Health Plan Administration and Management Sample Clauses

Health Plan Administration and Management. The Contractor shall be responsible for the administration and management of its responsibilities under this Contract and the health plan covered thereunder, including all subcontractors, employees, agents, and anyone acting for or on behalf of the Contractor. No subcontract or delegation of responsibility shall terminate the legal responsibility of the Contractor to SCDHHS to assure that all requirements under this Contract are carried out.
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Related to Health Plan Administration and Management

  • GENERAL ADMINISTRATION AND MANAGEMENT The City Manager of the City, or designee, shall be the City’s representative, and shall oversee and approve all services to be performed, coordinate all communications, and review and approve all invoices, under this Agreement.

  • Plan Administration AvMed may from time to time adopt reasonable policies, procedures, rules and interpretations to promote the orderly and efficient administration of this Contract.

  • Implementation and Management 1.1 Properly constituted Occupational Health and Safety (OH&S) Committees or, where there is no OH&S Committee, Site Safety Supervisors/Safety Officers in conjunction with worker representatives, are the appropriate bodies to implement and administer alcohol and drug policy/programs (* see below).

  • Program Administration An activity relating to the general management, oversight and coordination of community development programs. Costs directly related to carrying out eligible activities are not included.

  • Claims Administration An employee will be required to comply with any and all rules and regulations and/or limitations established by the carrier or applicable third party administrator and contained in the policy, and employees and their dependents shall look solely to such carrier or third party administration for the adjudication of the payment of any and all benefits claims.

  • Administration Services When a medical prescription drug is administered by infusion, the administration of the prescription drug may be covered separately from the prescription drug. See Infusion Therapy - Administration Services in the Summary of Medical Benefits for benefit limits and the amount you pay. Prescription drugs that are self-administered are not covered as a medical benefit but may be covered as a pharmacy benefit. Please see Pharmacy Prescription Drugs and Diabetic Equipment or Supplies – Pharmacy Benefits section above for additional information. Site of Care Program For some medical prescription drugs, after the first administration, coverage may be limited to certain locations (for example, a designated outpatient or ambulatory service facility, physician’s office, or your home), provided the location is appropriate based on your medical status. For a list of medical prescription drugs that are subject to this Site of Care Program, visit our website. Preauthorization may be required to determine medical necessity as well as appropriate site of care. If we deny your request for preauthorization, or you disagree with our determination for the appropriate site of care, you can submit a medical appeal. See Appeals in Section 5 for information on how to file a medical appeal.

  • EMPLOYEE-MANAGEMENT ADVISORY COMMITTEE 33.01 (a) An Employee-Management Advisory Committee (EMAC) shall be established within three (3) months of the signing of the Collective Agreement. The Union Representative shall provide the names of up to three (3) elected Employees and the Employer shall provide the names of up to three (3) appointed representatives to sit on the EMAC.

  • Monitoring and Management Information C10.1 The Contractor shall comply with the monitoring arrangements set out in the Monitoring Schedule including, but not limited to, providing such data and information as the Contractor may be required to produce under the Contract.

  • Joint Union/Management Committee It shall be appropriate for either the Union or the University to request that a Joint Union/Management committee be convened, with Environmental Health and Safety as a participating member, to discuss health and safety concerns and to explore options for addressing those concerns through appropriate training or other approaches.

  • Association-Management Committee There shall be an Association-Management Committee comprised of two (2) representatives of the parties. The Committee shall meet quarterly, unless otherwise mutually agreed. Agenda items to be discussed shall be exchanged in writing at least five calendar days prior to the meeting. Meetings of this Committee will be to discuss matters of mutual concern, matters relating to nursing, professional practice, scheduling and work load issues. The Committee shall promote and provide for effective and meaningful communication. The parties agree Self Scheduling is appropriate subject matter to discuss in this forum.

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