Cost-Sharing Reductions Clause Samples
The Cost-Sharing Reductions clause establishes provisions that lower the out-of-pocket expenses, such as deductibles, copayments, and coinsurance, for eligible individuals. Typically, this clause applies to certain health insurance plans and is designed to make healthcare more affordable for people with lower incomes by reducing the amount they must pay when receiving medical services. Its core practical function is to increase access to necessary healthcare by minimizing financial barriers for those who might otherwise be unable to afford care.
Cost-Sharing Reductions reductions as determined by the Exchange in the cost-sharing amounts for which the Member is otherwise responsible to pay under this Agreement.
Cost-Sharing Reductions. With respect to any Service designated as a “Full Service” rate in Section 1 Compensation for Vendor Services, United shall pay to Vendor any cost sharing reduction payment that United has or shall receive pursuant to Section 1402 of the Patient Protection and Affordable Care Act of 2010 (as amended), to the extent that such cost sharing reductions are attributable to Covered Services for which the Vendor is financially responsible under this Agreement.
Cost-Sharing Reductions. Carrier shall reduce an Enrollee’s cost-sharing according to the standard Cost-Sharing Reductions created for the standard silver QHP as described in Appendix 2: Marketplace Guidelines for Standard Plan Cost-Sharing Reductions. Carrier shall file Cost-Sharing variations for each of the following:
3.6.1 Silver QHP variations as described in 45 CFR 156.420;
3.6.2 Zero Cost-Sharing for American Indians/Alaska Natives with household incomes at or below 300% of the federal poverty level; and
3.6.3 Zero Cost-Sharing for items or services furnished directly by the Indian Health Service, an Indian Tribe, a Tribal organization, or an Urban Indian organization or through referral by an Indian Health Service health care provider to an in-network or out-of-network provider for American Indians/Alaska Natives with household incomes above 300% of the federal poverty level.
Cost-Sharing Reductions. Carrier will reduce the enrollee cost-sharing levels according to ACA. Carrier will use the standard Cost-Sharing Reductions created for the standard silver QHP. See Appendix 1: Cover Oregon Guidelines for Standard Plan Cost Sharing Reductions.
Cost-Sharing Reductions. Carrier shall reduce an eligible enrollee’s cost-sharing according to the standard Cost-Sharing Reductions created for the standard silver QHP as described in Appendix 2: Marketplace Guidelines for Standard Plan Cost-Sharing Reductions. Carrier shall file Cost-Sharing variations for each of the following:
3.6.1 Silver QHP variations as described in 45 CFR 156.420;
3.6.2 Zero Cost-Sharing for American Indians/Alaska Natives with household
3.6.3 Zero Cost-Sharing for items or services furnished directly by the Indian Health Service, an Indian Tribe, a Tribal organization, or an Urban Indian organization or through referral under contract health services for American Indians/Alaska Natives with household incomes above 300% of the federal poverty level.
Cost-Sharing Reductions. Carrier shall reduce an eligible enrollee’s cost-sharing according to the standard Cost-Sharing Reductions created for the standard silver QHP as described in Appendix 2: Marketplace Guidelines for Standard Plan Cost-Sharing Reductions. Carrier shall file Cost-Sharing variations for each of the following:
3.6.1 Silver QHP variations as described in 45 CFR 156.420;
3.6.2 Zero Cost-Sharing for American Indians/Alaska Natives with household incomes at or below 300% of the federal poverty level; and
3.6.3 Zero Cost-Sharing for items or services furnished directly by the Indian