Required termination includes Sample Clauses

Required termination includes. (1) The Enrollee becomes ineligible for Medical Assistance; (2) The Enrollee’s basis of eligibility changes and no longer meets enrollment criteria in section 3.1; (3) The Enrollee moves out of the MCO’s Service Area and the MMIS county of residence is updated per eligibility policy; (4) For MSHO, the Enrollee becomes ineligible for Medicare Part A or Part B; (5) The Enrollee’s MA Plan application is rejected by CMS or cancelled by the Beneficiary before the effective date. For MSHO enrollment, the Beneficiary will be re-enrolled in MSC+ retroactively, and the capitation will be re-processed; (6) For MSHO, for non-payment of Medical Spenddown if the Enrollee does not pay the Medical Spenddown in full for three (3) months directly to the State as described in section 3.1.8(2). The Enrollee will not be allowed to re-enroll in MSHO after termination for non- payment unless all past due Medical Spenddowns are paid in full and the Enrollee no longer has a Medical Spenddown at the time of application; (7) The Enrollee changes MCOs without cause within ninety (90) days following the Enrollee’s initial enrollment with the MCO. For counties where the MCO is the only choice, the Enrollee cannot disenroll, but may change Primary Care Providers pursuant to section 3.2.12. [42 CFR §438.56(c)] (8) The enrollee may change MCOs because of concerns with access, service delivery, or other good cause [42 CFR §438.56 and Minnesota Rules, Part 9500.1453]; (9) For MSC+, the Enrollee may elect to change MCOs once during the first year of initial enrollment in the MCO or during the first sixty (60) days after a change in enrollment from an MCO that is no longer participating [Minnesota Rules, Part 9500.1453, subpart 5]; (10) The Enrollee elects to change MCOs due to substantial travel time or Local Agency error [Minnesota Rules, Part 9500.1453, subparts 7 and 8]; (11) The Enrollee elects to change MCOs during an annual open enrollment period [Minnesota Rules, Part 9500.1453, subpart 5]; (12) The Enrollee misses the opportunity to change during the annual health-plan selection period due to disenrollment; or for MSHO, monthly, pursuant to section 3.2.7; and (13) The Enrollee elects to change MCOs within one hundred twenty (120) days following notice of a Material Modification of the MCO’s Provider network where a single-source Provider who is the only provider available to provide a specific service is removed from the network for cause under section 2.104(4);
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Required termination includes. (1) The Enrollee becomes ineligible for Medical Assistance. (2) The Enrollee’s basis of eligibility changes and no longer meets the enrollment criteria for SNBC; (3) The Enrollee moves out of the MCO’s Service Area and the MMIS county of residence is updated per eligibility policy. (4) The Enrollee becomes ineligible for Medicare Part A or Part B. If the Enrollee loses eligibility for both Parts A and B but remains eligible for Medical Assistance, the Enrollee remains eligible for SNBC. (5) The Enrollee does not pay the Medical Spenddown in full for three months directly to the STATE. The Enrollee will not be allowed to re-enroll in SNBC after termination for non- payment unless all past due Medical Spenddowns are paid in full and the Enrollee no longer has a Medical Spenddown at the time of application. (6) The SNBC SNP Enrollee elects to change MCOs as described in 42 CFR §422.62 (election of coverage for Medicare Advantage plan). (7) The Enrollee reaches the age of sixty-five (65).
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Required termination includes. (1) The Enrollee becomes ineligible for Medical Assistance; (2) The Enrollee’s basis of eligibility changes and no longer meets enrollment criteria in section 3.1;‌‌
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Related to Required termination includes

  • Required Termination If a court of competent jurisdiction or Government Authority issues a final non-appealable order or judgment holding that all or part of the Agreement or all or a part of the Services offered under the Agreement are in violation of any Law (each, a “Judgment”), the affected party has the right to terminate those portions of the Agreement that are part of such Judgment by providing the other party with written notice of its intent to terminate such portions of the Agreement, and subject to Section II.E, such termination of such portions of the Agreement will be effective as of the date specified in such notice.

  • Covered Termination “Covered Termination” shall mean Executive’s Constructive Termination or the termination of Executive’s employment by the Company other than for Cause.

  • Effective Period Termination This Agreement shall become effective as of the date of its execution and shall continue in full force and effect until terminated as hereinafter provided. This Agreement may be terminated by each Investment Company, on behalf of a Fund, or by the Custodian by 90 days notice in Writing to the other provided that any termination by an Investment Company shall be authorized by a resolution of the Board, a certified copy of which shall accompany such notice of termination, and provided further, that such resolution shall specify the names of the persons to whom the Custodian shall deliver the assets of the affected Funds held by the Custodian. If notice of termination is given by the Custodian, the affected Investment Companies shall, within 90 days following the giving of such notice, deliver to the Custodian a certified copy of a resolution of the Boards specifying the names of the persons to whom the Custodian shall deliver assets of the affected Funds held by the Custodian. In either case the Custodian will deliver such assets to the persons so specified, after deducting therefrom any amounts which the Custodian determines to be owed to it hereunder (including all costs and expenses of delivery or transfer of Fund assets to the persons so specified). If within 90 days following the giving of a notice of termination by the Custodian, the Custodian does not receive from the affected Investment Companies certified copies of resolutions of the Boards specifying the names of the persons to whom the Custodian shall deliver the assets of the Funds held by the Custodian, the Custodian, at its election, may deliver such assets to a bank or trust company doing business in the State of California to be held and disposed of pursuant to the provisions of this Agreement or may continue to hold such assets until a certified copy of one or more resolutions as aforesaid is delivered to the Custodian. The obligations of the parties hereto regarding the use of reasonable care, indemnities and payment of fees and expenses shall survive the termination of this Agreement.

  • Qualifying Termination If the Executive is subject to a Qualifying Termination, then, subject to Sections 4, 9, and 10 below, Executive will be entitled to the following benefits:

  • Termination Period This Option shall be exercisable for three (3) months after Participant ceases to be a Service Provider, unless such termination is due to Participant’s death or Disability, in which case this Option shall be exercisable for twelve (12) months after Participant ceases to be a Service Provider. Notwithstanding the foregoing sentence, in no event may this Option be exercised after the Term/Expiration Date as provided above and this Option may be subject to earlier termination as provided in Section 13 of the Plan.

  • Termination Due to Retirement Subject to Section 7 below, in the event of Termination due to Retirement, then (regardless of any subsequent death of the Employee) the Option will continue to vest pursuant to Section 3, and the last date on which the Option may be exercised is the day prior to the Expiration Date.

  • Termination Following a Change in Control (a) If the Executive's employment is terminated by the Company or any Subsidiary during the Severance Period, the Executive shall be entitled to the benefits provided by Section 4 unless such termination is the result of the occurrence of one or more of the following events: (i) The Executive's death; (ii) If the Executive becomes permanently disabled within the meaning of, and begins actually to receive disability benefits pursuant to, the long-term disability plan in effect for, or applicable to, Executive immediately prior to the Change in Control; or

  • Effective Date of Benefit Termination Medical, dental and life coverage termination will take effect on the first of the month following the loss of eligible employee or dependent status. Disability benefit coverage terminations will take effect on the day following loss of eligible employee status.

  • Date of Termination, Etc Date of Termination" shall mean (A) if your employment is terminated for Disability, 30 days after Notice of Termination is given (provided that You shall not have returned to the full-time performance of your duties during such 30-day period), and (B) if your employment is terminated pursuant to Section 3.2 or 3.3 above or for any other reason (other than Disability), the date specified in the Notice of Termination (which, in the case of a termination pursuant to Section 3.2 above shall not be less than 30 days, and in the case of a termination pursuant to Section 3.3 above shall not be less than 15 nor more than 60 days, respectively, from the date the Notice of Termination is given). However, if within 15 days after any Notice of Termination is given, or, if later, prior to the Date of Termination (as determined without regard to this provision), the party receiving the Notice of Termination notifies the other party that a dispute exists concerning the termination, then the Date of Termination shall be the date on which the dispute is finally determined, either by mutual written agreement of the parties, by a binding arbitration award, or by a final judgment, order, or decree of a court of competent jurisdiction (which is not appealable or with respect to which the time for appeal has expired and no appeal has been perfected). The Date of Termination shall be extended by a notice of dispute only if the notice is given in good faith and the party giving the notice pursues the resolution of the dispute with reasonable diligence. Notwithstanding the pendency of any such dispute, the Company will continue to pay You your full compensation in effect when the notice giving rise to the dispute was given (including, but not limited to, base salary) and continue You as a participant in all compensation, benefit, and insurance plans in which You were participating when the notice giving rise to the dispute was given, until the dispute is finally resolved in accordance with this Section. Amounts paid under this Section are in addition to all other amounts due under this Agreement and shall not be offset against or reduce any other amounts due under this Agreement.

  • Notice; Effective Date of Termination (a) Termination of Executive’s employment pursuant to this Agreement shall be effective on the earliest of: (i) immediately after the Company gives notice to Executive of Executive’s termination, with or without Cause, unless pursuant to Section 6.3(b)(i), if curable, or Section 6.3(b)(vi), in which case ten (10) days after notice if not cured or unless the Company specifies a later date, in which case, termination shall be effective as of such later date; (ii) immediately upon the Executive’s death; (iii) ten (10) days after the Company gives notice to Executive of Executive’s termination on account of Executive’s Disability, unless the Company specifies a later date, in which case, termination shall be effective as of such later date, provided that Executive has not returned to the full-time performance of Executive’s duties prior to such date; (iv) ten (10) days after the Executive gives written notice to the Company of Executive’s resignation, provided that the Company may set a termination date at any time between the date of notice and the date of resignation, in which case the Executive’s resignation shall be effective as of such other date. Executive will receive compensation through any required notice period; or (v) for a termination for Good Reason, immediately upon Executive’s full satisfaction of the requirements of Section 6.1(f). (b) In the event of a termination for Cause, written confirmation shall specify the subsection(s) of the definition of Cause relied on to support the decision to terminate.

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