Health Care Information Sample Clauses

Health Care Information. The Employer will not require employees to provide information about the health or medical condition of the employee or the employee’s family unless such information is specifically and directly related to the performance of duties within the scope of employment, fitness to hold the employee’s position or the providing of benefits requested by the employee. Health and medical information obtained by the Employer will be maintained in a separate, confidential file and access to this information by the Employer’s personnel will be limited to those persons with a legitimate business or legal need to know. Employees will not be requested to sign a general or unlimited waiver of medical confidentiality.
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Health Care Information. Did any member of your household NOT have healthcare coverage for the entire year? Provide copies of all Forms 1095-A, 1095-B, 1095-C for ALL members of your household. If any member of your household received an exemption from the marketplace, provide the Exemption Certificate Number (ECN). Did you receive any distributions from a Health Savings Account (HSA), Xxxxxx MSA, or Medicare Advantage MSA during the year? Did you have a financial interest in or signature authority over a financial account or asset located in a foreign country? Did you receive a distribution from, or were you a grantor of, or transferor to, a foreign trust? Did you have any income from, or pay taxes to, a foreign country? Did you own property in a foreign country? Did you receive any tips not reported to your employer? Did you receive any disability income during the year? Did you cash any U.S. savings bonds during the year? Did you receive any other income not provided with this organizer? If "Yes," explain Did you start a new business or purchase any rental property during the year? Did you sell an existing business, rental property, or other property during the year? Did you purchase any business assets or convert any assets to business use? If "Yes," provide the cost of the asset, the date it was placed in service, and business use percentage. Did you purchase any gasoline, diesel, or special fuels for non-highway business use? Did you buy or sell any stocks, bonds, or other investments during the year? Did you sell a principal residence during the year? If "Yes," provide closing documentation for the purchase and sale of the home Did you foreclose or abandon a principal residence or real property during the year? Did you refinance your principal home or second home or take out a home equity loan during the year? If "Yes," provide all escrow, closing, and other pertinent documentation and information. Did you receive any principal or interest during this year from property sold in prior years? Did you rent out your home or use it for business? Did you sell, exchange, or purchase any real estate during the year? Did you acquire a new or additional interest in a partnership or S corporation? Did you have any debts canceled or forgiven this year? Does anyone owe you money that has become uncollectible? Did you purchase a new hybrid, alternative motor, or electric motor energy-efficient vehicle during the year? If "Yes," provide the year, make, model, VIN, and date the vehicle was...
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Health Care Information. Upon request, the UT-AAUP shall be provided utilization information and all non- protected, non- confidential, health (PHI) information on all plans on an annual basis.
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Health Care Information. The Employer will not require employees to provide information about the health and/or medical condition of the employee or the employee’s family unless such information is specifically and directly related to the performance of duties within the scope of employment, fitness to hold the employee’s position or the providing of benefits requested by the employee. Acquiring this information by the Employer may require employees to sign a release of medical and/or health information. Health and medical information obtained by the Employer will be maintained in a separate, confidential file and access to this information by the Employer’s personnel will be limited to those persons with a legitimate business or legal need to know. Employees will not be requested to sign a general or unlimited waiver of medical confidentiality.
Sample 1
Health Care Information. Did any member of your household NOT have healthcare coverage for the entire year? Provide copies of all Forms 1095-A, 1095-B, 1095-C for ALL members of your household.
Sample 1

Related to Health Care Information

  • More Information For more specific information about the terms and conditions of the ICA or DCA program, please see the ICA Disclosure Booklet or DCA Disclosure Booklet (as applicable) available from IAR or on xxx.xxxxxxxxxxxx.xxx.xxx/xxxxxxxxxxx.

  • - CLEC INFORMATION 3.1 Except as otherwise required by law, CenturyLink will not provide or establish Interconnection, Unbundled Network Elements, ancillary services and/or resale of Telecommunications Services in accordance with the terms and conditions of this Agreement prior to CLEC's execution of this Agreement. The Parties shall complete CenturyLink's "New Customer Questionnaire," as it applies to CLEC's obtaining of Interconnection, Unbundled Network Elements, ancillary services, and/or resale of Telecommunications Services hereunder. 3.2 Prior to placing any orders for services under this Agreement, the Parties will jointly complete the following sections of CenturyLink's "New Customer Questionnaire:" General Information Billing and Collection (Section 1) Credit Information Billing Information Summary Billing OSS and Network Outage Notification Contact Information System Administration Contact Information Ordering Information for LIS Trunks, Collocation, and Associated Products (if CLEC plans to order these services) Design Layout Request – LIS Trunking and Unbundled Loop (if CLEC plans to order these services) 3.2.1 The remainder of this questionnaire must be completed within two (2) weeks of completing the initial portion of the questionnaire. This questionnaire will be used to: Determine geographical requirements; Identify CLEC identification codes; Determine CenturyLink system requirements to support CLEC's specific activity; Collect credit information; Obtain Billing information; Create summary bills; Establish input and output requirements; Create and distribute CenturyLink and CLEC contact lists; and Identify CLEC hours and holidays. 3.2.2 CLECs that have previously completed a Questionnaire need not fill out a New Customer Questionnaire; however, CLEC will update its New Customer Questionnaire with any changes in the required information that have occurred and communicate those changes to CenturyLink. Before placing an order for a new product, CLEC will need to complete the relevant New Product Questionnaire and amend this Agreement.

  • Insurance Information The institution will provide assistance in obtaining insurance for incoming and outbound mobile participants, accord- ing to the requirements of the Erasmus Charter for Higher Education. The receiving institution will inform mobile par- ticipants of cases in which insurance cover is not automatically provided. Information and assistance can be provided by the following contact points and information sources:

  • Patient Information Each Party agrees to abide by all laws, rules, regulations, and orders of all applicable supranational, national, federal, state, provincial, and local governmental entities concerning the confidentiality or protection of patient identifiable information and/or patients’ protected health information, as defined by any other applicable legislation in the course of their performance under this Agreement.

  • Substance Abuse Treatment Information Substance abuse treatment information shall be maintained in compliance with 42 C.F.R. Part 2 if the Party or subcontractor(s) are Part 2 covered programs, or if substance abuse treatment information is received from a Part 2 covered program by the Party or subcontractor(s).

  • Contractor Information The Contractor will provide up to date information for each of the following in the form and manner specified by OGS:

  • Root-­‐zone Information Publication ICANN’s publication of root-­‐zone contact information for the TLD will include Registry Operator and its administrative and technical contacts. Any request to modify the contact information for the Registry Operator must be made in the format specified from time to time by ICANN at xxxx://xxx.xxxx.xxx/domains/root/.

  • For More Information To obtain more information concerning the rules governing this Agreement, contact the Prototype Sponsor or Custodian listed on the Adoption Agreement.

  • False Information The Borrower or any Obligor has given the Bank false or misleading information or representations.

  • Budget Information Funding Source Funding Year of Appropriation Budget List Number Amount

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