Eligible Claims. Only “Eligible Claims” may be compensated in the Program. An Eligible Claim requires the following:
(1) The Claimant has received notification of her Final Enrollment Status as a Program Participant; and
(2) The Claimant has timely submitted a complete Claim Package as set forth in Article III.
Eligible Claims. (a) Professional Development: the Parties acknowledge that CUPE 3908 Unit 2 members are not required to engage in research and scholarship, as part of their employment responsibilities under this Collective Agreement. Eligible employees may submit professional and academic development proposals for assistance from the fund to a maximum per employee of not more than $300.00 per year;
(b) UHIP reimbursement: Eligible employees who demonstrate the need for financial assistance may apply for assistance with UHIP premium costs, up to a maximum per employee of $300.00 per year.
Eligible Claims. Such Investor or an Affiliate thereof, as of the date hereof, is the legal owner, beneficial owner and/or the investment advisor or manager for the legal or beneficial owner of such Eligible Claims set forth on such Investor’s Schedule 8(e) hereto (collectively, the “Relevant Claims”). There are no Eligible Claims of which such Investor or any of its Affiliates is the legal owner, beneficial owner and/or investment advisor or manager for such legal or beneficial owner that are not part of its Relevant Claims unless such Investor or any of its Affiliates does not possess the full power to vote and dispose of such claims; provided, that the Relevant Claims do not include any interest accrued on, or any repayments of, such Relevant Claims after September 30, 2009. Such Investor or the applicable Affiliate thereof has full power to vote, dispose of and compromise the aggregate principal amount of the Relevant Claims.
Eligible Claims. For a Service Failure to be eligible for Service Credits, all of the following shall apply:
a. a Service Failure occurs for more than one (1) hour and the Service Failure is verified by Relish, as defined within these Additional Terms;
b. claims must be made by the Customer using a UK Broadband claims form (available on request) within ten (10 days of the Service Failure being closed);
c. the Customer is not in breach of any part of the Agreement;
d. the Customer grants such rights of access and other assistance as Relish and/or its agents may require to enable it to repair any Service Failure; and
e. all claims for Service Credits will be verified by Relish, in its sole and absolute discretion;
Eligible Claims. Only “Eligible Claims” may be compensated in the Program. An Eligible Claim requires the following:
(1) The Claimant has received notification of her Final Enrollment Status as a Program Participant; and
(2) The Claimant has timely submitted a complete Claim Package as set forth in Article III, establishing each of the following:
a. Use of an Olmesartan Product for thirty (30) or more days, with first use of an Olmesartan Product commencing on a date on or prior to May 1, 2015, as documented in Contemporaneous Prescription Records and/or Contemporaneous Medical Records;
Eligible Claims. (1) A claim concerning a life insurance policy is eligible for compensation, if
(a) the claim relates to a life insurance policy in force between January 1, 1920 and May 8, 1945 and issued by or belonging to a specific German company and which has become due through death, maturity or surrender; and
(b) the insurance policy was not paid or not fully paid as required by the insurance contract or was confiscated by the German National Socialist Regime or by the government authorities as specified in the definition of Holocaust victim in Section 14; and
(c) the policy (or policies) in question was not covered by a decision of a German restitution or compensation authority. A policy or policies will be considered as having been covered by a decision of a German restitution or compensation authority, where the decision covers the same specific policy or policies as those referred to in the claimant’s claim form, except in cases where: • the claim was rejected by the German restitution or compensation authorities due to their own lack of jurisdiction; or • the claim was rejected by the German restitution or compensation authorities due to the fact that the claim was made by a person not entitled to claim; or • the claim was not timely filed; or • documentary evidence that would have led to a decision in favor of the claimant was previously unavailable but subsequently became available (such as opening of company or government archives); and
(d) the claimant is, in the following order of priority: • the policy beneficiary or his heir pursuant to the Succession Guidelines (Annex C); • the policyholder or his heir pursuant to the Succession Guidelines; • the insured or his heir pursuant to the Succession Guidelines; and
(e) the policy beneficiary or the policyholder or the insured life, who is named in the claim, was a Holocaust victim; and
(f) the claim was lodged before a date mutually agreed by the parties to this Agreement. This date, once agreed, will be appropriately publicized by the parties.
(2) A claim concerning non- life insurance is eligible for compensation, if
(a) the insured event occurred while the policy was in force at the time of the event. Notwithstanding the above, a non- life insurance claim shall not be eligible if it was caused by war unless it can be attributed to racial or religious persecution; and
(b) the claimant is entitled as policyholder or as rightful heir of the policyholder to benefits of the policy notwithstanding the statutes of...
Eligible Claims. A claim must meet all of the following criteria in order to qualify as an Eligible Claim under this Settlement Agreement:
a. The claim is for Medicare home health benefits under Parts A or B, not Part C;
b. The claim is for services provided to a Medicare beneficiary located in Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, or Vermont at the time the claim received the initial determination from the MAC;
c. The claim was denied on the basis that the beneficiary was not homebound;
d. The claim was denied on or between January 1, 2010 through August 3, 2015;
e. The claim is for services provided to a Medicare beneficiary who received a favorable final appellate decision that he or she was homebound at any of the four levels of Medicare administrative appeal prior to the denial date for that claim;
f. The appeal of that claim denial: (a) was pending at any of the four levels of Medicare appeal as of March 5, 2015; or (b) was within the time period for appeal at any of the four levels of Medicare administrative appeal as of March 5, 2015, and an appeal of the initial denial was timely filed;
g. Claims other than of the Named Plaintiffs that are currently the subject of any lawsuit pending in an Article III United States Court, or have been the subject of a final, non-appealable judgment by such courts, are not eligible for re-review;
h. The appeal of that claim denial is pursued by a beneficiary on his or her own behalf, or through a representative other than a provider, supplier, or Medicaid State Agency. Appeals of claim denials pursued by providers or suppliers or Medicaid State agencies are excluded. No provider or supplier or Medicaid State Agency is permitted to receive re-review on behalf of or by assignment from a class member;
i. Claim for services must not have been covered or paid for by Medicare or by any third-party payor or insurer except in the case of an individual Medicare beneficiary whose services were paid in full or part by Medicaid; and
j. For cases not currently pending in the Medicare administrative claims appeals process, there must not have been a determination by the last Medicare adjudicator to review the claim (MAC, Qualified Independent Contractor (QIC), Administrative Law Judge (ALJ), or Medicare Appeals Council (Appeals Council)) that there was a separate and independent basis for denial of the claim other than failure to meet the homebound requirements of the Medicare home health benefit.
Eligible Claims. Eligible Claims are any electronically or manually adjudicated Claim paid for a Covered Prescription Drug Service within existing benefit limits for an active eligible Member. Eligible Claims exclude (i) any reversals or Claims for non-eligible Members; (ii) any Claims from Cash Business; (iii) any Claims for Compound Prescriptions; (iv) any Claims from a Workers’ Compensation plan or other statutory plan providing monetary awards for persons injured on the job; (v) any Claims from Medicaid business; (vi) any Claims from 340B Covered Entities; (vii) any Claims for vaccines, over- the-counter products or over-the-counter equivalents, excluding diabetic test strips; (viii) any Claims for Covered Prescription Drug Services dispensed by a Long-Term Care Pharmacy, Home Infusion Pharmacy, Indian Health Service/Tribal/Urban Health Pharmacy, or Territory Pharmacy; any Military or VA Hospital Pharmacy (ix) any Claims for Medicare Parts B and D; and (x) any claims that originate outside of the United States. CLIENT shall not be owed a Rebate for any drug which BENECARD PBF does not receive a Rebate acknowledges the terms outlined in section H below.
Eligible Claims. Eligible Claims are any electronically or manually adjudicated Claim paid for a Covered Prescription Drug Service within existing benefit limits for an active eligible Member. Eligible Claims exclude (i) any reversals or Claims for non-eligible or non-active Members; (ii) any Claims from Cash Business; (iii) any Claims for Compound Prescriptions; (iv) any Claims from a Workers’ Compensation plan or other statutory plan providing monetary awards for persons injured on the job; (v) any Claims from Medicaid business; (vi) any Claims from 340B Covered Entities; (vii) any Claims for vaccines, over-the-counter products or over-the-counter equivalents, excluding diabetic test strips; (viii) any Claims for Covered Prescription Drug Services dispensed by a Long-Term Care Pharmacy, Home Infusion Pharmacy, Indian Health Service/Tribal/Urban Health Pharmacy, or Territory Pharmacy; any Military or VA Hospital Pharmacy (ix) any Claims for Medicare Parts B and D; (x) any claims that originate outside of the United States and (xi) claims that adjudicate with a DAW Code of 5, Single Source Generic Drugs, and Authorized Generic Drugs; (xii) any Claims that have a multisource code field in Medi-Span as a “Y” or a multisource code field in Medi-Span of M, N, or O with a Brand Name Code field of “G”; (xiii) any Claims that fall within the Excluded Claims Criteria set forth on Table A and (xiv) claims funded by alternative funding. CLIENT shall not be owed a Rebate for any drug which BENECARD PBF does not receive a Rebate and acknowledges the terms outlined in section H below.
Eligible Claims. Claims shall be deemed "Eligible Claims_ pursuant to Heller's xxxx xetermination of eligibility in accordance with its customary credit criteria. Without limiting the generality of the foregoing, the following Claims are not Eligible unless otherwise agreed by Heller:
