Acceptability of coverage providers. All coverages required by this section shall be acquired through providers with a Bests' rating of no less than A: VII or through sources that provide an equivalent level of reliability.
Acceptability of coverage providers Sample Clauses
Related to Acceptability of coverage providers
Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII.
Agreement of Coverage or a family member of a Member or the Member’s treating provider only when the Member is unable to provide consent. Adverse determinations eligible for External Review set forth in this section are only those relating to Medical Necessity, appropriateness of service, healthcare service, healthcare setting, or level of care or effectiveness of a healthcare service. HPN will provide the Member notice of such an adverse determination which will include the following statement: HPN has denied your request for the provision or payment of a requested healthcare service or course of treatment. You may have the right to have our decision reviewed by health care professionals who have no association with us if our decision involved making a judgment as to the Medical Necessity, appropriateness, health care setting, level of care or effectiveness of the health care service or treatment you requested, by submitting a request for External Review to the Office for Consumer Health Assistance. Additionally, as per applicable law and regulations, the notice will provide the Member the information outlined herein as well as the following: The telephone number for the Office for Consumer Health Assistance for the state of jurisdiction of the health carrier and the state in which the Member resides. The right to receive correspondence in a culturally and linguistically appropriate manner. The notice to the Member or the Member’s Authorized Representative will also include a HIPAA compliant authorization form by which the Member or the Member’s Authorized Representative can authorize HPN and the Member’s Physician to disclose protected health information (“PHI”), including medical records, that are pertinent to the External Review, and any other forms as required by Nevada law or regulation. The Member or the Member’s Authorized Representative may submit a request directly to OCHA for an External Review of an adverse determination by an Independent Review Organization (“IRO”) within four (4) months of the Member or the Member’s Authorized Representative receiving notice of such determination. The IRO must be certified by the Nevada Division of Insurance. Requests for an External Review must be made in writing and submitted to OCHA at the address below and should include the signed HIPAA authorization form, authorizing the release of your medical records. The entire External Review process and any associated medical records are confidential. Address Office for Consumer Health Assistance 0000 X. Xxxxxx Xxx., Xxxxx 000 Xxx Xxxxx XX 00000 Telephone Number(s) (000) 000-0000 (000) 000-0000 Fax: (000) 000-0000 Website xxx.XXX@xxxxxx.xx.xxx The determination of an IRO concerning an External Review in favor of the Member of an adverse determination is final, conclusive and binding. Upon receipt of the notice of a decision by the IRO reversing an adverse determination, HPN shall immediately approve coverage of the recommended or requested health care service or treatment that was the subject of the adverse determination. The cost of conducting an External Review of an adverse determination will be paid by HPN.
Evidence of Coverage The Contractor shall, upon request by DSHS, submit a copy of the Certificate of Insurance, policy, and additional insured endorsement for each coverage required of the Contractor under this Contract. The Certificate of Insurance shall identify the Washington State Department of Social and Health Services as the Certificate Holder. A duly authorized representative of each insurer, showing compliance with the insurance requirements specified in this Contract, shall execute each Certificate of Insurance. The Contractor shall maintain copies of Certificates of Insurance, policies, and additional insured endorsements for each subcontractor as evidence that each subcontractor maintains insurance as required by the Contract.
Duration of Coverage All required insurance shall be maintained during the entire term of the Agreement. In addition, Insurance policies and coverage(s) written on a claims-made basis shall be maintained during the entire term of the Agreement and until 3 years following the later of termination of the Agreement and acceptance of all work provided under the Agreement, with the retroactive date of said insurance (as may be applicable) concurrent with the commencement of activities pursuant to this Agreement. 3.
Termination of Coverage This Contract may be terminated as follows:
Verification of Coverage Prior to beginning any work under this Agreement, Consultant shall furnish City with certificates of insurance and with original endorsements effecting coverage required herein. The certificates and endorsements for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. The City reserves the right to require complete, certified copies of all required insurance policies at any time.
Fire and Extended Coverage Insurance Landlord agrees to keep in force policies of fire and extended coverage insurance which shall insure the Building against such perils or loss as Landlord may deem appropriate including vandalism and malicious mischief, in an amount equal to one hundred percent (100%) of the replacement cost of the Building and the improvements installed by the Landlord. Pursuant to Paragraph 4 Tenant is obligated to pay Landlord it's proportionate share of any such costs. Tenant agrees to maintain and keep in force, at its expense and throughout the term hereof, insurance against fire and such other risks as are from time-to-time included in standard extended coverage endorsements including vandalism and malicious mischief, insuring Tenant's stock-in-trade, trade fixtures, furniture, furnishings, floor and wall coverings, special equipment and all other items of personal property of Tenant located on or within the Premises and all such other improvements as are made by the Tenant to the Premises. Landlord and Tenant hereby mutually release and discharge the other from loss or damage to the described Premises or the contents, including any improvements and betterments located in or on the described Premises, to the extent such loss or damage is insured by the described fire and extended coverage insurance. Both Landlord and Tenant agree to furnish the other a certificate of insurance evidencing the required fire and extended coverage insurance and giving the certificate holder thirty (30) days notice of intent to cancel, non-renew or amend such insurance. If Tenant elects to satisfy this condition by self insuring, it may do so provided it provides Landlord and Landlord's insurance agent with (1) documentation establishing values of Tenant installed fixtures, furnishings, equipment, inventory and process equipment or other material used in Tenant's operation; (2) provide Landlord with financial statements and other information evidencing Tenant's financial ability to maintain the Premises and contents as self insured and (3) that Landlord's attorney shall prepare an agreement regarding subrogation of claims in the event of a casualty loss of Tenant's fixtures, furnishings and/or inventory.
Engineer Payment of Subproviders No later than ten (10) days after receiving payment from the State, the Engineer shall pay all subproviders for work performed under a subcontract authorized hereunder. The State may withhold all payments that have or may become due if the Engineer fails to comply with the ten-day payment requirement. The State may also suspend the work under this contract or any work authorization until subproviders are paid. This requirement also applies to all lower tier subproviders, and this provision must be incorporated into all subcontracts.
Coverage E – Personal Liability If a claim is made or a suit is brought against an "insured" for damages because of "bodily injury" or "property damage" caused by an "occurrence" to which this coverage applies, we will:
Scope of Coverage 1. This Section shall apply to an investment dispute between a Member State and an investor of another Member State that has incurred loss or damage by reason of an alleged breach of any rights conferred by this Agreement with respect to the investment of that investor.
