Inter-Plan Medicare Advantage Program Sample Clauses

Inter-Plan Medicare Advantage Program. Blue Cross and Blue Shield also participates in the Inter-Plan Medicare Advantage Program, the Inter-Plan Program for Members enrolled in a Medicare Advantage plan. In the event you elect to offer a Medicare Advantage plan to your Medicare-eligible Members, when Medicare Advantage Members access health care services outside of Massachusetts, the claim for those services will be processed through the Inter-Plan Medicare Advantage Program and presented to Blue Cross and Blue Shield for payment in accordance with the rules of the Inter-Plan Medicare Advantage Program policies then in effect. The Inter-Plan Medicare Advantage Program available to Members under this Agreement is described generally as follows. The cost of the covered health care service on which a Member’s cost share liability (such as coinsurance) is based will be either:  The Medicare allowable charge for covered services, or  The amount either Blue Cross and Blue Shield negotiates with the provider or the Host Plan negotiates with its provider on behalf of Blue Cross and Blue Shield members, if applicable. The amount negotiated may be either higher than, lower than, or equal to the Medicare allowable charge.
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Inter-Plan Medicare Advantage Program. Determination of Compliance:
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Inter-Plan Medicare Advantage Program. A Plan shall fully participate in the Inter-Plan Medicare Advantage Program through compliance with all Inter-Plan Medicare Advantage Program Policies and Provisions.
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Inter-Plan Medicare Advantage Program. A Controlled Affiliate shall fully participate in the Inter-Plan Medicare Advantage Program through compliance with all Inter-Plan Medicare Advantage Program Policies and Provisions.
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Related to Inter-Plan Medicare Advantage Program

  • Dependent Care Assistance Program The County offers the option of enrolling in a Dependent Care Assistance Program (DCAP) designed to qualify for tax savings under Section 129 of the Internal Revenue Code, but such savings are not guaranteed. The program allows employees to set aside up to five thousand dollars ($5,000) of annual salary (before taxes) per calendar year to pay for eligible dependent care (child and elder care) expenses. Any unused balance is forfeited and cannot be recovered by the employee.

  • Educational Program a. The educational program of the School (Section 4, Subsection 6 from the original contract and unchanged here) is as follows:

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  • Post-Award Small Business Program Re Representation If applicable, The Contractor shall report timely and accurately their small business program re-representation and update XXX.xxx.

  • PayPal's Seller Protection Program If you sell a good or service to a buyer, you may be eligible for PayPal's Seller Protection program. When it applies, PayPal's Seller Protection program entitles you to retain the full purchase amount. PayPal determines, in its sole discretion, whether your claim is eligible for PayPal’s Seller Protection Program. There is no limit on the number of payments eligible for PayPal's Seller Protection program. By accessing the transaction details page in your PayPal account you can see transactions that may be eligible for protection under this program. The Seller Protection Program terms and conditions are set out in the PayPal’s Seller Protection Program page and form part of this User Agreement.

  • Health Care Spending Account After six (6) months of permanent employment, full time and part time (20/40 or greater) employees may elect to participate in a Health Care Spending Account (HCSA) Program designed to qualify for tax savings under Section 125 of the Internal Revenue Code, but such savings are not guaranteed. The HCSA Program allows employees to set aside a predetermined amount of money from their pay, not to exceed the maximum amount authorized by federal law, per calendar year, of before tax dollars, for health care expenses not reimbursed by any other health benefit plans. HCSA dollars may be expended on any eligible medical expenses allowed by Internal Revenue Code Section 125. Any unused balance is forfeited and cannot be recovered by the employee.

  • E-Verify Program Grantee certifies that it utilizes and will continue to utilize the U.S. Department of Homeland Security's E-Verify system to determine the eligibility of:

  • HEALTH CARE PLANS ‌ Notwithstanding the references to the Pacific Blue Cross Plans in this article, the parties agree that Employers, who are not currently providing benefits under the Pacific Blue Cross Plans may continue to provide the benefits through another carrier providing that the overall level of benefits is comparable to the level of benefits under the Pacific Blue Cross Plans.

  • Health Care Savings Plan As provided in this Agreement, eligible ASF Members will participate in the health care savings plan (HCSP) established under Minnesota Statute 352.98, and as administered by the Plan Administrator. The Employer is responsible only for transferring funds, as specified in this agreement, to the Plan Administrator.

  • Resident Educator Program The four-year program is designed to provide newly licensed Ohio educators quality mentoring and guidance. Successful completion of the residency program is required to advance to a five-year professional educator license.

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