Additional Eligibility Parameters Sample Clauses

Additional Eligibility Parameters. Hospice. Enrollees who elect to enroll in the Hospice program while enrolled are not required to disenroll from the MCO’s SNBC SNP product. End Stage Renal Disease. SNBC SNP Enrollees who are identified by CMS as having ESRD after enrollment are not required to disenroll from the MCO’s SNBC SNP product. Individuals who develop ESRD while enrolled in a health plan (for example, a commercial or group health plan, or a Medicaid plan) offered by the MCO are eligible to elect the Medicare Advantage plan offered by that MCO. In order to be eligible, there must be no break in coverage between enrollment in the MCO, and the start of coverage in the Medicare Advantage plan offered by the same MCO. An individual who elects the SNBC SNP plan and who is medically determined to first have ESRD after the date on which the enrollment form is signed (or receipt date stamp if no date is on the form), but before the effective date of coverage under the SNBC SNP plan is still eligible to elect the SNBC SNP plan. Spenddown. SNBC SNP and SNBC non-SNP Enrollees who are enrolled into SNBC prior to acquiring a Medical Spenddown are not required to disenroll from SNBC provided the Enrollee agrees to pay the Medical Spenddown to the STATE on a monthly basis. Until further notice, the STATE will not enroll new Enrollees with Medical Spenddowns into SNBC. However, Potential Enrollees residing in a nursing facility and coded with a Medical (rather than Institutional) Spenddown because they have elected Hospice may be enrolled. Enrollees with a Medical Spenddown who are already enrolled in the MCO as of the effective date of this Contract are not required to disenroll from SNBC, subject to the payment of spenddown described in section 3.2.2(A)(5).
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Additional Eligibility Parameters 
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Related to Additional Eligibility Parameters

  • Service Eligibility Criteria 4.3.4.1 High capacity EELs must comply with the following service eligibility requirements:

  • Eligibility Changes Employees who become eligible for a full Employer Contribution must make their benefit elections within thirty (30) calendar days of becoming eligible. If employees do not choose a health plan administrator and a primary care clinic and do not waive coverage within this thirty (30) day timeframe, they will be enrolled in a Benefit Level Two clinic (or Level One, if available) that meets established access standards in the health plan with the largest number of Benefit Level One and Two clinics in the county of the employee’s residence at the beginning of the insurance year. If employees who become eligible for a partial Employer Contribution choose to enroll in insurance, they must do so within thirty (30) days of becoming eligible or during open enrollment. An employee may change their health or dental plan if the employee changes to a new permanent work or residence location and the employee's current plan is no longer available. If the employee has family coverage and if the new residence location is outside of the current plan’s service area, the employee shall be permitted to switch to a new plan administrator and new Benefit Level within thirty (30) days of the residence location change. The election change must be due to and correspond with the change in status. An employee who receives notification of a work location change between the end of an open enrollment period and the beginning of the next insurance year, may change their health or dental plan within thirty (30) days of the date of the relocation under the same provisions accorded during the last open enrollment period. An employee or retiree may also change health or dental plans in any other situation in which the Employer is required by the applicable federal or state law to allow a plan change.

  • Special Eligibility The following employees also receive an Employer Contribution:

  • Funding Eligibility Contractor understands, acknowledges, and agrees that, pursuant to Chapter 2272 (eff. Sept. 1, 2021, Ch. 2273) of the Texas Government Code, except as exempted under that Chapter, HHSC cannot contract with an abortion provider or an affiliate of an abortion provider. Contractor certifies that it is not ineligible to contract with HHSC under the terms of Chapter 2272 (eff. Sept. 1, 2021, Ch. 2273) of the Texas Government Code.

  • General Eligibility 1. Except as provided in #2 below, a teacher who received an evaluation rating of ineffective or improvement necessary in the prior school year is not eligible for any salary increase and remains at their prior year salary.

  • Benefit Eligibility For purposes of the Benefit Plan entitlement, common-law and same sex relationships will apply as defined.

  • ELIGIBILITY CONDITIONS The eligibility conditions specified in Adoption Agreement Section 2.01 are effective for Plan Years beginning after _______________________.

  • Qualification Criteria The College may offer or an employee may request an early retirement incentive provided the employee meets the following qualifications:

  • Continuing Eligibility To continue health benefits, a permanent intermittent employee must be credited with a minimum of 480 paid hours in a control period or 960 paid hours in two consecutive control periods.

  • Requesting Price Increase/Required Documentation Contractor must submit a written notification at least thirty (30) calendar days prior to the requested effective date of the change, setting the amount of the increase, along with an itemized list of any increased prices, showing the Contractor’s current price, revised price, the actual dollar difference and the percentage of the price increase by line item. Price change requests must include H-GAC Forms D Offered Item Pricing and E Options Pricing, or the documentation used to submit pricing in the original Response and be supported with substantive documentation (e.g. manufacturer's price increase notices, copies of invoices from suppliers, etc.) clearly showing that Contractor's actual costs have increased per the applicable line item bid. The Producer Price Index (PPI) may be used as partial justification, subject to approval by H-GAC, but no price increase based solely on an increase in the PPI will be allowed. This documentation should be submitted in Excel format to facilitate analysis and updating of the website. The letter and documentation must be sent to the Bids and Specifications manager, Xxxxxxx Xxxxxx, at Xxxxxxx.Xxxxxx@x-xxx.xxx Review/Approval of Requests If H-GAC approves the price increase, Contractor will be notified in writing; no price increase will be effective until Contractor receives this notice. If H-GAC does not approve Contractor’s price increase, Contractor may terminate its performance upon sixty (60) days advance written notice to H-GAC, however Contractor must fulfill any outstanding Purchase Orders. Termination of performance is Contractor’s only remedy if H-GAC does not approve the price increase. H-GAC reserves the right to accept or reject any price change request.

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