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EPO Plan Sample Clauses

EPO Plan. The Metro Health Select plan, an exclusive provider organization, which includes the following general specifications: 1. $0 co-pay for Office visits for preventative care (per ACA regulations; i.
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EPO Plan. The Metro Health Select an exclusive provider organization plan, which includes the following general specifications: 1. The current plan design is available on Kronos under the Benefits tab. Look for benefits link. 2. $0 co-pay for office visits for preventative care (per ACA regulations; i.e. annual physicals, well-child visits)
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EPO Plan. Metro Health Select, an exclusive provider organization plan, which includes the following general specifications: a. $0 co-pay for office visits for preventative care (per ACA regulations; i.e. annual physicals, well-child care visits.) b. $10 co-pay for each office visit for physical exams, allergy testing, hearing tests, outpatient surgery, specialty care, physical, speech, and/or occupational therapy): (limit of 2 months or 30 visits per therapy). c. Emergency room visit: $150 co-pay effective January 2018, waived if admitted. d. Hospital inpatient care at Metro Health facility: no charge. e. Home health services, hospice home care/respite care: no charge. f. Skilled care in a skilled nursing facility: no charge (limit of 100 days per year). g. Prescription Drug Co-Pay for a 30 Day supply Metro Pharmacy – $3 - Generic $10 – Formulary $15 – Non-formulary Retail Pharmacy – $3 – Generic $20 – Formulary $35 – Non-formulary h. As of January 1, 2018, there will be a co-pay for specialty drugs of 10% of the cost to a maximum of $100 co-pay for a 30-day supply. i. Any co-pay of a 30-day supply at a retail pharmacy for a maintenance drug will be doubled (2x) upon the 4th refill of the drug (i.e. $10 co-pay for formulary drug will be doubled to $20) except for controlled substance drugs. Not all specialty prescription drugs will be available by mail order or in 90-day supply. j. Durable medical equipment: no charge. The above benefits are subject to the rules and regulations of the EPO plan provider.
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EPO Plan. The Metro Health Select an exclusive provider organization plan, which includes the following general specifications: 1. The current plan design is available on Infonet under the Human Resources tab. Look for benefits link.
Sample 1
EPO Plan. Members will select a Primary Care Provider (PCP) from the Tier 1 Prime Healthcare Network Directory or the Tier 2 Blue Cross BlueCard PPO Network. Specialty and Facility care will be coordinated through a referral process with the PCP and the Prime Healthcare Utilization Review department. Referrals submitted to Prime UR with all pertinent information (i.e. CPT, Diagnosis codes, clinical information, also known as a clean referral) will be processed within seven business days from the date of receipt. Additional time may be necessary if the referral is missing pertinent data and Prime UR must contact the referring provider for additional information. No referral is necessary for the following services: PCP Office Visit, Pediatric Office Visit, Annual Well Exam, Urgent Care or Emergency Room Visit. If determined by Prime UM, Facility or specialist care not available in Tier 1 RI shall be referred to the Tier 2 Network and be paid out at tier one cost levels.
Sample 1

Related to EPO Plan

  • Profit Sharing Plan Under the Northrim BanCorp, Inc. Profit Sharing Plan (the “Plan”), Executive shall be eligible to receive an annual profit share based on performance as defined by the Board of Directors. Executive will be classified in the Executive tier under the Plan’s Responsibility Factors. If Employer is required to prepare an accounting restatement due to “material noncompliance of the Employer,” the Employer will recover from the Executive any incentive compensation during the three (3) years prior to the date of the restatement, in excess of what would have been paid under the restatement. Executive’s signature on this Agreement authorizes Employer to offset or deduct from any compensation Employer may owe Executive, any excess payments (in whole or in part) that Executive may owe Employer due to such restatement(s).

  • Deferral Plan The deferral portion of the plan shall involve an employee spreading four (4) years' salary over a five (5) year period, or such other schedule as may be mutually agreed between the employee and the Hospital. In the case of the four (4) years' salary over a five (5) year schedule, during the four (4) years of salary deferral, 20% of the employee's gross annual earnings will be deducted and held for the employee. Such deferred salary will not be accessible to the employee until the year of the leave or upon the collapse of the plan. In the case of another mutually agreed upon deferral schedule, the percentage of salary deferred shall be adjusted appropriately.

  • 125 Plan The Board will maintain a Section 125 plan for premiums only in addition to a flexible account that includes eligible medical expenses and dependent care expenses with participating employees paying whatever the administrative charge is to run the 125 Plan.

  • Deferred Compensation Plan Manager shall be eligible to participate in the First Mid-Illinois Bancshares, Inc. Deferred Compensation Plan in accordance with the terms and conditions of such Plan.

  • WELFARE PLAN Section 1: The Plan Section 2: Joint Welfare Board

  • Benefit Plan If an employee maintains coverage for benefit plans while on maternity or parental leave, the Employer agrees to pay the Employer's share of these premiums.

  • Plan The Award and all rights of the Participant under this Agreement are subject to the terms and conditions of the provisions of the Plan, incorporated herein by reference. The Participant agrees to be bound by the terms of the Plan and this Agreement. The Participant acknowledges having read and understanding the Plan, the Prospectus for the Plan, and this Agreement. Unless otherwise expressly provided in other sections of this Agreement, provisions of the Plan that confer discretionary authority on the Board or the Administrator do not (and shall not be deemed to) create any rights in the Participant unless such rights are expressly set forth herein or are otherwise in the sole discretion of the Board or the Administrator so conferred by appropriate action of the Board or the Administrator under the Plan after the date hereof.

  • Dental Plan (a) The Employer shall pay the monthly premium for employees entitled to coverage under a mutually acceptable plan which provides: (1) Part A, 100% coverage; (2) Part B, 65% coverage (3) Part C, 55% coverage. (b) Orthodontic services are subject to a lifetime maximum payment of $3,500 per patient.

  • Pension Plan Employers and/or individuals who manage, operate, assist or own, either partially or wholly, a company or companies working non-union in the construction industry on Mainland Nova Scotia within the craft jurisdiction of xxx Xxxxxxxxxx Local 83 shall not be eligible to be appointed to serve, or to continue to serve, as trustees on any trust fund referred to within this Collective Agreement. This provision shall apply to management trustees and union trustees alike. 29.01 It is agreed that the employer shall pay into the established Pension Fund an amount per hour for each hour paid as per the wage tables in Craft Schedule “A”, “B”, “S” and Appendix “MIP”. Pension contributions shall be calculated based on the base hourly rate and vacation pay, and no premium shall affect this. For the purposes of this Article, overtime rates payable in accordance with Article 16 are not premiums. Such contributions shall be paid to the Trustees of the Pension Fund on or before the fifteenth (15th) day of the month following the month such hours were worked and shall be accompanied by a remittance report form for each employee on a form prescribed by the Trustees of the Fund. Each monthly report and contributions shall include all obligations arising from hours worked up to the preceding calendar month. 29.02 It is agreed that provisions for an increase in the Pension Plan (other than those increases listed above) will be implemented if so desired by the Local, with the employer contribution to be deducted from the wages rates contained herein, provided the employer receives sixty (60) days notice of such change. 29.03 The Pension Plan shall be professionally administered. 29.04 Neither the United Brotherhood of Carpenters and Joiners of America, Local 83, nor the Nova Scotia Construction Labour Relations Association shall incur any legal liability with regard to claims arising from the Pension Plan. 29.05 Employers bound by, or subject to the Agreement, shall be required to maintain for a two (2) year period, a complete set of employment records including: • employee’s name, address, and S.I.N. • number of hours worked by the employee in each week • employee’s wage rate and gross earnings, amount(s) and description of deductions from the employee’s wages • particulars of pay allowances or other payments or benefits to which the employee is entitled.

  • Savings Plan Executive will be eligible to enroll and participate, and be immediately vested in, all Company savings and retirement plans, including any 401(k) plans, as are available from time to time to other key executive employees.

Most Referenced Clauses

Most Referenced Definitions