Time Limits to Present Initial Grievance An employee who wishes to present a grievance at Step 2 of the grievance procedure, in the manner prescribed in Clause 8.4, must do so no later than 30 days after the date: (a) on which they were notified orally or in writing, of the action or circumstances giving rise to the grievance; (b) on which they first became aware of the action or circumstances giving rise to the grievance.
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.
Disenrollment An Enrollee must be disenrolled from the Plan if the Beneficiary: a. No longer resides in the State of Mississippi; b. Is deceased; c. No longer qualifies for medical assistance under one of the Medicaid eligibility categories in the targeted population. The Contractor must notify the Division within three (3) days of their request that an Enrollee is disenrolled for a reason listed above and provide written documentation of disenrollment. Disenrollment shall be effective on the first day of the calendar month for which the disenrollment appears on the Enrollee Listing Report. The Contractor shall not disenroll an Enrollee because of an adverse change in the Enrollee’s health status, or because of the Enrollee’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from Enrollee’s special needs (except when Enrollee’s continued enrollment in the CCO seriously impairs the Contractor’s ability to furnish services to either this particular Enrollee or other Enrollees.) The Contractor must file a request to disenroll an Enrollee with the Division in writing stating specifically the reasons for the request if the reasons are for other than those specified above. An Enrollee may request disenrollment without cause during the ninety (90) days following the date the Division sends the Enrollee notice of enrollment or the date of the Enrollee’s initial enrollment, whichever is later, during the annual open enrollment period, upon automatic reenrollment if the temporary loss of Medicaid eligibility has caused the Enrollee to miss the annual disenrollment opportunity, or when the Division imposes an intermediate sanction on the Contractor as specified in this Contract. An Enrollee may request disenrollment from the CCO for cause if the CCO does not, because of moral or religious objections, cover the service the Enrollee seeks, the Enrollee needs related services to be performed at the same time, not all related services are available within the network, the Enrollee’s primary care provider or another provider determines receiving the services separately would subject Enrollee to unnecessary risk, poor quality of care, lack of access to services covered under the Plan, or lack of access to providers experienced in dealing with the Enrollee’s health care needs. Enrollee requests for disenrollment must be directed to the Division either orally or in writing. The effective date of any approved disenrollment will be no later than the first day of the second month following the month in which the Enrollee or the Plan files the request with the Division.
Prescription Safety Glasses Prescription safety glasses will be furnished by the employer. The employer retains the authority to establish reasonable rules and procedures regarding frequency of issue, replacement of damaged glasses, limits on reimbursement costs and coordination with the employer's vision plan.
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.
Secondary Schools In the middle and high schools, areas of certification shall be deemed to 21 be the areas for which the employee holds certification. No teacher assignment that would result 22 in a violation of state or federal law will be approved.
Grievance Commissioner System This is to confirm the discussion of the parties during collective bargaining that they are committed to encouraging early discussion and resolution of labour relations issues at the local level and seek to resolve grievances in a timely and cost efficient manner. To that end, this is to confirm that pursuant to Article 8, the parties agree that the Employer and Union at individual nursing homes may agree to utilize the following process in order to resolve a particular grievance through the utilization of a joint mediation-arbitration procedure:
Elementary Schools A. Each classroom shall have one text per child when the subject is being taught. Future textbook adoptions will include appropriate supplementary materials when those materials are recommended by the adoption committee. Any consumables or supplementary materials adopted shall be distributed according to the committee’s recommendation prior to implementing the adoption. When adopted, consumables, such as workbooks, will be distributed to each child before required usage of the materials. The joint Curriculum Committee shall be consulted prior to the discontinuance of such materials. (See Article XXVI). Newly employed teachers and all teachers who transfer to a new teaching assignment will be provided appropriate desk top supplies and Board adopted curriculum materials. If a teacher is transferring into a newly created classroom, appropriate furniture will be provided. The parties have agreed to an inventory (reference Appendix Z) of supplies, materials, and furniture. A teacher who is not provided the core inventory by September 1 or within thirty (30) days of assignment shall be entitled to appeal directly through the Federation to the appropriate Transformational Leader or his/her designee. B. Each child found to be without adequate health care, where immediate medical attention is needed, shall be referred by the Board to the appropriate social agency upon notification by the teacher. The teacher shall receive written confirmation of the referral within ten (10) school days. C. No teacher shall be required to supervise or be present in the dining area during a local, state or federal breakfast or lunch program. Such instructional time used for said programs shall be considered planning time for the teacher, at a place of his/her choice, within the building. D. No elementary teacher shall be assigned to teach in an area outside his/her certification, subject to Article IV, G- 4. E. Cafeteria duty shall be voluntary when service is performed by a teacher. F. No bus or other additional duties shall be assigned to an elementary teacher outside the six hour and fifteen minute duty day. G. Elementary teachers shall not be required to be present when other teachers are responsible for presenting materials to the class. If a demonstration lesson is requested by the teacher, he/she will be required to be present. Such requests shall be initiated by the teacher. H. Teachers in bilingual classes shall be capable of teaching in both languages when those bilingual teachers can be found. Volunteers, paraprofessionals or casual employees shall be prohibited from supplanting a teacher in bilingual or ESL programs. However, a paraprofessional ELDP tutor may be used to work under the direction of a regular teacher in the bargaining unit to assist those students who need reinforcement in English for less than a full class day. Regular contract teachers who will agree to obtain certification for bilingual or ESL classes shall be employed or used when teachers with fluency in two or more languages cannot be found. Consultants in these programs shall not replace or displace a teacher. I. Student test results for each elementary school shall be made available on a timely basis for achievement and other Ohio mandated tests and standardized tests when administered. J. When a teacher transfers, a three (3) day notice shall be given when possible. Two
Claims Review Population A description of the Population subject to the Claims Review.
Prescription Plan The PPO plan will include a comprehensive prescription 29 program:
