after enrollment, a Participant elects to receive the Medicare hospice benefit, the Participant will remain in the FIDA Plan, but will obtain the hospice service through the Medicare FFS benefit and the FIDA Plan would no longer receive Medicare Part C payment for that Participant. Medicare hospice services and all other Original Medicare services would be paid for under Medicare fee-for- service. FIDA Plans and providers of hospice services would be required to coordinate these services with the rest of the Participant’s care, including with Medicaid and Part D benefits and any additional benefits offered under the FIDA Plans. FIDA Plans would continue to receive Medicare Part D payment, for which no changes would occur. Medicaid services and payments for hospice Participants must comply with the FIDA Demonstration Medicaid 1915(b) waiver requirements.
Sample 1
Election of Medicare Hospice Benefit. If an enrollee elects to receive the Medicare hospice benefit, the enrollee will no longer be eligible for the demonstration. They will be disenrolled from the Demonstration and return to fee-for-service Medicare and Medicaid. The beneficiary will be required to select a Medicare Part D plan. A beneficiary who does not select a plan will be autoassigned, with LINet covering pharmacy services in the interim.
Sample 1
Election of Medicare Hospice Benefit. As in Medicare Advantage, if, after Enrollment, an Enrollee elects to receive the Medicare hospice benefit, the Enrollee will remain in the ICO, but will obtain the hospice service through the Medicare FFS benefit and the ICO would no longer receive Medicare Parts A & B component of the capitated payment for that Enrollee. Medicare hospice services and all other Original Medicare Parts A & B services would be paid for under Medicare FFS. The ICO and providers of hospice services would be required to coordinate these services with the rest of the Enrollee’s care, including with Medicaid and Part D benefits and any additional Flexible Benefits and supplemental benefits offered by the ICO. The ICO will continue to receive a Medicare Part D capitated payment, for which no changes would occur. Medicare Part D The Medicare Part D baseline for the Part D Direct Subsidy will be set at the Part D national average monthly bid amount (NAMBA) for the calendar year. CMS will estimate an average monthly prospective payment amount for the low-income cost-sharing subsidy and federal reinsurance amounts; these payments will be reconciled after the end of each payment year in the same manner as for all Part D sponsors. The monthly Medicare Part D Component for an Enrollee can be calculated by multiplying the Part D NAMBA by the RxHCC risk score assigned to the individual, and then adding to this estimated average monthly prospective payment amount for the low income cost-sharing subsidy and federal reinsurance amounts. Aggregate Savings Percentages Aggregate savings percentages will be applied equally, as follows, to the baseline spending amounts for the Medicare Parts A/B Component and the Medicaid Component of the capitated rate, provided that such savings percentages may be adjusted in accordance with Section 4.2.3.3 or Error: Reference source not found. Demonstration Year 1: 1% Demonstration Year 2: 2% Demonstration Year 3: 3% Demonstration Year 4: 3% Demonstration Year 5: 3% Demonstration Year 6: 3% Demonstration Year 7: 3% Demonstration Year 8: 3% Demonstration Year 9: 3% Demonstration Year 10: 3% Rate updates will take place on January 1st of each calendar year, however savings percentages will be calculated and applied based on Demonstration Years. Savings percentages will not be applied to the Part D Component of the rate. CMS will monitor Part D costs closely on an ongoing basis. Any material changes in Part D costs relative to the baseline may be factored into...
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Related to Election of Medicare Hospice Benefit

  • Post Retirement Health Care Benefit Employees who separate from State service and who, at the time of separation are insurance eligible and entitled to immediately receive an annuity under a State retirement program, shall be entitled to a contribution of two hundred fifty dollars ($250) to the Minnesota State Retirement System’s (MSRS) Health Care Savings Plan. Employees who have a HCSP waiver on file shall receive a two hundred fifty dollars ($250) cash payment. If the employee separates due to death, the two hundred fifty dollars ($250) is paid in cash, not to the HCSP. An employee who becomes totally and permanently disabled on or after January 1, 2008, who receives a State disability benefit, and is eligible for a deferred annuity under a State retirement program is also eligible for the two hundred fifty dollar ($250) contribution to the MSRS Health Care Savings Plan. Employees are eligible for this benefit only once.

  • How Are Distributions from a Xxxxxxxxx Education Savings Account Taxed For Federal Income Tax Purposes? Amounts distributed are generally excludable from gross income if they do not exceed the beneficiary’s “qualified higher education expenses” for the year or are rolled over to another Xxxxxxxxx Education Savings Account according to the requirements of Section (4). “Qualified higher education expenses” generally include the cost of tuition, fees, books, supplies, and equipment for enrollment at (i) accredited post-secondary educational institutions offering credit toward a bachelor’s degree, an associate’s degree, a graduate-level or professional degree or another recognized post-secondary credential and (ii) certain vocational schools. In addition, room and board may be covered if the beneficiary is at least a “half-time” student. This amount may be reduced or eliminated by certain scholarships, qualified state tuition programs, HOPE, Lifetime Learning tax credits, proceeds of certain savings bonds, and other amounts paid on the beneficiary’s behalf as well as by any other deductions or credits taken for the same expenses. The definition of “qualified education expenses” includes expenses more frequently and directly related to elementary and secondary school education, including the purchase of computer technology or equipment or Internet access and related services. To the extent payments during the year exceed such amounts, they are partially taxable and partially non-taxable similar to payments received from an annuity. Any taxable portion of a distribution is generally subject to a 10% penalty tax in addition to income tax unless the distribution is (i) due to the death or disability of the beneficiary, (ii) made on account of a scholarship received by the beneficiary, or (iii) is made in a year in which the beneficiary elects the HOPE or Lifetime Learning credit and waives the exclusion from income of the Xxxxxxxxx Education Savings Account distribution. You may be allowed to take both the HOPE or Lifetime Learning credits while simultaneously taking distributions from Xxxxxxxxx Education Savings Accounts. However, you cannot claim a credit for the same educational expenses paid for through Xxxxxxxxx Education Savings Account distributions. To the extent a distribution is taxable, capital gains treatment does not apply to amounts distributed from the account. Similarly, the special five- and ten-year averaging rules for lump-sum distributions do not apply to distributions from a Xxxxxxxxx Education Savings Account. The taxable portion of any distribution is taxed as ordinary income. The IRS does not require withholding on distributions from Xxxxxxxxx Education Savings Accounts.

  • Health Care Benefits (a) Each regular full-time employee may elect coverage for himself and his eligible dependents* under one of the following health insurance plans:

  • When Must Distributions from a Xxxxxxxxx Education Savings Account Begin? Distribution of a Xxxxxxxxx Education Savings Account must be made (or otherwise will be deemed made) no later than 30 days from the earlier of the beneficiary’s death or attainment of age 30. A distribution from a Xxxxxxxxx Education Savings Account may be rolled over to another beneficiary’s Xxxxxxxxx Education Savings Account according to the requirements of Section (4). Note that the Economic Growth and Tax Relief Reconciliation Act of 2001 waives the distribution age limitation if the beneficiary of the Xxxxxxxxx Education Savings Account is a “Special Needs” student.

  • Health Care Spending Account After six (6) months of permanent employment, full time and part time (20/40 or greater) employees may elect to participate in a Health Care Spending Account (HCSA) Program designed to qualify for tax savings under Section 125 of the Internal Revenue Code, but such savings are not guaranteed. The HCSA Program allows employees to set aside a predetermined amount of money from their pay, not to exceed the maximum amount authorized by federal law, per calendar year, of before tax dollars, for health care expenses not reimbursed by any other health benefit plans. HCSA dollars may be expended on any eligible medical expenses allowed by Internal Revenue Code Section 125. Any unused balance is forfeited and cannot be recovered by the employee.

  • How Are Contributions to a Xxxxxxxxx Education Savings Account Reported for Federal Tax Purposes? Contributions to a Xxxxxxxxx Education Savings Account are reported on IRS Form 5498-ESA.

  • Health Care Savings Plan As provided in this Agreement, eligible ASF Members will participate in the health care savings plan (HCSP) established under Minnesota Statute 352.98, and as administered by the Plan Administrator. The Employer is responsible only for transferring funds, as specified in this agreement, to the Plan Administrator.

  • Rollovers of Settlement Payments From Bankrupt Airlines If you are a qualified airline employee who has received a qualified airline settlement payment from a commercial airline carrier under the approval of an order of a federal bankruptcy court, you are allowed to roll over up to 90 percent of the proceeds to your Traditional IRA, within 180 days after receipt of such amount, or by a later date if extended by federal law. If you make such a rollover contribution, you may exclude the amount rolled over from your gross income in the taxable year in which the airline settlement payment was paid to you. If you are a qualified airline employee who has received a qualified airline settlement payment from a commercial airline carrier under the approval of an order of a federal bankruptcy court in a case filed after September 11, 2001, and before January 1, 2007, you are allowed to roll over any portion of the proceeds into your Xxxx XXX within 180 days after receipt of such amount, or by a later date if extended by federal law. For further detailed information and effective dates you may obtain IRS Publication 590-A, Contributions to Individual Retirement Arrangements (IRAs), from the IRS or refer to the IRS website at xxx.xxx.xxx.

  • What Forms of Distribution Are Available from a Xxxxxxxxx Education Savings Account Distributions may be made as a lump sum of the entire account, or distributions of a portion of the account may be made as requested.

  • Disclosure Statement for Xxxxxxxxx Education Savings Accounts 1. Who is Eligible for a Xxxxxxxxx Education Savings Account? Anyone may contribute to a Xxxxxxxxx Education Savings Account regardless of his or her relationship to the beneficiary. The beneficiary of a Xxxxxxxxx Education Savings Account

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