When You Are Covered by More Than One Insurer A healthcare coverage plan is considered the primary plan and its benefits will be paid first if: • the plan does not use similar COB rules to determine coverage; or • the plan does not have a COB provision; or • The plan has similar the COB rules and is determined to be primary under the order of benefit determination rules described below. Benefits under another plan include all benefits that would be paid if claims had been initially submitted under that plan. The following factors are used to determine which plan is primary and which plan is secondary: • if you are the main subscriber or a dependent; • if you are married, which spouse was born earlier in the year; • the length of time each spouse has been covered under the plan; • if a parental custody or divorce decree applies; or • if Medicare is your other coverage then Medicare guidelines will apply. These factors make up the order of benefit determination rules, described in greater detail below:
Knowledge and Scholarship in Special Field Each certificated support person demonstrates a depth and breadth of knowledge of theory and content in the special field. He demonstrates an understanding of a knowledge about common school education and the educational milieu grades K12, and demonstrates the ability to integrate the area of specialty into the total school milieu, to wit:
MEDICAL DISPUTE In the event of a dispute involving an employee's health as it affects the employee's ability to perform his/her job on return to work at the University from a layoff or leave of absence of any kind, and if the employee is not satisfied with the determination of the University's physician, the employee may submit a report from a medical doctor of his/her own choosing at his/her own expense. If the dispute still exists, at the request of the employee, the University's physician and the employee's doctor shall agree upon a third medical doctor to submit a report to the University and the employee, and the decision of such third party regarding the employee's health as it affects the employee's ability to perform his/her job will be binding on both parties. The expense of the examination by the third party shall be shared equally by the University and the employee.
Misrepresentation, Concealment or Fraud This entire policy is void if, whether before or after a loss:
Concealment Or Fraud We provide coverage to no "insureds" under this policy if, whether before or after a loss, an "in- sured" has:
Falsification Manipulating research materials, equipment, or processes, or changing or omitting data or results such that the research is not accurately represented in the research record.
Illness in the Immediate Family An employee may use up to one-half of his or her annual sick leave allocation in any calendar year in the event of illness or a spouse, child, parent, or domestic partner. At the City's request the employee will provide satisfactory evidence of the facts justifying such absence.
Services Provided by Attorneys Any services to be provided by a law firm or attorney must be reviewed and approved in writing in advance by the City Attorney. No invoices for services provided by law firms or attorneys, including, without limitation, as subcontractors of Contractor, will be paid unless the provider received advance written approval from the City Attorney.
Third Party Information I understand, in addition, that the Company has received and in the future will receive from third parties confidential or proprietary information (“Third Party Information”) subject to a duty on the Company’s part to maintain the confidentiality of such information and to use it only for certain limited purposes. During the term of my employment and thereafter, I will hold Third Party Information in the strictest confidence and will not disclose to anyone (other than Company personnel who need to know such information in connection with their work for the Company) or use, except in connection with my work for the Company, Third Party Information unless expressly authorized by an officer of the Company in writing.
Illness in the Family Where no one at home other than the employee can provide for the needs during illness of an immediate member of her family, an employee shall be entitled after notifying her supervisor, to use a maximum of five (5) accumulated sick leave days per illness to care for the member of the family who is ill.
