Health Plan Capitation Rates and Reform Kick Payments Sample Clauses

Health Plan Capitation Rates and Reform Kick Payments a. The Health Plan provider numbers associated with the capitation rates indicated in Exhibit 2–NR and 2-R tables are provided in Attachment I, Scope of Service, Exhibit 1, Maximum Enrollment Levels. b. For health plans serving non-Reform populations, Attachment I, Scope of Services, Exhibit 2-NR table(s) provides the capitation rates respective to the authorized areas of operation. The capitation rate payment shall be in accordance with Attachment II, Core Contract Provisions, Section XIII, Method of Payment. These rates are titled “ESTIMATED HEALTH PLAN RATES; NOT FOR USE UNLESS APPROVED BY CMS.” c. For health plans serving Reform populations, Attachment I, Scope of Services, Exhibit 2-R tables provide the capitation rates and Reform kick payments respective to the authorized areas of operation. The capitation rate payment shall be in accordance with Attachment II, Core Contract Provisions, Section XIII, Method of Payment. These rates are titled “ESTIMATED HEALTH PLAN RATES; NOT FOR USE UNLESS APPROVED BY CMS.” WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract
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Related to Health Plan Capitation Rates and Reform Kick Payments

  • Health Care Savings Plan As provided in this Agreement, eligible ASF Members will participate in the health care savings plan (HCSP) established under Minnesota Statute 352.98, and as administered by the Plan Administrator. The Employer is responsible only for transferring funds, as specified in this agreement, to the Plan Administrator. Subd. 1. All ASF Members who receive severance pay as defined in Section A of this article must participate in the health care savings plan. Subd. 2. All severance pay as defined in Section B of this article shall be transferred to the severed employee's health care savings plan account. At the time of separation, if an ASF Member has an approved exception to participation in the health care savings plan account from the plan administrator, then the ASF Member shall receive this payment in one lump sum payment of cash.

  • Compensation/Benefit Programs During the Term of Employment, the Executive shall be entitled to participate in all medical, dental, hospitalization, accidental death and dismemberment, disability, travel and life insurance plans, and any and all other plans as are presently and hereinafter offered by the Company to its executive personnel, including savings, pension, profit-sharing and deferred compensation plans, subject to the general eligibility and participation provisions set forth in such plans.

  • Incentive, Savings and Retirement Plans During the Employment Period, the Executive shall be entitled to participate in all incentive, savings and retirement plans, practices, policies and programs applicable generally to other peer executives of the Company and its affiliated companies, but in no event shall such plans, practices, policies and programs provide the Executive with incentive opportunities (measured with respect to both regular and special incentive opportunities, to the extent, if any, that such distinction is applicable), savings opportunities and retirement benefit opportunities, in each case, less favorable, in the aggregate, than the most favorable of those provided by the Company and its affiliated companies for the Executive under such plans, practices, policies and programs as in effect at any time during the 120-day period immediately preceding the Effective Date or if more favorable to the Executive, those provided generally at any time after the Effective Date to other peer executives of the Company and its affiliated companies.

  • Intercarrier Compensation 5.5.1 Intercarrier compensation for seven (7) or ten (10) digit dialed calls originated by ITC^DeltaCom utilizing Local Switching shall apply as follows: 5.5.2 For calls terminating to a BellSouth End User or to an End User served by BellSouth resold services, BellSouth shall charge ITC^DeltaCom for End Office Switching as set forth in Exhibit A at the terminating end office. 5.5.3 For calls terminating to a CLEC where such CLEC is utilizing a BellSouth switch port or port/loop combination to provide service to its End User, BellSouth shall charge ITC^DeltaCom for End Office Switching as set forth in Exhibit A at the terminating end office. BellSouth will not charge the terminating CLEC for End Office Switching as set forth in Exhibit A at the terminating end office. 5.5.3.1 For calls terminating to third party carriers, such as CLECs, wireless carriers and independent companies, utilizing their own switches to serve their End Users, ITC^DeltaCom is required to enter into interconnection or traffic exchange agreements with such third parties for the exchange of traffic through BellSouth’s network. If ITC^DeltaCom does not have such an agreement with a third party carrier and BellSouth is charged termination charges by a third party terminating a call originated by ITC^DeltaCom, or if such third party carrier bills BellSouth for terminating such calls, despite the existence of such an agreement, then BellSouth may, at its option: 5.5.3.1.1 pay such charges as billed by the third party carrier and charge End Office Switching as set forth in Exhibit A to ITC^DeltaCom for each such call; or 5.5.3.1.2 pay such charges as billed by the third party carrier and ITC^DeltaCom will reimburse the full amount of such charges within thirty (30) days of BellSouth’s request for reimbursement. 5.5.3.2 Intercarrier compensation for seven (7) or ten (10) digit dialed calls terminating to ITC^DeltaCom utilizing Local Switching shall apply as follows: 5.5.3.2.1 For calls originated by a BellSouth End User or by an End User served by resold BellSouth services, BellSouth shall not charge ITC^DeltaCom for End Office Switching at the terminating end office for use of the network component; therefore, ITC^DeltaCom shall not charge BellSouth intercarrier compensation or any other charges for termination of such calls. 5.5.3.2.2 For calls originated by a CLEC where such CLEC is utilizing a BellSouth switch port or port/loop combination to provide service to its End User, BellSouth shall not charge ITC^DeltaCom for End Office Switching at the terminating end office for use of the network component; therefore, ITC^DeltaCom shall not charge the originating CLEC or BellSouth intercarrier compensation or any other charges for termination of such calls. 5.5.3.2.3 For calls originated by third party carriers, such as CLECs, wireless carriers and independent companies,utilizing their own switches to serve their End Users, ITC^DeltaCom is required to enter into interconnection or traffic exchange agreements with such third parties for the exchange of traffic through BellSouth’s network. ITC^DeltaCom may xxxx the third parties according to such agreements and shall not xxxx BellSouth for the exchange of traffic through BellSouth’s network. 5.5.3.3 Intercarrier compensation shall apply as follows for intralata 1+ dialed calls originated by ITC^DeltaCom utilizing Local Switching where ITC^DeltaCom uses BellSouth’s CIC for its End User’s LPIC: 5.5.3.3.1 For calls terminating to a BellSouth End User or to an End User served by BellSouth resold services, BellSouth shall charge ITC^DeltaCom for End Office Switching as set forth in Exhibit A at the terminating end office. 5.5.3.3.2 For calls terminating to a CLEC where such CLEC is utilizing a BellSouth switch port or port/loop combination to provide service to its End User, BellSouth shall charge ITC^DeltaCom for End Office Switching as set forth in Exhibit A at the terminating end office. BellSouth will not charge the terminating CLEC for End Office Switching at the terminating end office. In the event that BellSouth is charged termination charges by the CLEC, BellSouth may pay such charges and ITC^DeltaCom will reimburse BellSouth the full amount of such charges within thirty (30) days following BellSouth’s request for reimbursement. 5.5.3.3.3 For calls terminating to third party carriers, such as CLECs, wireless carriers and independent companies, utilizing their own switches to serve their End Users, ITC^DeltaCom is required to enter into interconnection or traffic exchange agreements with such third parties for the exchange of traffic through BellSouth’s network. If ITC^DeltaCom does not have such an agreement with a third party carrier and BellSouth is charged termination charges by a third party terminating a call originated by ITC^DeltaCom, or if such third party carrier bills BellSouth for terminating such calls, despite the existence of such an agreement, then BellSouth may, at its option: 5.5.3.3.3.1 pay such charges as billed by the third party carrier and charge End Office Switching as set forth in Exhibit A to ITC^DeltaCom for each such call; or 5.5.3.3.3.2 pay such charges as billed by the third party carrier and ITC^DeltaCom will reimburse BellSouth the full amount of such charges within thirty (30) days following BellSouth’s request for reimbursement. 5.5.3.4 Intercarrier compensation shall apply as follows for intralata 1+ dialed calls terminating to ITC^DeltaCom utilizing Local Switching where the originating carrier uses BellSouth’s CIC for its End User’s LPIC: 5.5.3.4.1 For calls originated by a BellSouth End User or by an End User served by BellSouth resold service, BellSouth shall charge ITC^DeltaCom for End Office Switching as set forth in Exhibit A at the terminating end office for use of the End Office Switching network component in terminating such calls. ITC^DeltaCom may charge BellSouth for intercarrier compensation at the End Office Switching as set forth in Exhibit A for such calls. ITC^DeltaCom shall not charge originating or terminating switched access rates to BellSouth for termination of such calls. 5.5.3.5 For calls originated by or terminating to interexchange carriers through a switched access arrangement, ITC^DeltaCom may xxxx the interexchange carrier in accordance with ITC^DeltaCom’s tariff and will not xxxx BellSouth any charges for such call. ITC^DeltaCom shall pay BellSouth applicable charges for the use of BellSouth’s network in accordance with the rates set forth in Exhibit A for originating and terminating such calls.

  • Financial Services Compensation Scheme We are a participant in the Financial Services Compensation Scheme (the “FSCS”). As a retail client you may be eligible to claim compensation from the FSCS in certain circumstances if we, any approved bank, our nominee company or eligible custodian are in default. Most types of investment business are covered in full for the first £85,000 of any eligible claim. Not every investor is eligible to claim under this scheme: for further information please contact us, or the FSCS directly at xxx.xxxx.xxx.xx.

  • Special Parental Allowance for Totally Disabled Employees (a) An employee who: (i) fails to satisfy the eligibility requirement specified in subparagraph 17.05(a)(ii) solely because a concurrent entitlement to benefits under the Disability Insurance (DI) Plan, the Long-term Disability (LTD) Insurance portion of the Public Service Management Insurance Plan (PSMIP) or via the Government Employees Compensation Act prevents the employee from receiving Employment Insurance or Québec Parental Insurance Plan benefits, and (ii) has satisfied all of the other eligibility criteria specified in paragraph 17.05(a), other than those specified in sections (A) and (B) of subparagraph 17.05(a)(iii), shall be paid, in respect of each week of benefits under the parental allowance not received for the reason described in subparagraph (i), the difference between ninety-three per cent (93%) of the employee's rate of pay and the gross amount of his or her weekly disability benefit under the DI Plan, the LTD Plan or via the Government Employees Compensation Act. (b) An employee shall be paid an allowance under this clause and under clause 17.05 for a combined period of no more than the number of weeks during which the employee would have been eligible for parental, paternity or adoption benefits under the Employment Insurance or Québec Parental Insurance Plan, had the employee not been disqualified from Employment Insurance or Québec Parental Insurance Plan benefits for the reasons described in subparagraph (a)(i).

  • Extra Compensation The Board shall pay no fees, other than described above, to the PA/E unless authorized by the Board as follows: A. If the scope of the Project or site is changed, the Board and the PA/E shall negotiate a reasonable fee based upon the probable estimated construction cost in changing the scope of the work and the approximate percentage of the estimated construction cost which was used to negotiate this Agreement if, and, as such may be applicable. B. If the DOE or Board requires the PA/E to make major or costly changes to the Schematic, Preliminary or Construction Document Phase submittals, which changes are not caused by architectural or engineering error or oversight, the PA/E shall be paid to redesign for additional expenses in an amount agreed to by the parties. Under no circumstances will the principals of the PA/E and the principals of his consultants be paid a fee in excess of $125.00 per hour.

  • PROFESSIONAL COMPENSATION 11.1 The basic salaries of teachers covered by this Contract shall be set in accordance with the procedures set forth in this Agreement. 11.2 The salary of the teacher will be presumed correct as shown in the Uniform Teacher’s Contract unless the teacher or the Employer furnishes evidence of error. 11.3 An explanation as to how contract salary figures are computed will accompany the first paycheck of each school year. 11.4 Basic salaries for teachers shall be paid in twenty-six (26) payments. Basic salaries for teachers shall be paid in twenty-six (26) payments in a given calendar year. Exceptions may be made with the approval of the Cash Flow Committee. A teacher may receive the balance due on his contract with the first scheduled paycheck in July by written notice to the Business Office by May 1. If May 1 occurs on a day that school is not in session, the deadline shall be the next regular school day. A teacher who makes this election shall continue each year to receive the balance due on his contract with the first scheduled paycheck in July unless he notifies the Business Office by May 1 that he prefers to be paid in twenty-six (26) payments. Teachers will be notified by the Cash Flow Committee of the Xxxxxxx Teachers’ Federation prior to June 1 in the event the balance on teachers’ contracts due on the first scheduled paycheck in July cannot be paid. 11.5 New teachers will receive one half (½) of their first pay one payroll in advance and the remaining one half (½) on the next pay date. 11.6 Effective January 1, 2009, teacher pay will be issued via direct deposit only. 11.7 The Superintendent may approve additional compensation for individual teachers who have been authorized by the Superintendent to perform additional work assignments. 11.8 Payroll deductions for teachers shall be made as required by law or as mutually agreed to by the parties. Teachers may authorize deductions for tax-sheltered annuities during open enrollment periods of the carrier companies involved. 11.9 Deductions for daily absences not covered by provisions in the Contract shall be made at the same rate as earned. 11.10 Effective January 1, 1993, the Board shall pay directly to the Indiana State Teachers Retirement Fund each teacher’s three percent (3%) contribution to the fund. 11.11 The parties recognize that the salaries which appear on Regular Teacher’s Contracts and Teacher’s Temporary Contracts will be inaccurate whenever a salary increase is approved after these contracts have been executed. At the time of a teacher’s retirement, the Employer will review these contracts and, when necessary, revise the contracts for the five (5) years of service before retirement in which the teacher’s annual compensation was highest so they accurately reflect the sums which the teacher earned in each of those five (5) years. 11.12 The parties recognize that students are entitled to be taught by fully qualified teachers, while at the same time recognizing a professional responsibility to assist in the preparation of student teachers. Therefore, supervision by a teacher of a student teacher shall be voluntary. No teacher should serve as a supervising teacher more than one-half (1/2) of the total teaching time each year. This provision was not bargained and has been included for informational purposes only. Should 11.13 If the Employer determines that any committee should continue its work during the summer, teachers belonging to the committee performing such services shall be paid on the same basis and in the same manner as summer school teachers. If the Employer determines that professional development should occur in the summer, specific teachers invited to participate shall be paid on the same basis as summer school teachers.

  • SALARY DETERMINATION FOR EMPLOYEES IN ADULT EDUCATION [Not applicable in School District No. 62 (Sooke)]

  • Variable Compensation In addition to any interim award that the Company owes to the Executive under the Variable Compensation Plan (or any similar provisions in a successor to the Variable Compensation Plan), the Executive shall be paid a lump sum cash amount equal to 2.0 times the target annual award under the Variable Compensation Plan for the Executive’s job for the calendar year during which the Change in Control occurs. In order to be entitled to a payment pursuant to this Section 4(b), the Executive must have been a participant in the Company’s Variable Compensation Plan at some time during the calendar year in which the Change in Control occurred or the calendar year immediately preceding the calendar year in which the Change in Control occurred.

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