Common use of Actuary Clause in Contracts

Actuary. An individual who meets the qualification standards established by the American Academy of Actuaries for an actuary and follows the practice standards established by the Actuarial Standards Board. For purposes of developing and certifying capitation rates, an Actuary refers to an individual who is acting on behalf of the State Advance Directive – Written instructions (such as an advance health directive, a mental health advance directive, a living will, including Five Wishes, or a durable health care power of attorney) recognized under State law (whether statutory or as recognized by the courts of the State), relating to the provision of health care when an individual is incapacitated. Affiliate – Any person, firm, corporation (including, without limitation, service corporation and processional corporation), partnership (including, without limitation, general partnership, limited partnership and limited liability partnership), limited liability company, joint venture, business trust, association or other entity or organization that now or in the future directly or indirectly controls, is controlled by or is under common control with the Contractor. Annual Open Enrollment Period – The period designated by the State from October 1 to October 31 when members can elect to Transfer from one MCO to another MCO without good cause. Appeal – A review by the Contractor of an Adverse Benefit Determination.