HMO's Sample Clauses

HMO's. In accordance with the provisions of Federal law and the regulations thereunder, if applicable, the Employer shall make available the option of membership in qualified health maintenance organizations to employees and their eligible dependents who reside in the service area of qualified HMO's. By May 1, the Employer will provide information on HMO's to the Union in sufficient quantities to mail to its members.
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HMO's. The County will offer health coverage through one or two Health Maintenance Organizations (HMOs), or comparable experience rated plans. The co-pay for HMOs or comparable experience rated plans, currently offered by the County will be $10.00, however, the County may offer additional optional HMOs, or comparable experience rated plans, with a higher co-pay.
Sample 1
HMO's. The HMOs in existence on September 19, 1998 for Shuttle, Inc. Flight Attendants shall continue to be offered to those Flight Attendants. As to those HMOs not currently extended to mainline flight attendants, Shuttle flight attendants currently in those HMOs shall be allowed to continue in those HMOs for up to one year after the US Airway’s Medical/Dental plan becomes applicable to Shuttle flight attendants. HMOs will have to be financially viable and meet the administrative standards that US Airways uses in selecting HMOs. Once the US Airways Medical/Dental plan becomes available to Shuttle flight attendants, a special open enrollment period will be offered to Shuttle flight attendants. Thereafter, open enrollment periods will be offered annually.
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HMO's. The Town agrees to offer, as mandated by law, an option, to all full-time employees, the benefits of the Certified Health Maintenance Organizations. The Town agrees to share the cost of this option between the Town and full-time employees. The maximum premium that the Town will pay under this plan shall be equal to the highest cost plan now offered under the New York State Plan.
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HMO's. Medical Director or Designee conducts ongoing reviews of those services and supplies which are recommended or provided by Health Professionals to determine whether such services and supplies are Covered Benefits under this Certificate. If HMO’s Medical Director or Designee determines that the recommended services and supplies are not Covered Benefits, the Member will be notified. If a Member wishes to appeal such determination, the Member may then contact HMO to seek a review of the determination. Please refer to the Utilization Review Determination Appeal section of this Certificate.
Sample 1
HMO's. Employees in the HMO’s electing dependent coverage shall pay the amount they would pay for employee-only health and dental coverage plus a percentage of the difference between the monthly premiums for dependent health and dental coverage and the monthly premiums for employee-only health and dental coverage as follows: 2011-12 40% 2012-13 50% 2013-14 60%
Sample 1

Related to HMO's

  • Population The Population shall be defined as all Paid Claims during the 12-month period covered by the Claims Review.

  • Health Plan An appropriately licensed entity that has entered into a contract with Subcontractor, either directly or indirectly, under which Subcontractor provides certain administrative services for Health Plan pursuant to the State Contract. For purposes of this Appendix, Health Plan refers to UnitedHealthcare Insurance Company.

  • Medicaid If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements and is not entitled to any other third party coverage, the Resident may be eligible for Medicaid (often referred to as the “payor of last resort”). THE RESIDENT, RESIDENT REPRESENTATIVE AND SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS (APPROXIMATELY $50,000) AND/OR INSURANCE COVERAGE TO CONFIRM THAT A MEDICAID APPLICATION HAS OR WILL BE SUBMITTED TIMELY AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, RESIDENT REPRESENTATIVE AND/OR SPONSOR AGREE TO PREPARE AND FILE AN APPLICATION FOR MEDICAID BENEFITS PRIOR TO THE

  • Medi Cal/daily service logs and notes and other documents used to record provision of services provided by instructional assistants, behavior intervention aides, bus aides, and supervisors

  • HEALTH PROGRAM 3701 Health examinations required by the Employer shall be provided by the Employer and shall be at the expense of the Employer. 3702 Time off without loss of regular pay shall be allowed at a time determined by the Employer for such medical examinations and laboratory tests, provided that these are performed on the Employer’s premises, or at a facility designated by the Employer. 3703 With the approval of the Employer, a nurse may choose to be examined by a physician of her/his own choice, at her/his own expense, as long as the Employer receives a statement as to the fitness of the nurse from the physician. 3704 Time off for medical and dental examinations and/or treatments may be granted and such time off, including necessary travel time, shall be chargeable against accumulated income protection benefits.

  • Supplier Diversity Seller shall comply with Xxxxx’s Supplier Diversity Program in accordance with Appendix V.

  • Hospital This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.

  • Diversity The Employer and the Union recognize the values of diversity in the workplace and will work cooperatively toward achieving a work environment that reflects the interests of a diverse work force.

  • Pharmacy Pharmacy hereby represents that neither Pharmacy, nor, to the best of Pharmacy’s knowledge, Pharmacist, Pharmacy’s employees, agents or independent

  • Rosters 8.1 As far as practically possible, the Employer will draw up a roster 1 week in advance. Changes to rosters may occur with 24 hours notice or, subject to the availability of the Employee, with less notice if by mutual consent. 8.2 The Employer will ordinarily roster Employees in a manner that is both fair and equitable to ensure that, where applicable, the allocation of weekend and public holiday hours are equally divided between Employees on a rotating basis.

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