COVERED HEALTHCARE SERVICES This section describes covered healthcare services. This plan covers services only if they meet all of the following requirements: • Listed as a covered healthcare service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered healthcare service under this plan. • Medically necessary, consistent with our medical policies and related guidelines at the time the services are provided. • Not listed in Exclusions Section. • Received while a member is enrolled in the plan. • Consistent with applicable state or federal law. We review medical necessity in accordance with our medical policies and related guidelines. Our medical policies can be found on our website. Our medical policies are written to help administer benefits for the purpose of claims payment. They are made available to you for informational purposes and are subject to change. Medical policies are not meant to be used as a guide for your medical treatment. Your medical treatment remains a decision made by you with your physician. If you have questions about our medical policies, please call Customer Service. When a new service or drug becomes available, when possible, we will review it within six (6) months of one of the events described below to determine whether the new service or drug will be covered: • the assignment of an American Medical Association (AMA) Current Procedural Terminology (CPT) code in the annual CPT publication; • final Food and Drug Administration (FDA) approval; • the assignment of processing codes other than CPT codes or approval by governing or regulatory bodies other than the FDA; • submission to us of a claim meeting the criteria above; and • generally, the first date an FDA approved prescription drug is available in pharmacies (for prescription drug coverage only). During the review period, new services and drugs are not covered. For all covered healthcare services, please see the Summary of Medical Benefits and the Summary of Pharmacy Benefits to determine the amount that you pay and any benefit limits.
Cooperation on forestry matters and environmental protection 1. The aims of cooperation on forestry matters and environmental protection will be, but not limited to, as follows: (a) establishing bilateral cooperation relations in the forestry sector; (b) developing a training program and studies for sustainable management of forests; (c) improving the rehabilitation and sustainable management of forest with the aim of increasing carbon sinks and reduce the impact of climate change in the Asia-Pacific region; (d) cooperating on the execution of national projects, aimed at: improving the management of forest plantations for its transformation for industrial purposes and environmental protection; (e) elaborating studies on sustainable use of timber; (f) developing new technologies for the transformation and processing of timber and non-timber species; and (g) improving cooperation in agro-forestry technologies.
2. To achieve the objectives of the Article 149 (Objectives), the Parties may focus, as a means of cooperation and negotiations on concluding a bilateral agreement on forestry cooperation between the two Parties. Such collaboration will be as follows: (a) exchanges on science and technology as well as policies and laws relating the sustainable use of forest resources; (b) cooperation in training programs, internships, exchange of experts and projects advisory; (c) advice and technical assistance to public institutions and organizations of the Parties on sustainable use of forest resources and environmental protection; (d) facilitating forest policy dialogue and technical cooperation under the Network of Sustainable Forest Management and Forest Rehabilitation in Asia- Pacific Region, initiated at the 15th Asia Pacific Economic Cooperation (APEC) Meeting; (e) encouraging joint studies, working visits, exchange of experiences, among others; and (f) others activities mutually agreed.
Health Care Operations “Health Care Operations” shall have the same meaning as the term “health care operations” in 45 CFR §164.501.
Home Health Care This plan covers the following home care services when provided by a certified home healthcare agency: • nursing services; • services of a home health aide; • visits from a social worker; • medical supplies; and • physical, occupational and speech therapy.
Health Promotion and Health Education Both parties to this Agreement recognize the value and importance of health promotion and health education programs. Such programs can assist employees and their dependents to maintain and enhance their health, and to make appropriate use of the health care system. To work toward these goals:
MANAGEMENT OF EVALUATION OUTCOMES 12.1 Where the Employer is, any time during the Employee’s employment, not satisfied with the Employee’s performance with respect to any matter dealt with in this Agreement, the Employer will give notice to the Employee to attend a meeting;
12.2 The Employee will have the opportunity at the meeting to satisfy the Employer of the measures being taken to ensure that his performance becomes satisfactory and any programme, including any dates, for implementing these measures;
12.3 Where there is a dispute or difference as to the performance of the Employee under this Agreement, the Parties will confer with a view to resolving the dispute or difference; and
12.4 In the case of unacceptable performance, the Employer shall –
12.4.1 Provide systematic remedial or developmental support to assist the Employee to improve his performance; and
12.4.2 After appropriate performance counselling and having provided the necessary guidance and/or support as well as reasonable time for improvement in performance, the Employer may consider steps to terminate the contract of employment of the Employee on grounds of unfitness or incapacity to carry out his or her duties.
Extended Health Care Plan The Employer shall pay the monthly premium for regular employees entitled to coverage under a mutually acceptable extended health care plan.
Function of Joint Health and Safety Committee All incidents involving aggression or violence shall be brought to the attention of the Joint Health and Safety Committee. The Employer agrees that the Joint Health and Safety Committee shall concern itself with all matters relating to violence to staff.
HEALTH CARE PLANS Notwithstanding the references to the Pacific Blue Cross Plans in this article, the parties agree that Employers, who are not currently providing benefits under the Pacific Blue Cross Plans may continue to provide the benefits through another carrier providing that the overall level of benefits is comparable to the level of benefits under the Pacific Blue Cross Plans.
TEACHER EVALUATION A. The administration will be evaluating the teacher’s performance within the time of formal responsibility. The evaluation process and form will be shared with the Association Building Representatives at the beginning of each school year.
(a) Probationary teachers shall be evaluated at least two (2) times a year. The first evaluation will be completed prior to December 1st and the second prior to April 15th. Each evaluation will be based upon announced, unannounced, informal observations, on the performance of other duties and responsibilities and the goals developed in the Individualized Development Plan (IDP). The announced and unannounced observations should be a minimum of thirty (30) minutes in length. The observations may occur at anytime prior to the development of the written evaluation, but at least one of them must be planned in consultation with the probationary teacher. The results of formal observations will be discussed with the teacher in a timely manner. The information gathered during the observations will be used to write the evaluations.
(b) Tenured teachers will be evaluated on a rotating schedule, but no less than once every three- (3) years. The administration reserves the right to evaluate a tenured teacher more often. The evaluation will be based upon announced, unannounced, informal observations and on the performance of other duties and responsibilities. The announced and unannounced observations should be a minimum of thirty (30) minutes in length. The observations may occur at any time prior to the development of the written evaluation, but at least one of them must be planned in consultation with the tenured teacher. The results of formal observations will be discussed with the teacher in a timely manner. The information gathered during the observations will be used to write the evaluations.
2. The administrator shall prepare and submit a written evaluation and recommendations to the teacher prior to May 30th of the year they are evaluated. The administrator shall hold a conference with the teacher to discuss the written evaluation and recommendations.
3. Upon receipt of the evaluation the teacher will sign the form indicating his/her receipt of the report. The signature on the form does not constitute his/her approval unless specifically noted.
4. Teachers involved with the instruction of Advanced Placement courses will be evaluated. This evaluation in the first year will be made part of the formal evaluation only at the request of the teacher.
B. A teacher who disagrees with the content or procedure of evaluation may submit a written answer which shall be attached to the file copy of the evaluation in question and/or submit any complaints through Level 4 of the grievance procedure.
C. If an administrator believes a teacher is doing unacceptable work, the reasons shall be set forth in specific terms. Included will be examples of specific ways in which the teacher is to improve and assistance may be given by the administrator and other staff members. In subsequent conferences it shall be the responsibility of the individual teacher to inquire whether adequate improvement has taken place.
D. Monitoring and observation of the work performance of the teacher shall be conducted openly. The public address or audio system or similar types of communications will not be used for the purpose of evaluation.
E. The Board and the Association recognize that the ability of pupils to progress and mature academically is a combined result of the school, home, economic and social environment and that teachers alone cannot be held accountable for all aspects of the academic achievement of the pupil in the classroom. Test results of academic progress of students shall not be used as the sole determinant or in isolated instances to evaluate the quality of a teacher's service or fitness for retention.
F. All communications, including evaluations by Milan Administrators, commendations, and documented complaints directed toward the teacher which are to be included in the personnel file shall be made available for review of the teacher prior to placement in the file; a copy of any such communication will be provided to the teacher at this time. Pre-placement information such as confidential credentials, letters of reference from universities, individuals, or previous employers are exempt from such review. A written statement for inclusion in the personnel file may then be made by the teacher in regard to materials that were not signed by the teacher. A representative of the Association may accompany the teacher.
G. Ordinarily, observations of teachers shall not be for less than a full class period or for the duration of a particular teaching lesson.
