RECOGNITION AND COVERAGE 1. The Company recognizes the Union as the exclusive representative of a bargaining unit made up of production, maintenance, office, technical, clerical and railroad employees of the Company, excluding only managers, confidential employees, supervisors and guards as defined under the National Labor Relations Act. Individuals in the bargaining unit shall be known as “Employees.” Individuals who are employed by the Company and are not in the bargaining unit shall be known as “non-bargaining unit employees.” Individuals who are in the bargaining unit and those who are not in the bargaining unit shall be known collectively as “employees.”
2. Except as expressly provided herein, the provisions of this BLA constitute the sole procedure for the processing and settlement of any claim by an Employee or the Union of a violation by the Company of this Agreement. As the representative of the Employees, the Union may process grievances through the grievance procedure, including arbitration, in accordance with this BLA or may adjust or settle same.
3. When the Company establishes a new or changed job whose duties include a material level of production, maintenance, office, technical or clerical work; the resulting job shall be considered a job covered within the bargaining unit; provided that where non-bargaining unit duties are added to a job in the bargaining unit on a temporary basis, they may be withdrawn.
4. It is understood that supervisors at a plant shall not perform work on a job normally performed by the bargaining unit except:
a. experimental work;
b. demonstration work performed for the purpose of instructing and training Employees;
c. work required by conditions which, if not performed, might result in interference with operations, bodily injury or loss or damage to material or equipment; and
d. work that would be unreasonable to assign to an Employee or which is negligible in amount. reasonably be identified, the Company shall pay such Employee his/her applicable Regular Rate of Pay for the time involved or for four (4) hours, whichever is greater.
Single Coverage The School District will pay up to $28.00 per month for individual coverage for each full-time teacher who qualifies for and enrolls in the School District's group dental insurance plan.
Compensation and Billing 6.1 The Facility shall only seek payment from EGID for the provision of Covered Services. The Facility agrees to accept the amount of the Allowable Fee for Covered Services as payment in full and agrees to only request payment from the Member for deductible, co-insurance and amounts for defined Non-Covered Services attributable to the Member’s Health Choice Plan. The payment shall be calculated and limited to the methodologies defined by this Contract.
6.2 When the Allowable Fee exceeds billed charges, EGID shall pay the appropriate percentage of the Allowable Fee and Member shall pay the appropriate percentage of billed charges unless the Member has met the stop loss limitation and then EGID shall pay the Allowable Fee and the Member has no liability.
6.3 When processing inpatient claims, EGID shall determine the MS-DRG Allowable Fee for non- transfer cases according to the following formula: Skilled Nursing Facility Services, Day Treatment and Residential treatment will be reimbursed utilizing the per diem methodology. In no event shall a per diem qualify as an Outlier. These benefits shall be allowed when the Member has received Medically Necessary Covered Services subject to the following policy limitations and conditions:
a) EGID shall pay the appropriate percentage of the MS-DRG Allowable Fee and the Member shall pay the remainder of the MS-DRG Allowable Fee unless the Member has met the stop loss limitation, and then EGID shall pay one hundred percent (100%) of the MS-DRG Allowable Fee and the Member has no liability.
b) The MS-DRG shall be controlling, subject to EGID’s approval and Article X of the Contract.
c) The MS-DRG Allowable Fee does not include any physician professional component fees, which are considered for payment according to separately billed Current Procedural Terminology code Allowable Fees.
d) EGID may reduce its payment by any deductibles, coinsurance and co- payments owed by the Member.
e) EGID shall include the day of admission but not the day of discharge when computing the number of facility days provided to a Member. Observation Facility confinements for which a room and board charge is incurred shall be paid based on inpatient benefits.
f) In the case of a transfer, the Transfer Allowable Fee for the transferring Facility shall be calculated as follows: Transfer Allowable Fee = (MS-DRG Allowable Fee/Geometric Mean Length of Stay) x (Length of Stay + 1 day) The total Transfer Allowable Fee paid to the transferring Facility shall be capped at the amount of the MS-DRG Allowable Fee for a non-transfer case. EGID shall allow payment to the receiving Facility, if it is also the final discharging Facility, at the MS- DRG Allowable Fee as if it were an original admission.
g) EGID shall use the current version of the CMS MS-DRG grouper to categorize what shall constitute a procedure. XXXX’s and the Member’s financial liability shall be limited to the Allowable Fee as determined by XXXX.
h) The Facility agrees not to charge more for Medical Services to Members than the amount normally charged by the Facility to other patients for similar services.
i) For Outlier cases, EGID shall base its payment to the Facility using an Outlier Allowable Fee plus the MS-DRG Allowable Fee. The following formula shall be utilized to calculate the Outlier Allowable Fee: Outlier Allowable Fee = [Billed Charges – (MS-DRG Allowable Fee + Outlier Threshold)] x Marginal Cost Factor
6.4 When processing Outpatient claims, XXXX agrees to pay the Facility the Allowable Fee based on appropriate billing according to the following:
a) If a procedure does not have an Allowable Fee, EGID will allow a percentage of the billed charges for Covered Services.
b) EGID shall pay the appropriate percentage of the Allowable Fee and the Member shall pay the remainder based on the Member’s plan of benefits unless the Member has met the stop loss limitation, and then EGID shall pay 100% of the Allowable Fee and the Member has no liability.
Scope and Coverage 1. This Chapter applies to measures adopted or maintained by a Party affecting trade in services by service suppliers of the other Party. Such measures include measures affecting: (i) the purchase or use of, or payment for, a service; (ii) the access to and use of, in connection with the supply of a service, services which are required by the Parties to be offered to the public generally; or (iii) the presence, including commercial presence, of persons of a Party for the supply of a service in the territory of the other Party.
2. For purposes of this Chapter, measures adopted or maintained by a Party means measures adopted or maintained by: (i) central, regional or local governments and authorities; and (ii) non-governmental bodies in the exercise of powers delegated by central, regional or local governments or authorities.
3. This Chapter does not apply to: (a) government procurement; (b) air services (4) , including domestic and international air transportation services, whether scheduled or non-scheduled, and related services in support of air services, other than: (i) aircraft repair and maintenance services; (ii) the selling and marketing of air transport services; and (iii) computer reservation system (CRS) services; and (c) subsidies or grants provided by a Party, including government-supported loans, guarantees, and insurance.
4. This Chapter does not impose any obligation on a Party with respect to a natural person of the other Party seeking access to its employment market, or employed on a permanent basis in its territory, and does not confer any right on that natural person with respect to that access or employment.
5. This Chapter does not apply to services supplied in the exercise of governmental authority in a Party's territory. A service supplied in the exercise of governmental authority means any service which is supplied neither on a commercial basis, nor in competition with one or more service suppliers.
6. Nothing in this Chapter shall prevent a Party from applying measures to regulate the entry of natural persons of the other Party into, or their temporary stay in, its territory, including those measures necessary to protect the integrity of, and to ensure the orderly movement of natural persons across its borders, provided that such measures are not applied in such a manner as to nullify or impair the benefits accruing to the other Party under the terms of this Chapter.
Compensation and Employers Liability Insurance a. Statutory California Workers' Compensation coverage including broad form all-states coverage.
b. Employer's Liability coverage for not less than one million dollars ($1,000,000) per occurrence.
Commencement of Coverage Coverage under the provisions of this article shall apply to regular full-time and regular part-time employees who work 15 regular hours or more per week and shall commence on the first day of the calendar month immediately following the completion of the employee's probationary period.
’ Compensation and Employer’s Liability Coverage The Grantee shall provide workers’ compensation, in accordance with Chapter 440, F.S. and employer liability coverage with minimum limits of $100,000 per accident, $100,000 per person, and $500,000 policy aggregate. Such policies shall cover all employees engaged in any work under the Grant.
RECOGNITION OUTCOMES The receiving institution commits to provide the sending institution and the student with a Transcript of Records within a period stipulated in the inter-institutional agreement and normally not longer than five weeks after publication/proclamation of the student’s results at the receiving institution. The Transcript of Records from the receiving institution will contain at least the minimum information requested in this Learning Agreement template. Table E (or the representation that the institution makes of it) will include all the educational components agreed in table A and, if there were changes to the study programme abroad, in table C. In addition, grade distribution information should be included in the Transcript of Records or attached to it (a web link where this information can be found is enough). The actual start and end dates of the study period will be included according to the following definitions: The start date of the study period is the first day the student has been present at the receiving institution, for example, for the first course, for a welcoming event organised by the host institution or for language and intercultural courses. The end date of the study period is the last day the student has been present at the receiving institution and not his actual date of departure. This is, for example, the end of exams period, courses or mandatory sitting period. Following the receipt of the Transcript of Records from the receiving institution, the sending institution commits to provide to the student a Transcript of Records, without further requirements from the student, and normally within five weeks. The sending institution's Transcript of Records must include at least the information listed in table F (the recognition outcomes) and attach the receiving institution's Transcript of Record. In case of mobility windows, table F may be completed as follows: Component code (if any) Title of recognised component (as indicated in the course catalogue) at the sending institution Number of ECTS credits Sending institution grade, if applicable Mobility window Total: 30 ….. Where applicable, the sending institution will translate the grades received by the student abroad, taking into account the grade distribution information from the receiving institution (see the methodology described in the ECTS Users' Guide). In addition, all the educational components will appear as well in the student's Diploma Supplement. The exact titles from the receiving institution will also be included in the Transcript of Records that is attached to the Diploma Supplement. P Additional educational components above the number of ECTS credits required in his/her curriculum are listed in the LA and if the sending institution will not recognise them as counting towards their degree, this has to be agreed by all parties concerned and annexed to the LA
ELIGIBILITY and COVERAGE The following ETFO represented employees are eligible to receive benefits through this Trust:
Exclusions from Coverage The Long-Term Disability Plan does not cover total disabilities resulting from:
A) war, insurrection, rebellion, or service in the armed forces of any country;
B) voluntary participation in a riot or civil commotion, except while an employee is in the course of performing the duties of her regular occupation; C) intentionally self-inflicted injuries or illness.
