Enrollee Cost-Sharing Sample Clauses

Enrollee Cost-Sharing. DVHA must not apply co- payment requirements to children under age 21, pregnant women or individuals in long-term care facilities or for excluded services/supplies (e.g., family planning). Enrollee cost sharing shall be in accordance with the premium and co-payment provisions of the program as established under the State Plan and STC #21 of the Global Commitment to Health Demonstration.
Sample 1Sample 2Sample 3See All (4)
AutoNDA by SimpleDocs
Enrollee Cost-Sharing. 7.11.1 The Contractor shall ensure that Network Providers collect Enrollee cost-sharing only as specified in Attachment 8 to this Contract. 7.11.2 The Contractor shall ensure that it accurately differentiates the categories of MiSalud Enrollees in its Marketing Materials and communications, to clarify the cost-sharing rules that are applied to each group. The Contractor shall ensure that the Enrollee’s eligibility category appears on the Enrollee ID Card, so that cost-sharing is correctly determined. 7.11.3 The Contractor shall ensure that, in keeping with the Co-Payment policies included in Attachment 8, Medicaid and CHIP Eligible Persons bear no cost-sharing responsibility under MiSalud for services provided within the Contractor’s PPN or for the treatment of an Emergency Medical Condition. 7.11.4 As provided in Attachment 8 to this Contract, the Contractor shall impose Co-Payments for services provided in an emergency room outside the Enrollee’s PPN, but only in limited circumstances. 7.11.4.1 For Medicaid and CHIP Eligible Persons, the Contractor shall not impose any Co-Payment for the treatment of an Emergency Medical Condition. The Contractor shall, however, as provided in Attachment 8 to this Contract, impose Co-Payments for services provided in an emergency room to treat a condition that does not meet the definition of Emergency Medical Condition as set forth in this Contract. 7.11.4.2 No Co-Payments shall be charged for CHIP children under eighteen years of age under any circumstances; and
Sample 1Sample 2See All (4)
Enrollee Cost-Sharing. Enrollee cost sharing shall be in accordance with the premium and co-payment provisions of the program as established by the State of Vermont Legislature each year.
Sample 1

Related to Enrollee Cost-Sharing

  • Cost Sharing a) With respect to the funding in C6.1a), should there be an amount of employee co-pay, the Trust shall advise boards what that amount shall be. Unless advised otherwise, there will be no deductions upon the Participation Date. b) Any further cost sharing or funding arrangements as per previous local collective agreements in effect as of August 31, 2014 remain status quo.

  • Overtime Meal Allowance Employees required to work more than two (2) hours overtime consecutive with a shift shall be provided with a meal by the Employer.

  • Multi-Year Planning The CAPS will be in a form acceptable to the LHIN and may be required to incorporate (1) prudent multi-year financial forecasts; (2) plans for the achievement of performance targets; and (3) realistic risk management strategies. It will be aligned with the LHIN’s then current Integrated Health Service Plan and will reflect local LHIN priorities and initiatives. If the LHIN has provided multi-year planning targets for the HSP, the CAPS will reflect the planning targets.

  • Uniform Allowance ‌ If the Employer requires an employee to supply and/or maintain specified clothing in place of a uniform which would otherwise be supplied and maintained for jobs involving the direct care of patients/residents, then a clothing/maintenance allowance of ten dollars ($10.00) per bi-weekly pay period shall be paid. This allowance does not apply to non-patient/non-resident areas.

  • Sick Leave Donation Program A Labor Management Committee will be established for the purpose of proposing rules and procedures for a new, program. The LMC will be to develop consistent, transparent and equitable proposals for processes across all departments within the City. The LMC shall also explore proposals to lower the minimum leave bank required to donate sick leave and permit donation of sick leave upon separation from the City. The LMC must consult with the Office of Civil Rights to ensure compliance with the City’s Race and Social Justice Initiative. Once the LMC has developed its list of proposals, the City and Coalition of City Unions agrees to reopen each contract on this subject.

  • Overtime and Premium Pay A nurse shall be paid at the rate of one and one- half (1½) times the nurse’s regular hourly rate of pay for all hours worked in any one category listed below, including statutory overtime pay under 9.4.1 or premium pay under 9.4.2 through

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!