Where a Participating Insurer Sample Clauses

Where a Participating Insurer s denial pattern is determined by the Partnership program office to require explanation, the Partnership program office shall contact the Participating Insurer to determine any special considerations that may affect the Participating Insurer's level of denials and account for the pattern of denials. Where no satisfactory explanation is determined, or where the Participating Insurer continues to demonstrate similar denial patterns in the future, the Partnership program office shall forward the matter to the New York State Department of Financial Services for further review of the need for remedial or regulatory action.
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Related to Where a Participating Insurer

  • Non-Participation in Insurance Your initials on this clause of the Agreement acknowledges the Patient’s understanding that neither the CLINIC, nor its Physician, participate in any health insurance or HMO plans or panels and cannot accept Medicare eligible patients. We make no representations that any fees that You pay under this Agreement are covered by your health insurance or other third party payment plans. It is the Patient’s responsibility to determine whether reimbursement is available from a private, non-governmental insurance plan and to submit any required billing. (Initial)

  • Qualifying Insurers For insurance to satisfy the requirements of this section, all required insurance must be issued by an insurer with an A.M. Best rating of A - or better that is approved to do business in the State of California.

  • Self-insured programs and self-insured retentions Approval. Any self-insurance program, or self-insured retention must be approved separately in writing by the District's Risk Manager and shall protect the District, its Board of Trustees, and their officials, employees, volunteers, and agents in the same manner and to the same extent as they would have been protected had the policy or policies not contained such self-insurance or self- insured retention provisions.

  • Retiree Insurance 12.1 Employees who retire must meet the following conditions at the time of retirement in order to be eligible for the Employer contributions, listed in Sections 12.2 through 12.5 below, toward a health insurance plan offered by the Employer:

  • Insurers The Contractor shall obtain insurance from insurance companies identified as an admitted insurer/carrier in the State of Washington, with a Best’s Reports’ rating of B++, Class VII, or better. Surplus Lines insurance companies will have a rating of A-, Class VII, or better.

  • Approved Insurer Each insurance policy shall be:

  • Developer’s Insurance Developer shall comply with the insurance requirements as indicated in the Facilities Lease.

  • Employer Policies Employees shall be governed by written policies adopted by the Employer as publicized on bulletin boards, or by general distribution, provided such policies are not in conflict with the provisions of this Agreement.

  • Written Employee Jury Service Policy 1. Unless the Contractor has demonstrated to the County’s satisfaction either that the Contractor is not a “Contractor” as defined under the Jury Service Program (Section 2.203.020 of the County Code) or that the Contractor qualifies for an exception to the Jury Service Program (Section 2.203.070 of the County Code), the Contractor shall have and adhere to a written policy that provides that its Employees shall receive from the Contractor, on an annual basis, no less than five days of regular pay for actual jury service. The policy may provide that Employees deposit any fees received for such jury service with the Contractor or that the Contractor deduct from the Employee’s regular pay the fees received for jury service.

  • Independent Contractor; Workers’ Compensation Insurance The Contractor is performing as an independent entity under this Contract. No part of this Contract shall be construed to represent the creation of an employment, agency, partnership or joint venture agreement between the parties. Neither party will assume liability for any injury (including death) to any persons, or damage to any property, arising out of the acts or omissions of the agents, employees or subcontractors of the other party. The Contractor shall provide all necessary unemployment and workers’ compensation insurance for the Contractor’s employees, and shall provide the State with a Certificate of Insurance evidencing such coverage prior to starting work under this Contract.

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