Plan Name. Mainstream Base Period: CY '93 Plan Number: Rate Period: 7/95 - 5/96 County: Riverside Capitation Payable: End of Month Aid Code: Aged
Plan Name. Mainstream Base Period: CY '93 Plan Number: Rate Period: 6/96 - 9/97 County: San Bernardino Capitation Payable: End of Month Aid Code: Family Phys Pharm HIP HOP LTC Other Total Units per 1,000 eligibles 3.816 4.223 .370 2.232 .000 3.330 Age/sex Adjustment 1.026 .997 1.040 1.019 1.000 1.010 Aid Code Adjustment .989 .990 .985 .995 1.000 .976 Adjusted Units 3.872 4.168 .379 2.263 .000 3.283 Average Cost Per Unit 71.93 14.73 880.94 21.79 369.03 28.02 Area Adjustment 1.013 1.000 1.000 1.000 1.000 1.000 Adjusted Cost $ 72.87 $ 14.73 $ 800.94 $ 21.79 $ 369.03 $ 28.02 Interest Adjustment .997 1.000 .994 .997 .997 .997 Contract Cost per Eligible $ 281.31 $ 61.39 $ 331.87 $ 49.16 $ .00 $ 91.71 $ 815.44 Benefit Adjustments FY 94/95 1.003 .852 1.030 1.003 1.042 1.013 FY 95/96 1.000 .724 1.018 1.000 1.020 .976 Trend Adjustment 7/93 - 1/97 1.036 1.313 1.060 .925 1.000 1.454 Annual Cost Per Eligible $ 292.31 $ 49.72 $ 368.86 $ 45.61 $ .00 $ 131.84 $ 888.34 Mental Health Adjustment 1.4% 6.0% 6.6% 5.0% l.5% 4.5% Eyewear Adjustment 1.5% Cost Excluding Mental Health $ 288.22 $ 46.74 $ 344.52 $ 43.33 $ .00 $ 124.02 $ 846.83 Preliminary Monthly Rate $ 70.57 Adj. for Fee-for-Service Limitation -2.0% $ -1.41 CHDP 2.43 Final Rate $ 71.59 Attachment I
Plan Name. Enter the name of the Health Plan.
Examples of Plan Name in a sentence
Here’s a sample UnitedHealthcare member ID card to show you what yours will look like: Your UnitedHealthcare Plan Name (XXX) Sample A.
Sample Plan: Name, Title of person responsible for monitoring contract services, will meet with Contractor before the event to recap and ensure the deliverables are provided satisfactorily and the intended objectives are met.
Plan Name: The Cafeteria Plan of the School Board of Orange County Plan Type: Premium Conversion PlanEffective Date of the Plan: April 1, 1989 Company, Plan Sponsor, and Plan Administrator: The School Board of Orange County, Florida Address: 445 W.
Plan Name Please indicate how you have acquired the money you are investing: Accumulated savings Employment related e.g. bonus InheritanceTransfer from another providerPension lump sum Property saleReinvestment of matured funds Other (please describe) Please indicate method of payment: Cheque Please make your cheque payable to Meteor Investment Management Limited Client Account.
All hirers and sub-lessees are required to hold a Hall Hirers Public Liability Certificate for each and every hire.
More Definitions of Plan Name
Plan Name. Mainstream Base Period: CY '93 Plan Number: Rate Period: 6/96 - 9/97 County: San Bernardino Capitation Payable: End of Month Aid Code: Adult Phys Pharm HIP HOP LTC Other Total Units per 1,000 eligibles 22.752 5.069 3.590 4.465 .000 20.412 Age/sex Adjustment 1.000 1.000 1.000 1.000 1.000 1.000 Aid Code Adjustment 1.000 1.000 1.000 1.000 1.000 1.000 Adjusted Units 22.752 5.069 3.590 4.465 .000 20.412 Average Cost Per Unit 59.80 16.00 960.30 20.51 .00 43.66 Area Adjustment 1.013 1.000 1.000 1.000 1.000 1.000 Adjusted Cost $ 60.58 $ 16.00 $ 960.30 $ 20.51 $ .00 $ 43.66 Interest Adjustment .996 .999 .995 .993 .996 .995 Contract Cost per Eligible $ 1,372.80 $ 81.02 $ 3,430.24 $ 90.94 $ .00 $ 886.73 $ 5,861.73 Benefit Adjustments FY 94/95 1.003 .852 1.035 1.003 1.042 1.013 FY 95/96 1.000 .724 1.018 1.000 1.020 1.000 Trend Adjustment 7/93 - 1/97 1.099 1.023 1.126 1.169 1.000 1.195 Annual Cost Per Eligible $ 1,513.23 $ 51.13 $ 4,069.59 $ 106.63 $ .00 $ 1,073.42 $ 6,814.00 Mental Health Adjustment .1% 2.2% .3% 1.1% .0% .1% Eyewear Adjustment .4% Cost Excluding Mental Health $ 1,511.72 $ 50.01 $ 4,057.38 $ 105.46 $ .00 $ 1,068.06 $ 6,792.63 Preliminary Monthly Rate $ 566.05 Adj. for Fee-for-Service Limitation -2.0% $ -11.32 CHDP .00 Final Rate $ 554.73 Attachment I
Plan Name shall be HAMPSHIRE GROUP, LIMITED AND SUBSIDIARIES 401(k) RETIREMENT SAVINGS PLAN.
Plan Name. PSW Profit Sharing Plan ("Plan") The Employer should use this form to notify Fidelity of its intention to designate the above-referenced plan as an ERISA Section 404(c) plan. The Employer should refer to the ERISA Section 404(c) Information Guide before making an election below. Check one: |X| The Employer designates the Plan as an ERISA Section 404(c) plan. Fidelity will include the Notice of Limited Liability in the Plan Highlights brochure and Summary Plan Description. |_| The Employer does not designate the Plan as a 404(c) plan. o "Employer" By: /s/ Xxxxxxx Xxxxx Xxxx Date: 9/26/96 Title: President Please return to Fidelity with executed Adoption Agreement. [LOGO] ================================================================================ [Stamp] SEP 27 1996 ================================================================================ The CORPORATEplan FOR RETIREMENT(SM) Request for Waiver of Sales Charge
Plan Name. Smoker Code: Rider Name: Smoker Code: Life Rates: Reserve Basis:
Plan Name. Peet's Coffee & Tea, Inc. Savings & Retirement Plan. _______________________________________________________ Implementation Date: 04/01/1999 Number of Eligible Employees: 331 --- Number of Participants: __________ Select One: [_] Start-up Plan [X] Conversion Plan or Start-up Plan with assets transferred from another Plan.
Plan Name. Trust or Custodial Account Number: __________________________________ Address: ____________________________________________________________ Attn: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ Phone Number: _______________________________________________________ Delivery Technique ___ Mail check to receiving Qualified Plan or IRA. ___ Provide a check to me for delivery to receiving Qualified Plan or IRA. Check will only be negotiable by the receiving Qualified Plan or IRA.
Plan Name. IRA Custodial Account FFN: 50143000000-007 Case: 9070037 EIN: 00-0000000 Letter Serial No: D111853b NEW ENGLAND MUTUAL LIFE INSURANCE CO. 000 XXXXXXXX XXXXXX XXXXXX, XX 00000 DEPARTMENT OF THE TREASURY