PREMIUM RATE AND BENEFIT PROVISIONS Sample Clauses

PREMIUM RATE AND BENEFIT PROVISIONS. The Subscriber agrees to pay the HMO in advance, on a monthly or quarterly basis, unless otherwise agreed, the applicable premium rate as filed with and approved by the Commonwealth of Pennsylvania. In consideration of these payments to the HMO, the HMO agrees to provide access to medical and Hospital Covered Services and other Benefits as specified in this Subscriber Agreement for eligible persons who enroll hereunder, in accordance with the terms, conditions, Limitations and exclusions of this Subscriber Agreement. If the Subscriber provides incorrect or missing information which causes the premium to be calculated incorrectly, the HMO may, at its option and as allowed by law, either recoup any additional premium which would have been charged if accurate information had been provided, or terminate this Agreement as provided in Section EL - Eligibility, change, and Termination Rules Under The Plan. A Member may make payment of premium in advance directly to the HMO in person or by mail at the following address: Keystone Health Plan Central XX Xxx 000000 Xxxxxxxxxx, XX 00000-0000 If a Subscriber or dependent is determined by the Marketplace to be eligible for a Subsidy, the Member is responsible for payment of the premium less the amount, if any, of the Subsidy that the Marketplace has determined the Subscriber or dependent is eligible for in any full or partial calendar month. If required by the Marketplace, an Indian tribe, tribal organization or urban Indian organization may make payment of a Member’s premium pursuant to the rules of the Marketplace. If the Marketplace notifies the HMO that the Member’s eligibility for a Subsidy or cost sharing reductions has changed so that the Member is newly eligible for a Subsidy or cost sharing reduction, the HMO will change the Member’s enrollment to the applicable silver level plan as of the effective date required by the Marketplace. If the change occurs in the middle of an Agreement Year, the HMO will carry over any Cost Sharing Amounts that the Member paid under the prior plan of the standard plan. Premium rates may be changed prospectively with the prior approval of the Pennsylvania Insurance Department during any month in which this Agreement remains in effect, provided that prior written notice of such proposed change shall be given to the Subscriber by the HMO. To the extent that premiums are based on the age of a Member, premiums will be based on the age of such Member as of the date of Agreement issuance...
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PREMIUM RATE AND BENEFIT PROVISIONS. ‌ PREMIUM RATE CHANGES‌ AGE OF MEMBER‌ THIRD PARTY PAYMENTS‌ SECTION CSR – SUBSIDY AND COST SHARING REDUCTIONS‌ SUBSIDY‌ COST SHARE REDUCTIONS‌ INDIAN – NO COST SHARING‌ INDIAN – TRIBAL SERVICES‌
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PREMIUM RATE AND BENEFIT PROVISIONS. The Subscriber agrees to pay the HMO in advance, on a monthly or quarterly basis, unless otherwise agreed, the applicable premium rate as filed with and approved by the Commonwealth of Pennsylvania. In consideration of these payments to the HMO, the HMO agrees to provide access to medical and Hospital Covered Services and other Benefits as specified in this Subscriber Agreement for eligible persons who enroll hereunder, in accordance with the terms, conditions, Limitations and exclusions of this Subscriber Agreement. If the Subscriber provides incorrect or missing information which causes the premium to be calculated incorrectly, the HMO may, at its option and as allowed by law, either recoup any additional premium which would have been charged if accurate information had been provided, or terminate this Agreement as provided in Section EL - Eligibility, change, and Termination Rules Under The Plan. Premium rates may be changed prospectively with the prior approval of the Pennsylvania Insurance Department during any month in which this Agreement remains in effect, provided that prior written notice of such proposed change shall be given to the Subscriber by the HMO. To the extent that premiums are based on the age of a Member, premiums will be based on the age of such Member as of the date of Agreement issuance or on the Agreement Renewal Date. Keystone does not accept payment of premium from a third party except from a family member or unless otherwise required by law.
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PREMIUM RATE AND BENEFIT PROVISIONS. ‌ PREMIUM RATE CHANGES‌ AGE OF MEMBER‌ THIRD PARTY PAYMENTS‌
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Related to PREMIUM RATE AND BENEFIT PROVISIONS

  • Synopsis and Benefit to Xxxxxxx County The Agreement continues the contractual relationship between the Oregon State Marine Board and Xxxxxxx County through its Sheriff’s Office. The Sheriff’s Office will be reimbursed for marine law enforcement patrols, boater education, and boat inspections conducted throughout the County.

  • Termination Payments and Benefits Regardless of the circumstances of the Executive’s termination, Executive shall be entitled to payment when due of any earned and unpaid base salary, expense reimbursements and vacation days accrued prior to the termination of Executive’s employment, and other unpaid vested amounts or benefits under Company retirement and health benefit plans, and, as applicable, under Equity Agreements in accordance with their terms, and to no other compensation or benefits. (a) If (i) the Company terminates the Executive’s employment without Cause, or (ii) the Executive terminates employment with the Company within twelve (12) months following the occurrence of a Change in Control, provided that within such period, (a) either Executive’s job duties have been materially and permanently diminished or the Executive’s compensation has been materially decreased and (b) Executive provides written notice to the Company within ninety (90) days of the occurrence of an aforementioned event and the Company fails to cure the event within thirty (30) days following the Company’s receipt of the Executive’s written notice, then, in the case of either (i) or (ii) above, the Company will provide the Executive with separation payments of twelve (12) months base salary at Executive’s base salary rate at the time of Executive’s termination or if greater, the Executive’s base rate in effect on the Change of Control Date; to be paid in twenty-six (26) regular bi-weekly pay periods beginning on the first pay period occurring after the sixtieth (60th) day following the Executive’s termination, provided the Executive executes and does not subsequently revoke the Separation and General Release Agreement referenced below within such sixty (60) day period. (b) For a period of twelve (12) months from the Executive’s separation from service, the Company will pay to the Executive an amount, minus all applicable taxes and withholdings, equal to the full monthly cost (including any portion of the cost previously paid by the employee) to provide the same level of group health benefits maintained by Executive as of Executive’s separation from service, provided the Executive executes and does not subsequently revoke the Separation and General Release Agreement referenced below within such sixty (60) day period. (c) For purposes of this Agreement, “Change in Control” shall mean the occurrence of any one of the following events:

  • Payment and Benefits In consideration of the promises made in this Release, Employer has agreed to pay Executive the benefits as provided in that certain employment agreement made and entered into as of _________________________, by and between the Parties (the “Employment Agreement”). Executive understands and acknowledges that the benefits described in this Section 2 constitute benefits in excess of those to which Executive would be entitled without entering into this Release. Executive acknowledges that such benefits are being provided by Employer as consideration for Executive entering into this Release, including the release of claims and waiver of rights provided in Section 3 of this Release.

  • Wages and Benefits Wages, performance-sharing opportunities and benefits as identified in this Section 2 are considered to be ongoing obligations and will terminate at the extended expiration of local agreements, rather than at the expiration of this Agreement.

  • Other Payments and Benefits On any termination of employment, including, without limitation, termination due to the Employee’s death or Disability (as defined in Section 10) or for Cause, the Employee shall receive any accrued but unpaid salary, reimbursement of any business or other expenses incurred prior to termination of employment but for which the Employee had not received reimbursement, and any other rights, compensation and/or benefits as may be due the Employee in accordance with the terms and provisions of any agreements, plans or programs of the Company (but in no event shall the Employee be entitled to duplicative rights, compensation and/or benefits).

  • Insurance and Benefits Company shall allow Executive to participate in each employee benefit plan and to receive each executive benefit that Company provides for senior executives at the level of Executive's position.

  • Exclusivity of Salary and Benefits The Executive shall not be entitled to any payments or benefits other than those provided under this Agreement.

  • Accrued Compensation and Benefits Notwithstanding anything to the contrary in Section 2 and 3 above, in connection with any termination of employment upon or following a Change in Control (whether or not a Qualifying Termination or CIC Qualifying Termination), the Company or its subsidiary shall pay Executive’s earned but unpaid base salary and other vested but unpaid cash entitlements for the period through and including the termination of employment, including unused earned vacation pay and unreimbursed documented business expenses incurred by Executive prior to the date of termination (collectively “Accrued Compensation and Expenses”), as required by law and the applicable Company or its subsidiary, as applicable, plan or policy. In addition, Executive shall be entitled to any other vested benefits earned by Executive for the period through and including the termination date of Executive’s employment under any other employee benefit plans and arrangements maintained by the Company or its subsidiary, as applicable, in accordance with the terms of such plans and arrangements, except as modified herein (collectively “Accrued Benefits”). Any Accrued Compensation and Expenses to which the Executive is entitled shall be paid to the Executive in cash as soon as administratively practicable after the termination, and, in any event, no later than two and one-half (2-1/2) months after the end of the taxable year of the Executive in which the termination occurs or at such earlier time as may be required by applicable law or Section 10 below, and to such lesser extent as may be mandated by Section 9 below. Any Accrued Benefits to which the Executive is entitled shall be paid to the Executive as provided in the relevant plans and arrangements.

  • Severance Payments and Benefits (a) If a Change in Control occurs and within a period of twenty-four (24) months thereafter, Executive incurs a Separation from Service on account of (i) an involuntary termination by the Company for reasons other than death, Disability or Cause, or (ii) a voluntary termination elected by the Executive for Good Reason, then subject to (A) Executive signing and not revoking a separation and general release agreement (the “Release”) in a form provided by the Company as may be in use from time to time, and (B) Section 4 below, Executive shall (and the Company (or any successor thereto) shall pay, award and/or provide): (1) receive a lump-sum cash severance payment in an amount equal to the sum of (a) two times (2x) Executive’s Annual Compensation; (b) the product of (x) Executive’s Long-term Incentive Award Value, multiplied by (y) a fraction, the numerator of which is the number of full and partial calendar months between January 1 of the year of Separation from Service and the date of the Executive’s Separation from Service (provided, however, that such numerator shall not exceed six (6)) and the denominator of which is twelve (12); and (c) the product of (x) the greater of (A) Executive’s target annual bonus amount for the year in which the Separation from Service occurs, or (B) the highest annual bonus paid to the Executive out of the three (3) prior bonuses paid to the Executive prior to the Executive’s Separation from Service, multiplied by (y) a fraction, the numerator of which is the number of full and partial calendar months between January 1 of the year of Separation from Service and the date of the Executive’s Separation from Service and the denominator of which is twelve (12); and (2) receive eighteen (18) months of continued coverage under the Company’s group health plans (based on the level of the Executive’s coverage in effect on the date of the Executive’s Separation from Service), at the Company’s expense, subject to the Executive’s timely election of continuation coverage under the COBRA, it being understood that (a) in the event that the Executive becomes eligible to receive substantially similar or improved medical, dental or vision benefits from a subsequent employer (whether or not the Executive accepts such benefits), the Company’s obligations under this Section 3(a)(2) shall immediately cease, (b) the Executive will notify the Company of his eligibility for such benefits from a subsequent employer within thirty (30) days of such eligibility and (c) in the event that the Company’s making payments under this Section 3(a)(2) would violate nondiscrimination rules or result in the imposition of penalties under the PPACA, the parties agree to reform this Section 3(a)(2) in such manner as is necessary to comply with tax laws and the PPACA, as applicable. (3) become fully vested in all Company equity and long-term incentive awards granted to Executive (including, but not limited to, and all stock options, stock appreciation rights, restricted stock, restricted stock units, performance shares, performance units, and all other stock and cash-based long-term incentive awards) to the extent that such vesting is based on service with the Company. With respect to any performance shares and performance unit awards, (a) the final number of units and/or shares payable under such awards shall only be determined in accordance with the terms and conditions of the respective grant agreement governing such award, and accordingly, (b) distribution of such awards can only take place following such share and/or unit amount determination. Notwithstanding the foregoing, the full and immediate vesting of any restricted stock units, performance shares, performance units, shall not change the payment date thereof or otherwise apply to the extent it would result in adverse tax consequences under Section 409A of the Code; and (4) notwithstanding anything to the contrary in the respective award agreement(s), be entitled to exercise any stock options or stock appreciation rights until the expiration of twenty-four (24) months following Executive’s Separation from Service (or until such later date as may be applicable under the terms of the award agreement governing the stock option or stock appreciation right upon termination of employment), subject to the maximum full term of the stock option or stock appreciation right; provided, however, that, if any stock option or stock appreciation right is terminated or cashed-out in connection with a Change in Control, the Executive shall receive a lump-sum cash payment equal to the time value (i.e., under the Black Scholes option pricing model) of such stock options or stock appreciation rights inclusive of the economic value for the period of twenty-four (24) months following Executive’s Separation from Service (or until such later date as may be applicable under the terms of the award agreement governing the stock option or stock appreciation right upon termination of employment), subject to the maximum full term of the stock option or stock appreciation right. (b) If Executive is not a Specified Employee, all payments made to Executive under Section 3(a) immediately above shall be made on the sixtieth (60th) calendar day following Executive’s Separation from Service, provided that Executive’s Release must be effective and not revocable on the date payment is to be made in order to receive such payments. If Executive is a Specified Employee, to the extent required to comply with Section 409A of the Code, payments made under Section 3(a) immediately above shall be made within ten (10) calendar days following the date following the first (1st) day of the seventh (7th) month after the date of Executive’s Separation from Service, provided that no such payment shall be made to Executive if the Release has not become effective as of the six (6)-month anniversary of the date of Executive’s Separation from Service.

  • ADDITIONAL COMPENSATION AND BENEFITS The Executive shall receive the following additional compensation and welfare and fringe benefits:

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