Reconsideration If We did not attempt to consult with Your Provider who recommended the Covered Service before making an adverse determination, the Provider may request reconsideration by the same clinical peer reviewer who made the adverse determination or a designated clinical peer reviewer if the original clinical peer reviewer is unavailable. For Preauthorization and concurrent reviews, the reconsideration will take place within one (1) business day of the request for reconsideration. If the adverse determination is upheld, a notice of adverse determination will be given to You and Your Provider, by telephone and in writing.
DISMISSAL, SUSPENSION AND DISCIPLINE 13 11.1 Procedure 13 11.2 Dismissal and Suspension 13 11.3 Burden of Proof 13 11.4 Right to Grieve Other Disciplinary Action 13 11.5 Personnel File 13 11.6 Right to Have Union Representative Present 14 11.7 Abandonment of Position 14 11.8 Probation 14 11.9 Employee Investigations 15 ARTICLE 12 - SENIORITY 15 12.1 Seniority Defined 15 12.2 Seniority List 16 12.3 Loss of Seniority 16 12.4 Re-Employment 17 12.5 Bridging of Service 17 12.6 Same Seniority 17 ARTICLE 13 - LAYOFF AND RECALL 17 13.1 Definition of a Layoff 17 13.2 Pre-Layoff Canvass 17 13.3 Layoff 18 13.4 Bumping 18 13.5 Recall 19 13.6 Advance Notice 19 13.7 Grievance on Layoffs and Recalls 19 13.8 Worksite Closure 19 ARTICLE 14 - HOURS OF WORK 20 14.1 Definitions 20 14.2 Hours of Work 20 14.3 Rest Periods 21 14.4 Meal Periods 22 14.5 Flextime 22 14.6 Staff Meetings 22 (ii) 14.7 Standby Provisions 22 14.8 Conversion of Hours 23 ARTICLE 15 - SHIFTS 23 15.1 Exchange of Shifts 23 15.2 Shortfall of Shifts 23 15.3 Short Changeover Premium 23 15.4 Split Shifts 23 15.5 Work Schedules 23 ARTICLE 16 - OVERTIME 24 16.1 Definitions 24 16.2 Overtime Entitlement 24 16.3 Recording of Overtime 24 16.4 Sharing of Overtime 24 16.5 Overtime Compensation 24 16.6 No Layoff to Compensate for Overtime 24 16.7 Right to Refuse Overtime 25 16.8 Callback Provisions 25 16.9 Rest Interval 25 16.10 Overtime for Part-Time Employees 25 16.11 Authorization and Application of Overtime 25 ARTICLE 17 - HOLIDAYS 26 17.1 Paid Holidays 26 17.2 Holiday Falling on Saturday or Sunday 26 17.3 Holiday Falling on a Day of Rest 26
Reconsiderations and Appeals If you experience a problem relating to an authorization review, benefit denial, or other aspect of this plan, we have internal and external procedures to help you resolve your issue. The following sections detail the processes and procedures for filing: • Administrative Appeals; • Medical Reconsiderations and Appeals (including expedited appeals); • Prescription Drug Appeals: and
Right to Review After receiving written notice of the denial of a claim, a claimant or his representative shall be entitled to:
See Your Right to Reject Arbitration below. For this section, you and us includes any corporate parents, subsidiaries, affiliates or related persons or entities. Claim means any current or future claim, dispute or controversy relating to your Account(s), this Agreement, or any agreement or relationship you have or had with us, except for the validity, enforceability or scope of the Arbitration provision. Claim includes but is not limited to: (1) initial claims, counterclaims, crossclaims and third-party claims;
Suspension and Dismissal In the event an Employee alleges dismissal or suspension without just cause, the Employee may commence a grievance at Step II. The grievance shall be filed within ten (10) days of the occurrence.
DISCIPLINE AND DISMISSAL 6.8.1 The following principles are to be followed when dealing with disciplinary matters:
Duration of Review This Articulation Agreement shall be effective from the date of affixing signatures and is subject to annual review by all parties affixing signatures. Any changes must be written and reflected in a new agreement. If no changes are indicated by the annual review, continuance of this agreement will remain in effect until terminated. Either party may terminate this agreement immediately without cause on 90 days written notice. In the event this agreement is terminated, students who are impacted shall have the opportunity to obtain credit according to the terms herein. Morehead State University ( MSU ) Responsibilities MSU shall be responsible for: ● Ensuring all institutional policies apply to articulated credit courses. ● Ensuring articulated credit is properly documented on postsecondary transcript in accordance with this agreement. ● Providing KDE with current postsecondary primary point of contact information to be published for general inquiries related to this Articulation Agreement and notifying KDE when updates are applicable. Secondary School (K-12) Responsibilities Secondary School (K-12) shall be responsible for: ● Providing detailed information to students in writing (i.e., a syllabus) consistent with the public postsecondary institution policy, which shall include the nature of the course and the expectations and requirements that correspond to its official catalog description. Course requirement information must include course prerequisites, course content, grading policy, attendance requirements, course completion requirements, performance standards, information on adding and dropping courses and other related course information. ● Promoting articulated credit opportunities among qualified high school students, parents and high school faculty. ● Ensuring proper Technical Education Data System (TEDS) data entry is maintained to allow for student testing. ● Ensuring articulated credit documentation (e.g., high school transcript with state course codes identified, CTE EOP assessment certificate(s), industry certification certificate(s)) is provided to the student upon meeting requirements. This document was completed by: bdavis Digitally signed by bdavis Date: 2018.12.10 14:14:21 -05'00' Articulation Agreement Kentucky Department of Education And Xxxxxxxx State University In Reference to Production Crop Career and Technical Education End-of-Program Assessment Agreement Number: AG - 18-19 - 0008 Signature Page The Kentucky Department of Education (KDE) and Morehead State University ( MSU ) enter into this Articulation Agreement on this 10 day of December , 20 18 . This Articulation Agreement shall be effective from the date of affixing signatures and is subject to annual review by all parties affixing signatures. Any changes must be written and reflected in a new agreement. If no changes are indicated by the annual review, continuance of this agreement will remain in effect until terminated. Either party may terminate this agreement immediately for cause or may terminate without cause on 90 days written notice. In the event this agreement is terminated, students who are impacted shall have the opportunity to obtain credit according to the terms herein. In testimony thereof, witness the duly authorized signatures of the parties hereto: Kentucky Department of Education Xxxxx X. Xxxxx, Ph.D. Commissioner of Education Date Morehead State University signed by Xxx Xxxxxx 1/3/2019
Public Hearing 7. In the course of each proceeding, the competent investigating authority shall:
Access to Records The Contractor and its subcontractors, if any, shall maintain all books, documents, papers, accounting records, and other evidence pertaining to all costs incurred under this Contract. They shall make such materials available at their respective offices at all reasonable times during this Contract, and for three (3) years from the date of final payment under this Contract, for inspection by the State or its authorized designees. Copies shall be furnished at no cost to the State if requested.
