Health Care Coverage and Benefits Sample Clauses

Health Care Coverage and Benefits. Eligibility Screening, Enrollment and Referral Services Reference: “Presumptive (temporary or express) enrollment for patients eligible for BC-FPOS; Active application assistance for BC-FPOS; Follow-up on status of BC-FPOS enrollment; Tracking during Presumptive Enrollment to ensure Continuous Enrollment; Application assistance” (Page 50 and 167) “XX-XX/RH Programs provide maximum “managed enrollment” assistance to patients to support successful and timely applications and enrollment of eligible patients into the Badger Care Family Planning Only Service Program (BC-FPOS) Program.” (Page 118) Describe how this standard and practice is assured and consistently performed.  Prior to all established and new visits, and medical and/or supply pick-up visits, each individual is screened for eligibility and/or active enrollment in the Wisconsin Family Planning Waiver/Family Planning Only Services (FPOS) or Wisconsin BadgerCare/Medicaid. If not currently enrolled, eligible clients are temporarily enrolled in FPOS by PCRH staff at the time of their visit. Each client is educated on the benefits and the application process for continuous FPOS enrollment. It is suggested by PCRH staff that clients bring in all necessary documents needed for FPOS continuous enrollment at initial visits or when re-enrollment is due, as a computer is available at the clinic for clients to apply for continuous enrollment after their appointment. PCRH staff is available to assist when needed with enrollment (electronic application), re-enrollment, and eligibility documents (identification/citizenship, income verification, etc.). Clients completing applications at home are given a “cheat sheet” with application “tips” and are encouraged to call the clinic when they get to the “tracking page” in order to streamline the documentation submission. Many clients choose to bring required documentation into the clinic, and PCRH will then fax in information on the client’s behalf. In addition to assisting in the application/re- enrollment process, PCRH support staff are often seen as client advocates for FPOS/BC application approval and/or renewal. All ongoing clients are required to update their existing demographic form that documents their weekly/monthly income. This is resubmitted annually for re-enrollment in FPOS/BadgerCare. Clients are notified when making an appointment or requesting a supply pick-up that their FPOS/BadgerCare is either up-to-date, inactive, or date it will need to be renewe...
Sample 1
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Health Care Coverage and Benefits. Eligibility Screening, Enrollment and Referral Services Reference: “Presumptive (temporary or express) enrollment for patients eligible for BC-FPOS; Active application assistance for BC-FPOS; Follow-up on status of BC-FPOS enrollment; Tracking during Presumptive Enrollment to ensure Continuous Enrollment; Application assistance” (Page 50 and 167) “XX-XX/RH Programs provide maximum “managed enrollment” assistance to patients to support successful and timely applications and enrollment of eligible patients into the Badger Care Family Planning Only Service Program (BC-FPOS) Program.” (Page 118) Describe how this standard and practice is assured and consistently performed.  At the initial visit, all RH clients, male and female, are screened for insurance coverage. Those who are eligible for WFPOS or BC+ are provided information on how to apply for this coverage. Temporary Enrollment (TE) is provided by RHC office staff. RHC staff will also help facilitate the 12 month continuous enrollment for Medicaid WI Family Planning Only Services (FPOS) and BadgerCare Plus for pregnant women. The RHC staff has the ability to fax required documents to EDS at the front desk. If they would like, our clients will have the opportunity to complete online application in a private setting in the RHC education room. The OCHD-RHC staff has developed a follw-up monthly chart to record which clients have not yet successfully submitted their Medicaid application. Reminder phone calls or letters are sent to clients and “back dating” is requested for those who need to re-apply after 30 days. The individual bills for unpaid visits are sent to clients directly if the Medicaid application is unsuccessful two months after the first attempt. This allows the client time to follow up with Medicaid and do a re-application to cover the previous three months..
Sample 1
Health Care Coverage and Benefits. Eligibility Screening, Enrollment and Referral Services Reference: “Presumptive (temporary or express) enrollment for patients eligible for BC-FPOS; Active application assistance for BC-FPOS; Follow-up on status of BC-FPOS enrollment; Tracking during Presumptive Enrollment to ensure Continuous Enrollment; Application assistance” (Page 50 and 167) “XX-XX/RH Programs provide maximum “managed enrollment” assistance to patients to support successful and timely applications and enrollment of eligible patients into the Badger Care Family Planning Only Service Program (BC-FPOS) Program.” (Page 118) Describe how this standard and practice is assured and consistently performed.  Temporary enrollment in BC-FPOS is completed with each new client encounter, unless they prefer to self-pay per the fee schedule. When a new client is scheduling an appointment, the Family Planning Nurse asks the client to present to the clinic with a photo ID, social security number, and proof of income from the last 30 days (e.g. paystubs). If the client presents with the proper proof, continuous enrollment can be submitted on the same day. If not, the client is encouraged to provide the proof at their earliest convenience. Once the initial continuous enrollment is established, the enrollment process is completed on an annual basis to ensure coverage does not lapse.
Sample 1
Health Care Coverage and Benefits. Eligibility Screening, Enrollment and Referral Services Reference: “Presumptive (temporary or express) enrollment for patients eligible for BC-FPOS; Active application assistance for BC-FPOS; Follow-up on status of BC-FPOS enrollment; Tracking during Presumptive Enrollment to ensure Continuous Enrollment; Application assistance” (Page 50 and 167) “XX-XX/RH Programs provide maximum “managed enrollment” assistance to patients to support successful and timely applications and enrollment of eligible patients into the Badger Care Family Planning Only Service Program (BC-FPOS) Program.” (Page 118) Describe how this standard and practice is assured and consistently performed.  KCDOH front line staff are trained as Certified Account Counselors (CAC) to assess eligibility and follow-up with those found eligible for the Badger Care Family Planning Only Service Program (BC-FPOS) Program to support successful and timely applications and enrollment (temporary or express). Staff then monitor patient follow-through to assure that they obtain continued benefit services. At this time, our staff are still using paper application as we do not have access to an online platform. However, we would like to work closely with the State to establish electronic submissions to facilitate temporary enrollment applications. Once available we plan to streamline the application process so that patients can have the option of completing their enrollment at a clinic kiosk.
Sample 1

Related to Health Care Coverage and Benefits

  • Health Care Coverage The Company shall continue to provide Executive with medical, dental, vision and mental health care coverage at or equivalent to the level of coverage that the Executive had at the time of the termination of employment (including coverage for the Executive’s dependents to the extent such dependents were covered immediately prior to such termination of employment) for the remainder of the Term of Employment, provided, however that in the event such coverage may no longer be extended to Executive following termination of Executive’s employment either by the terms of the Company’s health care plans or under then applicable law, the Company shall instead reimburse Executive for the amount equivalent to the Company’s cost of substantially equivalent health care coverage to Executive under ERISA Section 601 and thereafter and Section 4980B of the Internal Revenue Code (i.e., COBRA coverage) for a period not to exceed the lesser of (A) 18 months after the termination of Executive’s employment or (B) the remainder of the Term of Employment, and provided further that (1) any such health care coverage or reimbursement for health care coverage shall cease at such time that Executive becomes eligible for health care coverage through another employer and (2) any such reimbursement shall be made no later than the last day of the calendar year following the end of the calendar year with respect to which such coverage or reimbursement is provided. The Company shall have no further obligations to the Executive as a result of termination of employment described in this Section 8(a) except as set forth in Section 12.

  • Insurance and Benefits Company shall allow Executive to participate in each employee benefit plan and to receive each executive benefit that Company provides for senior executives at the level of Executive's position.

  • Health Benefits The method for determining the Employer bi-weekly contributions to the cost of employee health insurance programs under the Federal Employees Health Benefits Program (FEHBP) will be as follows:

  • Health Insurance Benefits To the extent provided by the federal COBRA law or, if applicable, state insurance laws, and by the Company’s current group health insurance policies, Executive will be eligible to continue Executive’s group health insurance benefits at Executive’s own expense. If Executive timely elects continued coverage under COBRA, the Company shall pay Executive’s COBRA premiums, and any applicable Company COBRA premiums, necessary to continue Executive’s then-current coverage for a period of 18 months after the date of Executive’s termination of employment; provided, however, that any such payments will cease if Executive voluntarily enrolls in a health insurance plan offered by another employer or entity during the period in which the Company is paying such premiums. Executive agrees to immediately notify the Company in writing of any such enrollment. Notwithstanding the foregoing, if the Company determines, in its sole discretion, that it cannot provide the foregoing benefit without potentially incurring financial costs or penalties under applicable law (including, without limitation, Section 2716 of the Public Health Service Act), the Company shall in lieu thereof provide to Executive a taxable monthly amount to continue his group health insurance coverage in effect on the date of separation from service (which amount shall be based on the premium for the first month of COBRA coverage), which payments shall be made regardless of whether Executive elects COBRA continuation coverage and shall commence in the month following the month in which Executive incurs a separation from service and shall end on the earlier of (x) the date on which Executive voluntarily enrolls in a health insurance plan offered by another employer or entity during the period in which the Company is paying such amounts and (y) 18 months after the date of Executive’s separation from service.

  • Health Insurance Coverage (a) An employee who is laid off or separated from employment on or after July 1, 1994, under circumstances which entitle such employee to reemployment rights under this Article, other than pursuant to Section 23, may elect to continue membership in their health benefit plan, upon advance payment of the regular percentage contribution to the cost of the plan, during the first six

  • Health Care Benefits (a) Each regular full-time employee may elect coverage for himself and his eligible dependents* under one of the following health insurance plans:

  • HEALTH AND INSURANCE BENEFITS 22.01 All health and insurance benefit premium costs paid by the Employer shall prorate in accordance with the proration formula under Article 22.12 of this Agreement. Same sex spouse is eligible to be a dependent for insured benefits.

  • Extended Health Care Coverage A) The Employer shall pay one hundred percent (100%) of the monthly premiums for extended health care coverage for regular employees and their eligible dependents (including common-law spouses) under the Pacific Blue Cross Plan, or any other plan mutually acceptable to the Union and the Employer (See also Appendix “I”). The plan benefits shall be expanded to include:

  • Workplace Safety Insurance Benefits (WSIB) Top Up Benefits If the employee is in a class of employees that, on August 31, 2012, was entitled to use unused sick leave credits for the purpose of topping up benefits received under the Workplace Safety and Insurance Act, 1997;

  • Benefit Coverage The Company agrees to provide pension and welfare benefits as described in the Company Booklets, benefit plan documents or policies of insurance for the duration of the Agreement.

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