Unsubstantiated Claims/Ineligible Expenses Sample Clauses

Unsubstantiated Claims/Ineligible Expenses. If a participant is not able to substantiate a claim, or if payment for an expense is advanced through the debit card and subsequently deemed ineligible for reimbursement, CYC will attempt to collect these amounts from the participant. Where CYC is unsuccessful, Employer will be responsible for collecting such amounts. CYC will make data available to the Employer that identifies the employees and amounts to enable Employer to deduct an amount equal to the unsubstantiated or ineligible reimbursement from the participant's paycheck or to add to the participant’s taxable wages, as allowed by state law.
Sample 1
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Unsubstantiated Claims/Ineligible Expenses. If a Participant is not able to substantiate a claim, or if payment for an expense is advanced through the debit card and subsequently deemed ineligible for reimbursement, Optum will offset against future contributions, and if necessary, attempt to collect these amounts from the Participant. Where Optum is unsuccessful, Customer will be responsible for collecting such amounts. Optum will make data available to the Customer that identifies the employees and amounts to enable Customer to deduct an amount equal to the unsubstantiated or ineligible reimbursement from the Participant's paycheck or to add to the Participant’s taxable wages, as allowed by state law.
Sample 1
Unsubstantiated Claims/Ineligible Expenses. If a Program Participant is not able to substantiate a claim, the claim will be denied. If payment for an expense is advanced through the debit card and subsequently deemed ineligible for reimbursement, Claims Administrator will deny further access to the debit card after first going through a receipt request and substantiation process and will attempt to collect these amounts from the Program Participant. Where Claims Administrator is unsuccessful, Plan Sponsor will be responsible for collecting such amounts in accordance with IRS guidance. Claims Administrator will provide data to the Plan Sponsor identifying the employees and the ineligible amounts to enable Plan Sponsor to deduct an amount equal to the unsubstantiated or ineligible reimbursement from the employee's paycheck, or to add the amount to the Program Participants taxable wages, as allowed by applicable law.
Sample 1
Unsubstantiated Claims/Ineligible Expenses. If a participant is not able to substantiate a claim, SALUSION will offset against future contributions, and if necessary, attempt to collect these amounts from the participant. Where SALUSION is unsuccessful, Employer will be responsible for collecting such amounts. SALUSION will make data available to the Employer that identifies the employees and amounts to enable Employer to deduct an amount iii) equal to the unsubstantiated or ineligible reimbursement from the participant'spaycheck or to add to the participant’s taxable wages, as allowed by state law.
Sample 1

Related to Unsubstantiated Claims/Ineligible Expenses

  • Ineligible Expenses 🗷 Cable television deposits or services. 🗷 Mortgage assistance and utility assistance for homeowners. 🗷 Security and janitorial (salaries and benefits associated with providing security, janitorial services). 🗷 Essential facility equipment and supplies (e.g. common-use toiletries, food served in shelters, bedding, mats, cots, towels, microwave, etc.) 🗷 Expendable transportation costs directly related to the transportation of eligible households (bus tokens and fuel for a shelter van). 🗷 On-site and off-site management costs related to the building. 🗷 Facility-specific insurance and accounting. 🗷 Replacement or operating reserves. 🗷 Debt service. 🗷 Construction or rehabilitation of facilities. 🗷 Mortgage payment for a facility.

  • Eligible Expenses (a) The IESO will provide funding to the Recipient for Eligible Expenses, up to the Maximum Funding Amount, that are evidenced by supporting documentation as set out in this Funding Agreement or as otherwise required by the IESO.

  • Compensation for Reimbursable Expenses 11.8.1 Reimbursable Expenses are in addition to compensation for Basic, Supplemental, and Additional Services and include expenses incurred by the Architect and the Architect’s consultants directly related to the Project, as follows:

  • Disputed Claims 4.1 Notwithstanding paragraph 4.5 of this Schedule, payment by the Authority of all or any part of any invoice rendered or other claim for payment by the Contractor shall not signify approval of such invoice/claim. The Authority reserves the right to verify invoices/claims after the date of payment and subsequently to recover any sums which have been overpaid.

  • Reimbursable Expenses; Maximum Total Payment; Invoicing District will make no payment until this Contract is fully executed by the authorized representatives of both parties.

  • Allowable Expenses Contractor may submit for reimbursement, without mark-up, only the following categories of expense: • •

  • Covered Claims Claim" means any claim, dispute or controversy between you and us that in any way arises from or relates to this Agreement, the Account, the issuance of any Card, any rewards program, any prior agreement or account. "Claim" includes disputes arising from actions or omissions prior to the date any Card was issued to you, including the advertising related to, application for or approval of the Account. "Claim" has the broadest possible meaning, and includes initial claims, counterclaims, cross-claims and third-party claims. It includes disputes based upon contract, tort, consumer rights, fraud and other intentional torts, constitution, statute, regulation, ordinance, common law and equity (including any claim for injunctive or declaratory relief). "Claim" does not include disputes about the validity, enforceability, coverage or scope of this Arbitration Provision or any part thereof (including, without limitation, the prohibition against class proceedings, private attorney general proceedings and/or multiple party proceedings described in Paragraph C.7 (the "Class Action Waiver"), the last sentence of Paragraph

  • Plan Arrangements Eligibility – Claim Types All claim types are eligible to be processed through Inter-Plan Arrangements, as described above, except for all dental benefits, and those prescription drug benefits or vision benefits that may be administered by a third party contracted by us to provide the specific service or services. BlueCard® Program Under the BlueCard® Program, when you receive covered healthcare services within the geographic area served by a Host Blue, BCBSRI will remain responsible for doing what we agreed to in the contract. However, the Host Blue is responsible for contracting with and generally handling all interactions with its participating providers. When you receive covered healthcare services outside our service area and the claim is processed through the BlueCard Program, the amount you pay for covered healthcare services is calculated based on the lower of: • the billed covered charges for your covered services; or • the negotiated price that the Host Blue makes available to BCBSRI. Often, this “negotiated price” will be a simple discount that reflects an actual price that the Host Blue pays to your healthcare provider. Sometimes, it is an estimated price that takes into account special arrangements with your healthcare provider or provider group that may include types of settlements, incentive payments and/or other credits or charges. Occasionally, it may be an average price, based on a discount that results in expected average savings for similar types of healthcare providers after taking into account the same types of transactions as with an estimated price. Estimated pricing and average pricing also take into account adjustments to correct for over- or underestimation of past pricing of claims, as noted above. However, such adjustments will not affect the price we have used for your claim because they will not be applied after a claim has already been paid. Negotiated (non–BlueCard Program) Arrangements With respect to one or more Host Blues, in certain instances, instead of using the BlueCard Program, we may process your claims for covered healthcare services through Negotiated Arrangements for National Accounts. The amount you pay for covered healthcare services under this arrangement will be calculated based on the negotiated price (refer to the description of negotiated price in the BlueCard® Program section above) made available to us by the Host Blue.

  • Claims Payment The Reinsurer will be liable to the Company for its share of the benefits owed under the express contractual terms of the Reinsured Policies and as specified under the terms of this Agreement. The Reinsurer will not participate in any ex gratia payments made by the Company (i.e., payments the Company is not required to make under the Reinsured Policy terms.) The payment of death benefits by the Reinsurer will be in one lump sum regardless of the mode of settlement under the Reinsured Policy. Benefit payments from the Reinsurer will be due within 30 days of the claim satisfying the requirements established under this Agreement. The Reinsurer’s share of any interest payable under the terms of a Reinsured Policy or applicable law which is based on the death benefits paid by the Company, will be payable provided that the Reinsurer will not be liable for interest accruing on or after the date of the Company’s payment of benefits. The Reinsurer will make payment to the Company for each such claim. For Waiver of Premium claims, the Company will continue to pay premiums for reinsurance, except premiums for disability reinsurance. The Reinsurer will pay its proportionate share of the gross premium waived by the Company on the Reinsured Policy, including its share of the premiums for benefits that remain in effect during disability. For claims on Accelerated Benefit riders reinsured under this Agreement, the benefit amount payable by the Reinsurer will be calculated by multiplying the total accelerated death benefit rider payout by the ratio of the reinsured Net Amount at Risk, as defined in Exhibit C-1, to the face amount of the Reinsured Policy.

  • Compensation Claims (a) The Employer agrees to cooperate toward the prompt disposition of employee on-the-job injury claims. The Employer shall provide worker’s compensation protection for all employees even though not required by state law, or the equivalent thereof, if the injury arose out of or in the course of employment. No employee will be disciplined or threatened with discipline as a result of filing an on-the-job injury report. The Employer or its designee shall not visit an injured worker at his/her home, at a hospital or any location outside the employee’s home terminal without his/her consent.

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