MULTIPLE PROGRAMS Sample Clauses

MULTIPLE PROGRAMS. Applicant shall not enroll an otherwise eligible Customer for participation in other Con Edison Demand Response programs if such Customer is enrolled as a participant in the DLM Program unless (i) Applicant is the customer (including a Customer) in each instance and is enrolled by Applicant as the customer on its own behalf in each instance, or (ii) Applicant is an Aggregator in each instance (Applicant-Aggregator) and Applicant-Aggregator enrolls the same customer in each instance. Unless the foregoing exception criteria are met, Customers with previously existing Demand Response contracts with Con Edison cannot participate in the DLM Program, and so shall not be eligible to receive incentives under previously existing Demand Response contracts and the DLM Program. Except for the prohibition against Applicant also receiving incentives under other Con Edison Demand Response programs, Applicant may receive incentives under other programs operated by Con Edison or other agencies. Consistent with the foregoing, with the Company’s prior consent, Applicant may be permitted to apply any portion of Load Relief with respect to a Customer beyond the Portfolio Quantity of Load Relief associated with individual Aggregations hereunder to arrangements related to other Company programs, but only so long as such load relief (or Load Relief) first counts to satisfy the Load Relief contracted for pursuant to the DLM Program hereunder. Consistent with the immediate foregoing, Applicant shall inform any Customer to be enrolled for participation in the DLM Program that such Customer will then forego any of two compensation streams that may be received by Customer as part of a Con Edison “Rider R Tariff” program for the duration of the term hereof, particularly “Demand Reduction Value” (DRV) and “Locational System Relief Value” (LSRV) compensation streams. In addition, a Customer may not enroll in the DLM Program while enrolled as part of a Con Edison “Rider L Tariff” program, and Applicant shall notify Con Edison that a Customer previously participating in a Rider L program is no longer doing so and may therefore be eligible to enroll in the DLM Program if the Enrollment Deadline has not passed.
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MULTIPLE PROGRAMS. If a Program project also qualifies for incentives under the Energy Efficiency Portfolio Standard (“EEPS”), Demand Management Program (“DMP”), a New York Independent System Operator (“NYISO”) program or other programs operated by Con Edison or other agencies, the Program will allow Customer/Applicant to receive funds from all sources provided that the Customer/Applicant meets the Program’s performance criteria and does not, if applicable, receive greater funds than the Customer/Applicant actually expended for the project. Customer and Applicant are responsible for adherence to the foregoing. QUALIFYING PROJECTS: Projects eligible for Program incentives include distributed generation, demand response resources, the installation of electric energy efficiency, and demand management measures identified as eligible and approved by the Company. To qualify, projects must achieve demand reductions (measured in kW) in order to reduce the identified networks’ demand at critical times in relation to the networks’ coincident peak demand.
Sample 1
MULTIPLE PROGRAMS. Producer acknowledges that in cases where multiple or group programs are offered by the same insurer in the same state for the same line of business, producer will offer the lowest priced policy available for a client or prospective client or will refer the client to the insurer’s web-site or toll free access line where the client can obtain the lowest priced policy available.
Sample 1

Related to MULTIPLE PROGRAMS

  • In-Service Programs The parties to this collective agreement recognize the value of in-service education both to the employee and the Employer. A) The Employer reserves the right to identify specific in-service programs deemed compulsory. B) Employees required to attend such programs will be paid at the applicable rate of pay.

  • Value-Based Programs If you receive covered healthcare services under a Value-Based Program inside a Host Blue’s service area, you will not be responsible for paying any of the Provider Incentives, risk-sharing, and/or Care Coordinator Fees that are a part of such an arrangement, except when a Host Blue passes these fees to us through average pricing or fee schedule adjustments. The following defined terms only apply to the BlueCard section only: • Care Coordinator Fee is a fixed amount paid by us to providers periodically for Care Coordination under a Value-Based Program. • Care Coordination is organized, information-driven patient care activities intended to facilitate the appropriate responses to an enrolled member’s healthcare needs across the continuum of care. • Value-Based Program (VBP) is an outcomes-based payment arrangement and/or a coordinated care model facilitated with one or more local providers that is evaluated against cost and quality metrics/factors and is reflected in provider payment. • Provider Incentive is an additional amount of compensation paid to a healthcare provider by us, based on the provider’s compliance with agreed-upon procedural and/or outcome measures for a particular group of covered persons. Federal or state laws or regulations may require a surcharge, tax or other fee that applies to insured accounts. If applicable, we will include any such surcharge, tax or other fee as part of the claim charge passed on to you. • Enrolled Member Liability Calculation When covered healthcare services are provided outside of BCBSRI service area by nonparticipating providers, the amount an enrolled member pays for such services will generally be based on either the Host Blue’s nonparticipating provider local payment or the pricing arrangements required by applicable law. In these situations, the enrolled member may be responsible for the difference between the amount that the nonparticipating provider bills and the payment BCBSRI will make for the covered services as set forth in this paragraph. Federal or state law, as applicable, will govern payments, including but not limited to, emergency services, air ambulance services, and certain covered healthcare services rendered by a nonparticipating provider. • Exceptions In some exception cases, BCBSRI may pay claims from nonparticipating healthcare providers outside of BCBSRI service area based on the provider’s billed charge. This may occur in situations where an enrolled member did not have reasonable access to a participating provider, as determined by BCBSRI. In other exception cases, BCBSRI may pay such claims based on the payment BCBSRI would pay to a local nonparticipating provider (as described in the above subsection “How Non-network Providers Are Paid”). This may occur where the Host Blue’s corresponding payment would be more than BCBSRI in-service area nonparticipating provider payment. BCBSRI may choose to negotiate a payment with such a provider on an exception basis. Unless otherwise stated, in any of these exception situations, the enrolled member may be responsible for the difference between the amount that the nonparticipating healthcare provider bills and payment BCBSRI will make for the covered services as set forth in this paragraph. Blue Cross Blue Shield Global® Core If you are outside the United States (hereinafter “BlueCard service area”), you may be able to take advantage of the Blue Cross Blue Shield Global Core when accessing covered healthcare services. The Blue Cross Blue Shield Global Core is unlike the BlueCard Program available in the BlueCard service area in certain ways. For instance, although the Blue Cross Blue Shield Global Core assists you with accessing a network of inpatient, outpatient and professional providers, the network is not served by a Host Blue. As such, when you receive care from providers outside the BlueCard service area, you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services. • Inpatient Services: In most cases, if you contact the service center for assistance, hospitals will not require you to pay for covered inpatient services, except for your cost-share amounts/deductibles, coinsurance, etc. In such cases, the hospital will submit your claims to the service center to begin claims processing. However, if you paid in full at the time of service, you must submit a claim to receive reimbursement for covered healthcare services. • Outpatient Services: Physicians, urgent care centers and other outpatient providers located outside the BlueCard service area will typically require you to pay in full at the time of service. You must submit a claim to obtain reimbursement for covered healthcare services. Preauthorization may be required for outpatient services. • Submitting a Blue Cross Blue Shield Global Core Claim: When you pay for covered healthcare services outside the BlueCard service area, you must submit a claim to obtain reimbursement. For institutional and professional claims, you should complete a Blue Cross Blue Shield Global Core claim form and send the claim form with the provider’s itemized bill(s) to the service center (the address is on the form) to initiate claims processing. Following the instructions on the claim form will help ensure timely processing of your claim. The claim form is available from BCBSRI, the service center or online at xxx.xxxxxxxxxxxxxx.xxx. If you need assistance with your claim submission, you should call the service center at 0.000.000.XXXX (2583) or call collect at 0.000.000.0000, 24 hours a day, seven days a week.

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