Payments for Plan Members Under Capitation Who Do Not Select PCP at Time of Enrollment Sample Clauses

Payments for Plan Members Under Capitation Who Do Not Select PCP at Time of Enrollment. For a Plan Member who is enrolled in a Plan requiring selection of a primary care physician in a local market in which Company compensates all primary care Physicians on a capitated basis, if the Plan Member does not choose a primary care Physician upon enrollment, Company shall assign the Plan Member to a primary care Physician that is a Participating Physician randomly related to the Plan Member’s home address zip code or on the basis of another reasonable method developed by Company. The Plan Member shall have the right to select a new primary care Physician at any time in accordance with such Plan Member’s Plan. Company shall pay the assigned primary care Physician capitation or other contract rates, and the assigned primary care Physician shall become responsible for the care of the Plan Member in accordance with the applicable terms of such Participating Physician’s agreement with Company, from the date of notice of the assignment; provided that if Company sends the notice of assignment after the Plan Member’s coverage becomes effective, then Company shall pay such Participating Physician, Physician Group or Physician Organization, as applicable, the applicable rate retroactive to the Plan Member’s effective date. The Certification to be filed annually and at the end of the Effective Period must include the training and policy manual materials promulgated to effectuate this commitment, and in effect during the Effective Period, as well as any forms or other informational materials distributed to randomly designated Plan Members notifying them of their right to select a new primary care Physician.
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Related to Payments for Plan Members Under Capitation Who Do Not Select PCP at Time of Enrollment

  • How Are Contributions to a Xxxxxxxxx Education Savings Account Reported for Federal Tax Purposes? Contributions to a Xxxxxxxxx Education Savings Account are reported on IRS Form 5498-ESA.

  • Pension Contributions While on Short Term Disability Contributions for OMERS Plan Members When an employee/plan member is on short-term sick leave and receiving less than 100% of regular salary, the Board will continue to deduct and remit OMERS contributions based on 100% of the employee/plan member’s regular pay.

  • Coverage for Members Who Are Hospitalized on Their Effective Date If you are in the hospital on your effective date of coverage, healthcare services related to such hospitalization are covered as long as: (a) you notify us of your hospitalization within forty-eight (48) hours of the effective date, or as soon as is reasonably possible; and (b) covered healthcare services are received in accordance with the terms, conditions, exclusions and limitations of this agreement. As always, benefits paid in such situations are subject to the Coordination of Benefits provisions.

  • When Must Distributions from a Xxxxxxxxx Education Savings Account Begin? Distribution of a Xxxxxxxxx Education Savings Account must be made (or otherwise will be deemed made) no later than 30 days from the earlier of the beneficiary’s death or attainment of age 30. A distribution from a Xxxxxxxxx Education Savings Account may be rolled over to another beneficiary’s Xxxxxxxxx Education Savings Account according to the requirements of Section (4). Note that the Economic Growth and Tax Relief Reconciliation Act of 2001 waives the distribution age limitation if the beneficiary of the Xxxxxxxxx Education Savings Account is a “Special Needs” student.

  • How Are Distributions from a Xxxxxxxxx Education Savings Account Taxed For Federal Income Tax Purposes? Amounts distributed are generally excludable from gross income if they do not exceed the beneficiary’s “qualified higher education expenses” for the year or are rolled over to another Xxxxxxxxx Education Savings Account according to the requirements of Section (4). “Qualified higher education expenses” generally include the cost of tuition, fees, books, supplies, and equipment for enrollment at (i) accredited post-secondary educational institutions offering credit toward a bachelor’s degree, an associate’s degree, a graduate-level or professional degree or another recognized post-secondary credential and (ii) certain vocational schools. In addition, room and board may be covered if the beneficiary is at least a “half-time” student. This amount may be reduced or eliminated by certain scholarships, qualified state tuition programs, HOPE, Lifetime Learning tax credits, proceeds of certain savings bonds, and other amounts paid on the beneficiary’s behalf as well as by any other deductions or credits taken for the same expenses. The definition of “qualified education expenses” includes expenses more frequently and directly related to elementary and secondary school education, including the purchase of computer technology or equipment or Internet access and related services. To the extent payments during the year exceed such amounts, they are partially taxable and partially non-taxable similar to payments received from an annuity. Any taxable portion of a distribution is generally subject to a 10% penalty tax in addition to income tax unless the distribution is (i) due to the death or disability of the beneficiary, (ii) made on account of a scholarship received by the beneficiary, or (iii) is made in a year in which the beneficiary elects the HOPE or Lifetime Learning credit and waives the exclusion from income of the Xxxxxxxxx Education Savings Account distribution. You may be allowed to take both the HOPE or Lifetime Learning credits while simultaneously taking distributions from Xxxxxxxxx Education Savings Accounts. However, you cannot claim a credit for the same educational expenses paid for through Xxxxxxxxx Education Savings Account distributions. To the extent a distribution is taxable, capital gains treatment does not apply to amounts distributed from the account. Similarly, the special five- and ten-year averaging rules for lump-sum distributions do not apply to distributions from a Xxxxxxxxx Education Savings Account. The taxable portion of any distribution is taxed as ordinary income. The IRS does not require withholding on distributions from Xxxxxxxxx Education Savings Accounts.

  • Rollovers of Xxxx Elective Deferrals Xxxx elective deferrals distributed from a 401(k) cash or deferred arrangement, 403(b) tax-sheltered annuity, 457(b) eligible governmental deferred compensation plan, or federal Thrift Savings Plan, may only be rolled into your Xxxx XXX.

  • Reallocation to a Class with an Equal Salary Range Maximum 1. If the employee meets the skills and abilities requirements of the position, the employee remains in the position and retains existing appointment status.

  • Oregon Public Service Retirement Plan Pension Program Members For purposes of this Section 2, “employee” means an employee who is employed by the State on or after August 29, 2003 and who is not eligible to receive benefits under ORS Chapter 238 for service with the State pursuant to Section 2 of Chapter 733, Oregon Laws 2003.

  • Contributions for OTPP Plan Members i. When an employee/plan member is on short term sick leave and receiving less than 100% of regular salary, the Board will continue to deduct and remit OTPP contributions based on 100% of the employee/plan member’s regular pay.

  • When Must Distributions from a Traditional IRA Begin You must begin receiving the assets in your account no later than April 1 following the calendar year in which you reach RMD age.

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