Monthly Eligibility File Sample Clauses

Monthly Eligibility File. Guarantee: Preferred Provider guarantees that 100% of eligibility updates (defined as the number of electronic eligibility files updated) will be processed within 24 hours of receipt of complete and accurate data (if a file requires adjustments, the customer will be notified by email as soon as the need is identified). Definition: Complete enrollment/eligibility data is defined as employee name, address, provider selection, DOB, SSN, and covered dependent information if applicable, as well as mutually agreed upon eligibility specifications. The guarantee is contingent upon the file being transmitted successfully to Preferred Provider (files received after 12:00 Noon EST will be considered as having been received on the next business day). Any eligibility file received which must be adjusted by Preferred Provider using a file fix will not be included in the reconciliation. The Electronic Report (ELR) will be used to determine the completeness of the data provided by Group. Measurement and Penalty: Preferred Provider shall pay Group $ for failure to meet the standard outlined in the chart in Exhibit I-C, following receipt of a complete and accurate file, to an annual maximum amount of $ annually. Preferred Provider’s results will be used to determine whether the terms of the guarantee have been met.
Sample 1
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Related to Monthly Eligibility File

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  • 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.

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  • Full Employer Contribution - Basic Eligibility Employees covered by this Agreement who are scheduled to work at least seventy-five (75) percent of the time are eligible for the full Employer Contribution. This means:

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  • Partial Employer Contribution - Basic Eligibility The following employees covered by this Agreement receive the full Employer Contribution for basic life coverage, and at the employee's option, a partial Employer Contribution for health and dental coverages if they are scheduled to work at least fifty (50) percent but less than seventy-five (75) percent of the time. This means:

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