Member Payment Liability Protection Sample Clauses

Member Payment Liability Protection. Pursuant to s. 1932 (b)(6), Social Security Act (as enacted by section 4704 of the Balanced Budget Act of 1997), the Health Plan shall not hold members liable for the following: 1. For debts of the Health Plan, in the event of the Health Plan’s insolvency; 2. For payment of covered services provided by the Health Plan if the Health Plan has not received payment from the Agency for the covered services, or if the provider, under contract or other arrangement with the Health Plan, fails to receive payment from the Agency or the Health Plan; and/or 3. For payments to a provider, including referral providers, that furnished covered services under a contract, or other arrangements with the Health Plan, that are in excess of the amount that normally would be paid by the enrollee if the covered services had been received directly from the Health Plan.
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Member Payment Liability Protection. Pursuant to s. 1932 (b)(6), Social Security Act (as enacted by section 4704 of the Balanced Budget Act of 1997), the Health Plan shall not hold members liable for the following:
Sample 1Sample 2Sample 3See All (4)
Member Payment Liability Protection. The PDHP shall not hold members liable for the following in accordance with Section 1932 (b)(6), Social Security Act (enacted by Section 4704 of the Balanced Budget Act of 1997): a. For debts of the PDHP, in the event of the PDHP’s insolvency. b. For payment of covered services provided by the PDHP if the PDHP has not received payment from the Agency for the services, or if the health care provider, under contract or other arrangement with the PDHP, fails to receive payment from the Agency or the PDHP. c. For payments to the health care provider, including referral providers, that furnished covered services under a contract, or other arrangement with the PDHP, that are in excess of the amount that normally would be paid by the member if the service had been received directly from the PDHP.
Sample 1
Member Payment Liability Protection. 1. Pursuant to Section 1932 (b)(6), Social Security Act (as enacted by Section 4704 of the Balanced Budget Act of 1997), the STP shall not hold Medicaid Beneficiaries liable for the following: a. For debts of the STP, in the event of the STPs Insolvency; b. For payment of Covered Services provided by the STP if the STP has not received payment from the Commission for the Covered Services, and/or, c. For payments to a STP that furnished Covered Services under a contract, or other arrangement with the STP, that are in excess of the amount that normally would be paid by the Medicaid Beneficiary if the Covered Services had been received directly from the STP.
Sample 1
Member Payment Liability Protection. Pursuant to s. 1932 (b)(6), Social Security Act (as enacted by section 4704 of the Balanced Budget Act of 1997), the Health Plan shall not hold members liable for the following: 1. For debts of the Health Plan, in the event of the Health Plan’s insolvency; 2. For payment of covered services provided by the Health Plan if the Health Plan has not received payment from the Agency for the covered services, or if the provider, under contract or other arrangement with the Health Plan, fails to receive payment from the Agency or the Health Plan; and/or 3. For payments to a provider, including referral providers, that furnished covered services under a contract, or other arrangements with the Health Plan, that are in excess of the amount that normally would be paid by the enrollee if the covered services had been received directly from the Health Plan. Unless otherwise stated, this amendment shall be effective upon execution by both Parties. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in this Contract. This amendment, and all its attachments, are hereby made part of this Contract. This amendment cannot be executed unless all previous amendments to this Contract have been fully executed.
Sample 1
Member Payment Liability Protection. The contractor shall not hold members liable for the following in accordance with Section 1932 (b)(6), Social Security Act (enacted by Section 4704 of the Balanced Budget Act of 1997): A. For debts of the contractor, in the event of the contractor’s insolvency. B. For payment of covered services provided by the contractor if the contractor has not received payment from the Agency for the services, or if the health care provider, under contract or other arrangement with the contractor, fails to receive payment from the Agency or the contractor. C. For payments to the health care providers that furnished covered services under a contract, or other arrangement with the contractor, that are in excess of the amount that normally would be paid by the member if the service had been received directly from the contractor.
Sample 1
Member Payment Liability Protection. The contractor shall not hold members liable for the following in accordance with Section 1932 (b)(6), Social Security Act (enacted by Section 4704 of the Balanced Budget Act of 1997):
Sample 1
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Related to Member Payment Liability Protection

  • Overdraft Liability The following actions may be taken by us if we receive a draft or other item drawn against your account and there are insufficient funds based on the available balance in your account to cover the draft or item: • Cover the draft or item in accordance with the terms of any written overdraft plan that you have established with us. • Pay the draft or item and create an overdraft to your account. Any negative balance on your account is immediately due and payable, unless we agree otherwise in writing. We may place a hold on balances in any other account you have with us until the overdraft is paid or we may set-off the amount of the overdraft against any of your other accounts in accordance with the terms of this agreement, unless prohibited by applicable law. • Return the draft or item unpaid. We may, at our option and without notice to you, refuse to pay any draft or item if it would create an overdraft, even though we may have previously established a pattern of honoring such drafts or items. We have no obligation to notify you before we decide to either pay a draft or item that creates an overdraft or to dishonor a draft or item that is drawn against insufficient available funds. Drafts or other transfers or payment orders that are drawn against insufficient funds may be subject to a service charge set forth in the Fee Schedule. National Automated Clearing House Association (NACHA) Rules allow Originating Depository Financial Institutions to reinitiate/resubmit an ACH debit returned due to NSF or uncollected funds up to two times. If the same draft or other transfer or payment order is submitted a second time, and there are insufficient funds in the account, it may be returned unpaid a second time with a fee assessed on the same item a second time. If we pay a draft or item against insufficient available funds or an overdraft is otherwise created on the account, you agree to pay any overdraft immediately. You agree to reimburse us for the cost and expenses we incur in recovering the overdraft from you, including our reasonable attorney’s fees and court costs.

  • Liability Protection Whenever an action or proceeding for damages is filed against any Bargaining Unit employee arising from his/her act or omission while performing his/her official duties, such employee(s) may request that the Attorney General defend the action or proceeding at the expense of the state. If the Attorney General determines that the employee was acting in good faith and within the course of his or her official duties, the Attorney General will defend the employee. If the body presiding over the action determines that the employee was acting within the scope of his or her official duties and enters a judgment against the employee, the judgment will be satisfied by the state.

  • Joint Liability 26.1. Notwithstanding anything contained herein or in any agreement between the Issuer and the RTA, the Issuer and the RTA shall be jointly and severally responsible and liable to CDSL, its participants and beneficial owners for compliance with all obligations under this Agreement as also under the Bye Laws and Operating Instructions.

  • Tenant Liability In the event of any sublease or assignment, whether or not with Landlord’s consent, Tenant shall not be released or discharged from any liability, whether past, present or future, under this Lease, including any liability arising from the exercise of any renewal or expansion option, to the extent such exercise is expressly permitted by Landlord. Tenant’s liability shall remain primary, and in the event of default by any subtenant, assignee or successor of Tenant in performance or observance of any of the covenants or conditions of this Lease, Landlord may proceed directly against Tenant without the necessity of exhausting remedies against said subtenant, assignee or successor. After any assignment, Landlord may consent to subsequent assignments or subletting of this Lease, or amendments or modifications of this Lease with assignees of Tenant, without notifying Tenant, or any successor of Tenant, and without obtaining its or their consent thereto, and such action shall not relieve Tenant or any successor of Tenant of liability under this Lease. If Landlord grants consent to such sublease or assignment, Tenant shall pay all reasonable attorneys’ fees and expenses incurred by Landlord with respect to such assignment or sublease. In addition, if Tenant has any options to extend the term of this Lease or to add other space to the Premises, such options shall not be available to any subtenant or assignee, directly or indirectly without Landlord’s express written consent, which may be withheld in Landlord’s sole discretion.

  • Credit Union Liability If we do not properly complete a transaction according to this Agreement, we will be liable for your losses or damages not to exceed the amount of the transaction, except as otherwise provided by law. We will not be liable if: (1) your account contains insufficient funds for the transaction; (2) circumstances beyond our control prevent the transaction; (3) your loss is caused by your or another financial institution's negligence; or (4) your account funds are subject to legal process or other claim. We will not be liable for consequential damages, except liability for wrongful dishonor. We exercise ordinary care if our actions or nonactions are consistent with applicable state law, Federal Reserve regulations and operating letters, clearinghouse rules, and general financial institution practices followed in the area we serve. You grant us the right, in making payments of deposited funds, to rely exclusively on the form of the account and the terms of this Agreement. Any conflict regarding what you and our employees say or write will be resolved by reference to this Agreement.

  • CONTRIBUTION IN THE EVENT OF JOINT LIABILITY (a) To the fullest extent permissible under applicable law, if the indemnification, hold harmless and/or exoneration rights provided for in this Agreement are unavailable to Indemnitee in whole or in part for any reason whatsoever, the Company, in lieu of indemnifying, holding harmless or exonerating Indemnitee, shall pay, in the first instance, the entire amount incurred by Indemnitee, whether for judgments, liabilities, fines, penalties, amounts paid or to be paid in settlement and/or for Expenses, in connection with any Proceeding without requiring Indemnitee to contribute to such payment, and the Company hereby waives and relinquishes any right of contribution it may have at any time against Indemnitee. (b) The Company shall not enter into any settlement of any Proceeding in which the Company is jointly liable with Indemnitee (or would be if joined in such Proceeding) unless such settlement provides for a full and final release of all claims asserted against Indemnitee. (c) The Company hereby agrees to fully indemnify, hold harmless and exonerate Indemnitee from any claims for contribution which may be brought by officers, directors or employees of the Company other than Indemnitee who may be jointly liable with Indemnitee.

  • FINANCIAL INSTITUTION’S LIABILITY Liability for failure to make transfers. If we do not complete a transfer to or from your account on time or in the correct amount according to our agreement with you, we will be liable for your losses or damages. However, there are some exceptions. We will not be liable, for instance:

  • Contingent Liability Where we effect or arrange a Transaction, you should note that, depending upon the nature of the Transaction, you may be liable to make further payments when the Transaction fails to be completed or upon the earlier settlement or closing out of your position. You may be required to make further variable payments by way of margin against the purchase price of the investment, instead of paying (or receiving) the whole purchase (or sale) price immediately. The movement in the market price of your investment will affect the amount of margin payment you will be required to make. You need to monitor your margin levels on a daily basis. You agree to pay us on demand such sums by way of margin as are required from time to time as we may in our discretion reasonably require for the purpose of protecting ourselves against loss or risk of loss on present, future or contemplated Transactions under this Agreement. Please note that in the event that you fail to meet a margin call, we may immediately close out the position. Margin must be paid in cash in currency acceptable by us, as requested from time to time by the Company. Cash Margin paid to us is held as client money in accordance with the requirements of the Client Money Rules. Margin deposits shall be made by wire transfer, credit card, e-wallet or by such other means as The Company may direct. If there is an Event of Default or this Agreement terminates, we shall set-off the balance of cash margin owed by us to you against your obligations (as reasonably valued by us). The net amount, if any, payable between us following such set-off, shall take into account the Liquidation Amount payable under Clause 15 (Netting). You agree to execute such further documents and to take such further steps as we may reasonably require perfecting our security interest over and obtain legal title to the Secured Obligations. You undertake neither to create nor to have outstanding any security interest whatsoever over, nor to agree to assign or transfer, any of the cash margin transferred to us, except a lien routinely imposed on all securities in a clearing system in which such securities may be held. In addition, and without prejudice to any rights to which we may be entitled under this Agreement or any Applicable Regulations, we shall have a general lien on all cash held by us or our Associates or our nominees on your behalf until the satisfaction of the Secured Obligations.

  • Administrative Civil Liability The Settling Respondent hereby agrees to the imposition of an administrative civil liability of $368,940 to resolve the alleged violation set forth in section II as follows: a. No later than 30 days after the Regional Water Board or its delegate signs this Stipulated Order, the Settling Respondent shall mail a check for State Water Resources Control Board Accounting Office Attn: ACL Payment P.O. Box 1888 Sacramento, CA 95812-1888 The Settling Respondent shall email a copy of the check to the State Water Board, Office of Enforcement (xxx.xxxxxx@xxxxxxxxxxx.xx.xxx), and to the Regional Water Board (xxxxx.xxxxx@xxxxxxxxxxx.xx.xxx). b. The Parties agree that the remaining $184,470 of the administrative liability shall be paid to the Regional Monitoring Program, care of the San Francisco Estuary Institute (SFEI), for implementation of a supplemental environmental project (SEP) named “High-Speed Mapping of Water Quality Parameters on the Eastern Shoal of South San Francisco Bay” as follows: i. $184,470 (SEP Amount) shall be paid in the manner described in section III, paragraph 1.b.ii, solely for use toward the SEP. Funding this project will result in high-speed mapping of water quality parameters covering the eastern shoals of South San Francisco Bay monthly over the course of four months. A complete description of the SEP is provided in Attachment B, incorporated herein by reference. ii. No later than 30 days after the Regional Water Board or its delegate signs this Stipulated Order, the Settling Respondent shall mail a check for $184,470, made payable to “Regional Monitoring Program,” referencing the Order number on page one of this Stipulated Order, to: Regional Monitoring Program c/o San Francisco Estuary Institute 0000 Xxxxxxx Xxxxxx Richmond, CA 94804 The Settling Respondent shall email a copy of the check to the State Water Board, Office of Enforcement (xxx.xxxxxx@xxxxxxxxxxx.xx.xxx), and to the Regional Water Board (xxxxx.xxxxx@xxxxxxxxxxx.xx.xxx).

  • Railroad Protective Liability (Additional requirement applicable when working on railroad property.) Named Insured: Applicable Railroad Limits - Bodily Injury & Property Damage: Per Railroad Requirements

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