Full Risk Plans Sample Clauses

Full Risk Plans. Compensation for the Full Risk Plan products is as follows: Capitation Rate For $ 0.08 $ 0.15 $ 0.225 $ 0.30 $ 0.375 $ 0.45 $ 0.525 Full Risk Plan Member per Month Visit Range per Quarter Less than 600 visits 601 visits through 1,200 visits 1,201 visits through 1,800 visits 1,801 visits through 2,400 visits 2,401 visits through 3,000 visits 3,001 visits through 3,600 visits 3,601 visits through 4,200 visits In the event visits exceed [****] visits per quarter, the per member per month capitation rate shall increase by [****] pmpm for each incremental increase of [****] per quarter in the same pattern as the rates outlined above. The parties shall review the number of visits provided within a quarter within sixty (60) days of the close each quarter. In the event the capitation rate for any quarter requires adjustment due to the actual number of visits provided, Company shall reimburse Group any underpayments and Group shall reimburse Company any overpayments.
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Related to Full Risk Plans

  • Health and Welfare Plans (a) A copy of the master contracts with the carriers for the extended health care, dental and group life plans shall be sent to the President of the Union. (b) The Employer will consult the Union before developing any pamphlet explaining the highlights of the plans for distribution to employees. The cost of such a pamphlet shall be borne by the Employer.

  • Welfare Plans Effective as of the Closing Date, Purchaser shall provide group health, life insurance, long term disability and other welfare and fringe benefit plan coverage and benefits (for the purposes of this Section 6.8, “Purchaser’s Health, Welfare and Fringe Benefit Plans”) for Newsprint Employees and Apache Employees who are offered and accept employment with Purchaser as of the Closing Date and who otherwise qualify for such coverage or benefits. In the case of Hourly Newsprint Employees and Hourly Apache Employees, such coverage or benefits shall provide substantially comparable coverage and benefits in the aggregate as Seller’s health, life insurance, welfare and fringe benefit plans provide (for the purposes of this Section 6.8, “Seller’s Health, Welfare and Fringe Benefit Plans”) and otherwise comply with the relevant Collective Bargaining Agreements and in part shall provide for Purchaser’s assumption and continuation of Seller’s Health, Welfare and Fringe Benefit Plans covering Hourly Newsprint Employees and Hourly Apache Employees. In the case of Salaried Employees, Purchaser shall offer substantially comparable coverage and benefits in the aggregate as provided under Seller’s Health, Welfare and Fringe Benefit Plans, except for including retiree health and retiree life insurance. Purchaser may assume and continue any or all of Seller’s Health, Welfare and Fringe Benefit Plans, except for Seller’s health and dental benefits for Salaried Employees, coverage under which shall be provided to Retained Employees and Hired Employees in accordance with the terms of the Transitional Services Agreement. A Newsprint Employee’s or Apache Employee’s last continuous period of service with Seller or Apache shall be counted as if it had been service for Purchaser in determining eligibility for the coverage and benefits set forth in this Section 6.8. Attached as Schedule 6.8 is a list of the last continuous period of service of Newsprint Employees and Apache Employees as of the date set forth on Schedule 6.8. If Purchaser assumes and continues one or more of Seller’s Health, Welfare and Fringe Benefit Plans, the parties shall enter into the Welfare Benefit Plans Assignment and Assumption Agreement in this regard.

  • As-Built Plans Within thirty (30) days after completion of Tenant’s Changes requiring the submission of plans to Landlord, Tenant shall furnish to Landlord a complete set of “as-built” plans and specifications.

  • HEALTH AND WELFARE PLAN 9.01 The Employer shall make available the following or similar benefits as mutually agreed between the Employer and the Union to eligible regular full-time employees (as defined below). The cost of the benefits under Sections 9.07, 9.08, 9.09, 9.10, 9.11, 9.12 and 9.13 below shall be paid one hundred percent (100%) by the Employer. An eligible full-time employee shall be one who has three (3) consecutive months current employment at the effective date of the Plan. Benefits for full-time employees who are laid off will be maintained by the Employer for one half (½) of the employee's recall period as specified in Section 14.04 on the following basis: - B.C. Medical Services Plan (M.S.P.) - Group Life Insurance - Hearing aid, eyeglasses and prescription drug coverage A regular full-time employee who does not have three (3) months' current consecutive full-time service at the effective date of the Plan, or a new employee, shall be eligible the day following the date their current consecutive full-time service reaches three (3) months. 9.02 A regular full-time employee reduced to part-time shall continue to be eligible to participate in the Plan. Full-time employees reducing to below thirty-two (32) hours per week shall receive proportionate Weekly Indemnity benefits. Employees shall return completed enrollment forms as soon as possible. The Employer will only offer benefits after first eligibility test is met. If refused at that time by the employee, further testing is not required. If an employee later wants coverage, it is his or her responsibility to make application to the Employer. If he or she is eligible for coverage, the same rules regarding late enrollment as apply to full- time staff may be imposed. 9.03 The Employer shall also make available the benefits to employees (except students) who work an average of thirty-two (32) hours per week for a period of three (3) consecutive months. Such employees shall receive the same benefits as set out for full-time employees in this Section of the Agreement. 9.04 For the purposes of entitlement and disentitlement, the conditions set out below will apply: A. Employees who average thirty-two (32) hours per week for a three (3) month period will be eligible for all benefits under Section 9 on the first of the month following meeting this requirement. Eligibility verifications will be done each month ending on the last Saturday of the month on a 4, 4, 5 basis, i.e.: if an employee had averaged thirty-two (32) hours per week in the three (3) months prior to April 25, he/she would become eligible for the benefit package on May 1. B. If an employee fails to meet the eligibility test, he/she will continue to be eligible for three (3) months. At that time he/she will be tested again and, if eligible, will continue receiving benefits. If not eligible, will cease receiving benefits. Thereafter at the end of each month, the employee's eligibility will be tested and, as soon as he/she becomes eligible again, benefits will be reinstated. 9.05 The Employer shall also make available: - Medical Services Plan (M.S.P.) - Extended Health Benefit (E.H.B.) - Hearing Aid, Eyeglass, Prescription Drug Plan (H.E.P.) to employees (except students) who work an average of twenty-four (24) hours per week for a period of three (3) consecutive months. For the purposes of entitlement and disentitlement, the hours' tests set out above will apply, but will be based on twenty-four (24) hours instead of thirty-two (32) hours per week. New employees who are covered by the B.C. Medical Services Plan at the date of their employment can elect to maintain their continuity of coverage to be paid as defined above. 9.06 Enrollment of group benefits shall be compulsory at the option of the Employer. The Employer, at his option, may require all enrollment cards to be signed within three (3) months from the date that regular full-time employment commenced. If, under exceptional circumstances, an employee does not sign an enrollment card within three (3) months of employment, he or she may be allowed a further month of grace at the option of the Employer. A period of grace longer than one (1) month may be allowed by the Employer; but, in such cases, a medical examination at the employee's own expense shall be compulsory and a three (3) month penalty period may be imposed.

  • Medical Plans The Employer will maintain the current health (including vision) and dental insurance programs and practices. For Calendar Years 2022 — 2023, the Employer shall contribute 80% of the premium charge for PPO plans, 85% of premium for the EPO plan, 85% of premium for the IHM plan, 80% for the prescription drug plan and 50% for the dental plan.

  • Excess/Umbrella Liability Policies Required insurance coverage limits may be provided through a combination of primary and excess/umbrella liability policies. If coverage limits are provided through excess/umbrella liability policies, then a Schedule of underlying insurance listing policy information for all underlying insurance policies (insurer, policy number, policy term, coverage and limits of insurance), including proof that the excess/umbrella insurance follows form must be provided after renewal and/or upon request.

  • Health Plans A. The health plans offered and benefits provided by those plans shall be those recommended by the JLMBC, approved by the City Council, and administered by the Personnel Department in accordance with LAAC Section 4.

  • Insurance Programs 35.1 Fringe Benefits a. The Board agrees to provide the: Individual core plan premium on behalf of each regular full time employee Part-time regular employees may receive pro-rated insurance benefits if eligible by the carrier. b. When an employee and legally recognized spouse are both employed by the district and are eligible for the school district group plan, the district shall, at the employees' option, combine the district's insurance contribution toward the family plan.

  • Umbrella Policies Contractor may satisfy basic coverage limits through any combination of basic coverage and umbrella insurance.

  • Work Plans Tenant shall prepare and submit to Landlord for approval schematics covering the Tenant Improvements prepared in conformity with the applicable provisions of this Work Letter (the “Draft Schematic Plans”). The Draft Schematic Plans shall contain sufficient information and detail to accurately describe the proposed design to Landlord and such other information as Landlord may reasonably request. Landlord shall notify Tenant in writing within ten (10) business days after receipt of the Draft Schematic Plans whether Landlord approves or objects to the Draft Schematic Plans and of the manner, if any, in which the Draft Schematic Plans are unacceptable. Landlord’s failure to respond within such ten (10) business day period shall be deemed approval by Landlord. If Landlord reasonably objects to the Draft Schematic Plans, then Tenant shall revise the Draft Schematic Plans and cause Landlord’s objections to be remedied in the revised Draft Schematic Plans. Tenant shall then resubmit the revised Draft Schematic Plans to Landlord for approval, such approval not to be unreasonably withheld, conditioned or delayed. Landlord’s approval of or objection to revised Draft Schematic Plans and Tenant’s correction of the same shall be in accordance with this Section until Landlord has approved the Draft Schematic Plans in writing or been deemed to have approved them. The iteration of the Draft Schematic Plans that is approved or deemed approved by Landlord without objection shall be referred to herein as the “Approved Schematic Plans.”

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