Contractor or MCO definition

Contractor or MCO means the MCO that is a party to this Contract and is an insurer licensed or approved by TDI as an HMO, ANHC formed in compliance with Chapter 844 of the Texas Insurance Code, or an EPO with an Exclusive Provider Benefit Plan approved by TDI in accordance with 28 T.A.C. §3.9201-3.9212. Copayment (CHIP only) means the amount that a Member is required to pay when utilizing certain CHIP Covered Services. Once the copayment is made, further payment is not required by the Member.

Examples of Contractor or MCO in a sentence

  • The Department shall ensure that a participant who is disenrolled receives appropriate choice counseling and is permitted to enroll with a new Contractor or MCO of the participant’s choosing.

  • The Contractor shall provide assistance to any participant electing to terminate his or her enrollment, by making appropriate referrals and providing the individual’s participant record to new providers and/or a participant’s new Contractor or MCO.

  • In other cases, the CBO would be funded through a provider that is part of a VBP arrangement with the BH Primary Contractor or MCO, and so payment would not be going through a claims system.

  • Dollars may come from the MCOs directly or through the network providers in the VBP arrangement with the BH Primary Contractor or MCO.

  • In some cases, payment will be made to a CBO through whatever vendor management/payment process the BH Primary Contractor or MCO has in place.

Related to Contractor or MCO

  • The Contractor or Contractors means the firm, company or person engaged by the SBIIMS to carry out the work. It shall also include their legal representative(s), successors or assigns.

  • Principal of a state contractor or prospective state contractor means (i) any individual who is a member of the board of directors of, or has an ownership interest of five per cent or more in, a state contractor or prospective state contractor, which is a business entity, except for an individual who is a member of the board of directors of a nonprofit organization, (ii) an individual who is employed by a state contractor or prospective state contractor, which is a business entity, as president, treasurer or executive vice president, (iii) an individual who is the chief executive officer of a state contractor or prospective state contractor, which is not a business entity, or if a state contractor or prospective state contractor has no such officer, then the officer who duly possesses comparable powers and duties, (iv) an officer or an employee of any state contractor or prospective state contractor who has managerial or discretionary responsibilities with respect to a state contract, (v) the spouse or a dependent child who is eighteen years of age or older of an individual described in this subparagraph, or (vi) a political committee established or controlled by an individual described in this subparagraph or the business entity or nonprofit organization that is the state contractor or prospective state contractor.

  • Contractor Group means the Contractor, its subcontractors of any tier, its and their respective Affiliates, successors and permitted assignees, and its and their respective directors, officers, employees (including agency personnel);

  • Contractor / Vendor means the Tenderer whose bid has been accepted and awarded Letter of Acceptance for a specific item followed by the signing of Contract.

  • Forced labor or services means labor or services that are performed or provided by another person and are obtained or maintained through coercion.

  • Supplier/Contractor means the individual, firm or company with whom the contract has been concluded for supplying the Goods and Services under the Contract. The Supplier/Contractor shall be deemed to include its successors (approved by the purchaser), representatives, heirs, executors, administrators and permitted;

  • Contractor Parties means a Contractor’s members, directors, officers, shareholders, partners, managers, principal officers, representatives, agents, servants, consultants, employees or any one of them or any other person or entity with whom the Contractor is in privity of oral or written contract (e.g. subcontractor) and the Contractor intends for such other person or entity to perform under the Contract in any capacity. For the purpose of this Contract, vendors of support services, not otherwise known as human service providers or educators, shall not be considered subcontractors, e.g. lawn care, unless such activity is considered part of a training, vocational or educational program.

  • Contractor’s Equipment means all apparatus, machinery, vehicles and other things required for the execution and completion of the Works and the remedying of any defects. However, Contractor’s Equipment excludes Temporary Works, Employer’s Equipment (if any), Plant, Materials and any other things intended to form or forming part of the Equipment.

  • Contractor means the individual or entity, that has entered into this contract with the Commonwealth.

  • Plumbing contractor means a licensed master plumber or a person who employs a licensed master plumber full-time to directly supervise the installation of plumbing as his or her representative engaged in the business of plumbing for a fixed sum, price, fee percentage, valuable consideration, or other compensation and who is licensed as a plumbing contractor.

  • Supplier/Contractor means the individual, firm or company with whom the contract has been concluded for supplying the Goods and Services under the Contract. The Supplier/Contractor shall be deemed to include its successors (approved by the purchaser), representatives, heirs, executors, administrators and permitted;

  • Subcontractor means any supplier, distributor, vendor, or firm that furnishes supplies or services to or for a prime contractor or another subcontractor.

  • Subcontractor employee, as used in this clause, means any officer, partner, employee, or agent of a subcontractor.

  • Contractors means the bidder whose bid has been accepted by the COE;

  • Prospective state contractor means a person, business entity or nonprofit organization that (i) submits a response to a state contract solicitation by the state, a state agency or a quasi-public agency, or a proposal in response to a request for proposals by the state, a state agency or a quasi-public agency, until the contract has been entered into, or (ii) holds a valid prequalification certificate issued by the Commissioner of Administrative Services under section 4a-100. "Prospective state contractor" does not include a municipality or any other political subdivision of the state, including any entities or associations duly created by the municipality or political subdivision exclusively amongst themselves to further any purpose authorized by statute or charter, or an employee in the executive or legislative branch of state government or a quasi-public agency, whether in the classified or unclassified service and full or part-time, and only in such person's capacity as a state or quasi-public agency employee.

  • Covered Personnel means any Person who is or was an employee, consultant or independent contractor of the Covered Parties as of the date of the relevant act prohibited by this Section 2(a) or during the one (1) year period preceding such date.

  • Contractor employee means prime Contractor and subcontractor employees who require agency access to perform work under a CMS contract.

  • Contractor Project Manager means the employee identified in a Statement of Work as the Contractor project manager.

  • Third Party Contractor as used in the Student Data Protection Act and “Operator” as used in COPPA. De-Identified Information (DII): De-Identification refers to the process by which the Contractor removes or obscures any Personally Identifiable Information (“PII”) from Education Records in a way that removes or minimizes the risk of disclosure of the identity of the individual and information about them.

  • Recovered material means waste materials and by-products recovered or diverted from solid waste, but the term does not include those materials and by-products generated from, and commonly reused within, an original manufacturing process.

  • Bidder/Contractor means the interested Firm/ Company/ Supplier/ Distributors that may provide or provides related Equipment/Services to any of the public/private sector organization under the contract and have registered for the relevant business thereof.

  • Contractor System means the information and communications technology system used by the Contractor in performing the Services including the Software, the Contractor Equipment and related cabling (but excluding the Authority System).

  • Contractor Personnel means Contractor’s employees and subcontractors (as well as any employees or subcontractors of those subcontractors) performing the Services.

  • Remedial Work has the meaning assigned such term in Section 8.10(a).

  • Prime Contractor employee, as used in this clause, means any officer, partner, employee, or agent of a prime Contractor.

  • contract worker means a natural person who is —