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Other Populations Sample Clauses

Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Upon review of the total care management costs from the CY 2017 through first half 2021 cost reports, we determined that the care management costs represent approximately half of total administrative expenses for all MCOPs in composite. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 45-64 plan management PMPM and the AAA Plus Plan Management PMPM Costs.
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Upon review of the total care management costs from the CY 2021 through first half 2023 cost reports, we determined that the care management costs represent approximately half of total administrative expenses for all MCOPs in composite. Using a consistent approach with the administrative cost development, we increased care management costs for the Institutional, Community Waiver 18-44 and all Community Well populations for CY 2024. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 45-64 plan management PMPM and the AAA Plus Plan Management PMPM Costs. Fees and Taxes are loaded to the capitation rates after the application of non-benefit expenses. This includes the Health Insuring Corporation (HIC) Franchise Fee along with the HIC tax. The HIC Franchise Fee consists of a PMPM amount that varies based on an entity’s Medicaid member months. The development of the actuarially sound capitation rates includes HIC Franchise Fee (collected by ODM) and HIC tax (collected by the Ohio Department of Insurance) components. HIC Franchise Fee amounts were developed by MCOP based on projected Medicaid member months for January through June 2024, and then weighted based on regional enrollment by MCOP. As the HIC Franchise Fee is assessed on a state fiscal year basis, we anticipate amending the CY 2024 capitation rates to reflect HIC Franchise Fee amounts applicable to July through December 2024. The HIC tax will remain at 1% of total capitation.
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. We determined that the 4.0% trend increase over the current PMPM care management values, after rebasing of the Community Waiver 60+ costs, would result in a reasonable composite normalized PMPM in comparison to the YTD June 2017 cost report data. As a result, care management costs for the Institutional, Community Waiver 18 – 44 and all Community Well populations were increased by 4.0% over current levels. The resulting PMPMs were then averaged based upon July 2017 MyCare enrollment to develop plan management rates that are uniform across regions. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 18-44 and 65+ amounts.
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Upon review of the total care management costs from the CY 2017 through first half 2020 cost reports, we determined that the care management costs represent approximately half of total administrative expenses for all MCOPs in composite. We determined that a 50% distribution between care management expenses and other administrative expenses, after rebasing of the Community Waiver 60+ costs, would result in a reasonable composite normalized PMPM in comparison to the CY 2019 cost report data. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 45-64 plan management PMPM and the AAA Plus Plan Management PMPM Costs.
Other PopulationsAt present, common seal populations are reported to be declining in several areas of Europe, including some that are strongholds for this species, such as Scotland and Norway. In Scotland, strong declines have been seen since 2000; Shetland 30%, Orkney 75% and the Firth of Tay 85% (SCOS 2013). The number of seals declined In Norway by 10% between surveys carried out in the period 1996-1999 and in 2003-2005 (Xxxxxxx et al. 2010). Other areas have been surveyed less well, but available data indicate concerns for conservation, e.g. for the Xxxxxx coast of Russia (Zyryanov & Xxxxxx 2010), the Baltic (Xxxxxxxx & Xxxxxxx 2010), Iceland (Xxxxxxxx & Xxxxxxxxx 2010) and Greenland (Xxxxxx- Asvid 2010). In recent decades, there has been an increase in the number of common seals in the Wadden Sea and Southwest Delta (CBS et al. 2013). A similar increasing trend was found for common seals in Denmark and Southern Sweden (Regions Skagerrak, Kattegat, Limfjord and western Baltic; Xxxxx et al. 2010). There has been a different trend in England, in comparison to Scotland. Counts in the Wash and eastern England did not demonstrate any recovery from the 2002 epidemic until 2009, but numbers have increased in the past three years (SCOS 2013). Grey seal populations in Europe are increasing in many regions, including the mainland European coast, United Kingdom (Duck & Xxxxxxxx 2007), Norway (Xxxxxxx & Xxxx 2007), and the Baltic (Xxxxxxx et al. 2007). A decline was reported for Iceland (Hauksson 2007). No recent data were available for the Murmam coast of Russia (Ziryanov & Mishin 2007) and the Faroe islands (Xxxxxxxxx 2007). Generally, a reduction in recruitment seems to play a role in the areas with a declining abundance of common seals (Xxxxx et al. 2003; Xxxxxxxx et al. 2010). Declines were also observed in North American common seal populations. For Sable Island, Canada, food shortages arising from competition with grey seals were suggested to play a role, along with shark-inflicted mortality (Xxxxx et al. 2003). The decline in the western Gulf of Alaska was thought to be related to overfishing of shrimp and capelin which are important prey species for young common seals in this area (Xxxxxx 1996). Several possible causes were suggested for the decline in Scotland, namely competition with grey seals through dietary and foraging area overlap, disease, and in particular the ingestion of toxins from harmful algae and physical trauma (SCOS 2013). For Norway, increased hunting, h...
Other Populations. Neither waiver coordination services nor non-waiver care management services are required to be contracted with the AAAs for the other MyCare populations. Thus, the total care management costs are additionally referenced as plan management costs. Care management costs from the YTD June 2016 cost reports were used to develop expenditure estimates for these populations. Because large variances exist among MCOP care management costs on a population by population basis, the cost report care management data was composited and normalized for comparison to composite care management costs included in the current capitation rates. We determined that the 2.0% trend increase over the current PMPM care management values, after rebasing of the Community Waiver 60+ costs, would result in a reasonable composite normalized PMPM in comparison to the YTD June 2016 cost report data. As a result, care management costs for the Institutional, Community Waiver 18 – 44 and all Community Well populations were increased by 2.0% over current levels. The resulting PMPMs were then averaged based upon August 2016 MyCare enrollment to develop plan management rates that are uniform across. The care management costs for the Community Waiver 45-64 population were developed as a member weighted average of the Community Waiver 18-44 and 65+ amounts.

Related to Other Populations

  • Other Positions Executive shall immediately resign, and shall be deemed to have immediately resigned without the requirement of any additional action, from any and all position Executive holds with the Company and its Affiliates on Executive’s Date of Termination.

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

  • Vaccinations Contractor understands, acknowledges, and agrees that, pursuant to Article II of the General Appropriations Act, none of the General Revenue Funds appropriated to the Department of State Health Services (DSHS) may be used for the purpose of promoting or advertising COVID-19 vaccinations in the 2024-25 biennium. It is also the intent of the legislature that to the extent allowed by federal law, any federal funds allocated to DSHS shall be expended for activities other than promoting or advertising COVID-19 vaccinations. Contractor represents and warrants that it is not ineligible, nor will it be ineligible during the term of this Contract, to receive appropriated funding pursuant to Article II.

  • Job Postings and Applications ‌ If a vacancy or a new job is created for which union personnel might reasonably be recruited, the following shall apply: (a) If the vacancy or new job has a duration of thirty (30) calendar days or more, the vacancy or new job including salary range, a summary of the job description, the required qualifications, the hours of work, including start and stop times and days off, the work area and the commencement date shall, before being filled, be posted for a minimum of seven (7) calendar days, in a manner which gives all employees access to such information, provided that no employees shall be entitled to relieve other regular employees under this clause on more than two (2) occasions in one calendar year unless the Employer and the Union otherwise agree in good faith. (b) Notwithstanding (a) above, if a temporary absence is one of less than ninety (90) calendar days, the work of the absent employee may be performed by employees working in float pool positions, where float pools exist. (c) Notwithstanding (a) above, if the vacancy is a temporary one of less than ninety (90) calendar days and the work is not being performed by a float employee, the position shall not be posted and instead shall be filled as follows: (i) where practicable by qualified regular employees who have indicated in writing their desire to work in such position consistent with the requirements of Article 14. Should a vacancy under this Article result in backfilling of more than one (1) vacancy (including the initial vacancy) the second (2nd) vacancy may be filled by an employee registered for casual work unless the Employer and the Union agree otherwise in good faith. If the application of this paragraph requires the Employer to pay overtime to the employee pursuant to Article 19, the proposed move shall not be made. An employee who accepts work under this provision is not eligible to work in another Article 16.01(c) assignment that conflicts with the accepted one. Probationary employees and employees undergoing a qualifying period shall not be considered for a 16.01(c) assignment in a different classification. (ii) by employees registered for casual work in accordance with the casual addendum. (iii) in cases of unanticipated or unplanned temporary absences, such temporary absence may first be filled under (c)(ii) for a period of up to seven (7) days. (d) A part-time employee who has accepted a casual assignment which conflicts with a temporary vacancy referred to in paragraph (c)(i) above shall be considered unavailable for such temporary vacancy. A part-time employee who has accepted a temporary vacancy referred to in paragraph (c)(i) above which conflicts with a casual assignment shall be considered unavailable for such casual assignment. Where an employee declines an offer to work under (c)(i) the Employer need not offer the work again to that employee under (c)(ii), if she/he is also registered for casual work. (e) Existing local agreements will be in force and effect (including termination clauses) unless changed by mutual agreement by the parties at the local level. (f) Where the local agreement covering access to work by part-time employees (former “15.01c”) does not contain a termination clause, the agreement may be terminated on giving of six (6) months’ notice by either party. (g) By mutual agreement, the parties may vary the job posting process set out in Article 16.01.

  • Prescriptions and bottles of these medications may be sought by individuals with chemical dependency and should be closely safeguarded. It is expected that you will take the highest possible degree of care with your medication and prescription. They should not be left where others might see or otherwise have access to them.

  • New Job Classifications When a new classification (which is covered by the terms of this collective agreement) is established by the Hospital, the Hospital shall determine the rate of pay for such new classification and notify the local Union of the same. If the local Union challenges the rate, it shall have the right to request a meeting with the Hospital to endeavour to negotiate a mutually satisfactory rate. Such request will be made within ten (10) days after the receipt of notice from the Hospital of such new occupational classification and rate. Any change mutually agreed to resulting from such meeting shall be retroactive to the date that notice of the new rate was given by the Hospital. If the parties are unable to agree, the dispute concerning the new rate may be submitted to arbitration as provided in the agreement within fifteen (15) days of such meeting. The decision of the arbitrator (or board of arbitration as the case may be) shall be based on the relationship established by comparison with the rates for other classifications in the bargaining unit having regard to the requirements of such classification. When the Hospital makes a substantial change in the job content of an existing classification which in reality causes such classification to become a new classification, the Hospital agrees to meet with the Union if requested to permit the Union to make representation with respect to the appropriate rate of pay. If the matter is not resolved following the meeting with the Union, the matter may be referred to arbitration as provided in the agreement within fifteen (15) days of such meeting. The decision of the arbitrator (or board of arbitration as the case may be) shall be based on the relationship established by comparison with the rates for other classifications in the bargaining unit having regard to the requirements of such classifications. The parties further agree that any change mutually agreed to or awarded as a result of arbitration shall be retroactive only to the date that the Union raised the issue with the Hospital. The parties further agree that the above process as provided herein shall constitute the process for Pay Equity Maintenance as required by the Pay Equity Act.

  • DEFINTIONS “Covered subcontract,” as used in this clause, means any subcontract, except a subcontract for the acquisition of commercial items or commercially available off-the-shelf items, that is in excess of $1 million and uses Fiscal Year 2010 funds. (b) The Contractor -

  • Medications Psychotropic medications and medications associated with treating a diagnosed mental health condition.

  • Prescription Glasses This plan covers prescription glasses as follows: • Frames - one (1) collection frame per plan year; • Lenses - one (1) pair of glass or plastic collection lenses per plan year. This includes single vision, bifocal, trifocal, lenticular, and standard progressive lenses. This plan covers the following lens treatments: • UV treatment; • tint (fashion, gradient, and glass-grey); • standard plastic scratch coating; • standard polycarbonate; and • photocromatic/transitions plastic. This plan covers one (1) supply of contact lenses as follows: • conventional contact lenses - one (1) pair per plan year from a selection of • extended wear disposable lenses - up to a 6-month supply of monthly or two- week single vision spherical or toric disposable contact lenses per plan year; or • daily wear disposable lenses - up to a 3-month supply of daily single vision spherical disposable contact lenses per plan year. This plan also covers the evaluation, fitting, or follow-up care related to contact lenses. This plan covers additional contact lenses if your prescribing network provider submits a verification form, with the regular claim form, verifying that you have one of the following conditions: • anisometropia of 3D in meridian powers; • high ametropia exceeding -10D or +10D in meridian powers; • keratoconus when the member’s vision is not correctable to 20/25 in either or both eyes using standard spectacle lenses; and • vision improvement for members whose vision can be corrected two lines of improvement on the visual acuity chart when compared to the best corrected standard spectacle lenses.

  • Other Policies All other matters relating to the employment of the Employee not specifically addressed in this Agreement shall be subject to the general policies regarding executive employees of the Company as in effect from time to time.