Plan Offer to Dual Eligibles Residing in CMS-approved Service Areas Sample Clauses

Plan Offer to Dual Eligibles Residing in CMS-approved Service Areas. (a) The MA Dual SNP will offer the MA Product to Dual Eligibles who: (1) reside in a Texas service area where the MA Dual-SNP has been authorized, per CMS, to offer the MA Dual SNP plan, and
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Related to Plan Offer to Dual Eligibles Residing in CMS-approved Service Areas

  • Eligible Population 5.1 Program eligibility is determined by applicable law set forth in Program rules and the requirements established in the Program Policy Manual.

  • Selection Criteria for Awarding Task Order The Government will award to the offeror whose proposal is deemed most advantageous to the Government based upon an integrated assessment using the evaluation criteria. The Government will evaluate proposals against established selection criteria specified in the task order RFP. Generally, the Government's award decision will be based on selection criteria which addresses past performance, technical acceptability, proposal risk and cost. Among other sources, evaluation of past performance may be based on past performance assessments provided by TO Program Managers on individual task orders performed throughout the life of the contract. The order of importance for the factors will be identified in the RFP for the specified task order.

  • LEAST RESTRICTIVE ENVIRONMENT/DUAL ENROLLMENT CONTRACTOR and XXX shall follow all LEA policies and procedures that support Least Restrictive Environment (“LRE”) options and/or Dual Enrollment options for students to have access to the general curriculum and to be educated with their nondisabled peers to the maximum extent appropriate. CONTRACTOR shall ensure that LRE placement options are addressed at all IEP team meetings regarding students for whom ISAs have been or may be executed. This shall include IEP team consideration of supplementary aids and services, goals and objectives necessary for placement in the LRE and necessary to enable students to transition to less restrictive settings. When an IEP team has determined that a student should be transitioned into the public school setting, CONTRACTOR shall assist the LEA in implementing the IEP team’s recommendations activities to support the transition.

  • Loop Provisioning Involving Integrated Digital Loop Carriers 2.6.1 Where InterGlobe has requested an Unbundled Loop and BellSouth uses IDLC systems to provide the local service to the End User and BellSouth has a suitable alternate facility available, BellSouth will make such alternative facilities available to InterGlobe. If a suitable alternative facility is not available, then to the extent it is technically feasible, BellSouth will implement one of the following alternative arrangements for InterGlobe (e.g. hairpinning):

  • ADDITIONAL CONTRACTOR TERMS AND CONDITIONS WITHIN AN AUTHORIZED USER AGREEMENT Additional Contractor Terms and Conditions may become part of an Authorized User Agreement in accordance with Section 28 of Appendix B. EMPLOYEE INFORMATION REQUIRED TO BE REPORTED BY CERTAIN CONSULTANT CONTRACTORS AND SERVICE CONTRACTORS Civil Service Law § 97 and State Finance Law § 163 establish reporting requirements for maintaining certain information concerning Contract Employees working under State Agency service and consulting Contracts. State Agency consultant Contracts are defined as “Contracts entered into by a state Agency for analysis, evaluation, research, training, data processing, computer programming, engineering, environmental health and mental health services, accounting, auditing, paralegal, legal, or similar services” (“covered consultant Contract” or “covered consultant services”). The information must be provided to the state Agency awarding such Contracts, OSC, DOB and CS. To meet these requirements, the Contractor agrees to complete:

  • Alternate Work Sites Employees may be assigned or authorized to report to work at an alternative work site(s) and be paid for the time worked.

  • Plan Arrangements Eligibility – Claim Types All claim types are eligible to be processed through Inter-Plan Arrangements, as described above, except for all dental benefits, and those prescription drug benefits or vision benefits that may be administered by a third party contracted by us to provide the specific service or services. BlueCard® Program Under the BlueCard® Program, when you receive covered healthcare services within the geographic area served by a Host Blue, BCBSRI will remain responsible for doing what we agreed to in the contract. However, the Host Blue is responsible for contracting with and generally handling all interactions with its participating providers. When you receive covered healthcare services outside our service area and the claim is processed through the BlueCard Program, the amount you pay for covered healthcare services is calculated based on the lower of: • the billed covered charges for your covered services; or • the negotiated price that the Host Blue makes available to BCBSRI. Often, this “negotiated price” will be a simple discount that reflects an actual price that the Host Blue pays to your healthcare provider. Sometimes, it is an estimated price that takes into account special arrangements with your healthcare provider or provider group that may include types of settlements, incentive payments and/or other credits or charges. Occasionally, it may be an average price, based on a discount that results in expected average savings for similar types of healthcare providers after taking into account the same types of transactions as with an estimated price. Estimated pricing and average pricing also take into account adjustments to correct for over- or underestimation of past pricing of claims, as noted above. However, such adjustments will not affect the price we have used for your claim because they will not be applied after a claim has already been paid. Negotiated (non–BlueCard Program) Arrangements With respect to one or more Host Blues, in certain instances, instead of using the BlueCard Program, we may process your claims for covered healthcare services through Negotiated Arrangements for National Accounts. The amount you pay for covered healthcare services under this arrangement will be calculated based on the negotiated price (refer to the description of negotiated price in the BlueCard® Program section above) made available to us by the Host Blue.

  • Commingling of Resold Services with Unbundled Network Elements and Combinations of Unbundled Network Elements 6.7.1 To the extent it is Technically Feasible and pursuant to the terms of Section 9.1, CLEC may Commingle Telecommunications Services purchased on a resale basis with an Unbundled Network Element or combination of Unbundled Network Elements.

  • Benchmarks for Measuring Accessibility For the purposes of this Agreement, the accessibility of online content and functionality will be measured according to the W3C’s Web Content Accessibility Guidelines (WCAG) 2.0 Level AA and the Web Accessibility Initiative Accessible Rich Internet Applications Suite (WAI-ARIA) 1.0 for web content, which are incorporated by reference. Adherence to these accessible technology standards is one way to ensure compliance with the College’s underlying legal obligations to ensure that people with disabilities are able to acquire the same information, engage in the same interactions, and enjoy the same benefits and services within the same timeframe as their nondisabled peers, with substantially equivalent ease of use; that they are not excluded from participation in, denied the benefits of, or otherwise subjected to discrimination in any College programs, services, and activities delivered online, as required by Section 504 and the ADA and their implementing regulations; and that they receive effective communication of the College’s programs, services, and activities delivered online.

  • District’s Evaluation of Consultant and Consultant’s Employees and/or Subcontractors The District may evaluate the Consultant in any way the District is entitled pursuant to applicable law. The District’s evaluation may include, without limitation:

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