Participant Handbook Sample Clauses

Participant Handbook. The CHC-MCO must provide a Participant handbook with information on Participant rights and protections as outlined in this Agreement and Exhibit L, Participant Rights and Responsibilities, and how to access services, in the appropriate language or alternative format to Participants within five (5) business days of a Participant’s Start Date. As directed by the Department, the CHC-MCO must use the Participant handbook template developed by the Department to create a Participant handbook that complies with this section and Exhibit M, Participant handbook. The CHC-MCO may provide the Participant handbook in formats other than hard copy. The CHC-MCO will provide Participants with the handbook in one of the following manners: • A printed copy of the information mailed to the Participant’s mailing address; • By email after obtaining the Participant’s agreement to receive the information by email; • By posting on the CHC-MCO’s website and advising the Participant in paper or electronic form that the information is available on the Internet and including the applicable Internet address, provided that Participants with disabilities who cannot access this information online are provided auxiliary aids and services upon request at no cost; or • By any other method that can reasonably be expected to result in the enrollee receiving that information. The CHC-MCO must inform Participants what formats are available and how to access each format. The CHC-MCO must annually review the Participant handbook and document that it reviewed the Participant handbook for accuracy and that all necessary modifications were made. The CHC-MCO must notify all Participants on an annual basis of any changes made, and the formats and methods available to access the handbook. Upon request, the CHC-MCO must provide a hard copy of the Participant handbook to the Participant.
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Participant Handbook. The CHC-MCO must provide a Participant handbook, or other written materials, with information on Participant rights and protections as outlined in this Agreement and Exhibit FF Participants’ Rights and how to access services, in the appropriate language or alternate format to Participants within five (5) business days of a Participant’s effective date of Enrollment. The CHC-MCO may provide the Participant handbook in formats other than hard copy. If this option is exercised, the CHC-MCO must inform Participants what formats are available and how to access each format. The CHC-MCO must annually review the Participant handbook and document it reviewed the Participant handbook for accuracy and that all necessary modifications were made. The CHC-MCO must notify all Participants on an annual basis of any changes made, and the formats and methods available to access the handbook. Upon request, the CHC-MCO must provide a hard copy of the Participant handbook to the Participant.
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Participant Handbook. The publication prepared by the FIDA-IDD Plan and issued to Participants at the time of Enrollment and annually thereafter to inform them of their benefits and services, how to access health care services, and to explain their rights and responsibilities as a FIDA-IDD Plan Participant.
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Participant Handbook the Electricity Demand Reduction Pilot Scheme: Participant Handbook published by the Department of Energy and Climate Change on 24 October 2014 (version 2.0)5 (or a Revised Version) Peak Applicable Hours each of the following hours:
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Participant Handbook. 17. Provider Directory .............................................................................
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Participant Handbook. The Participant will be provided with a Handbook that described the Provider's policies, procedures, rights and expectations pertaining to the Participant. By signing this Agreement the Participant and Purchaser acknowledges receipt of the Handbook that it has been read, and agrees to comply with all policies, procedures and expectations.
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Participant Handbook. ‌ The CHC-MCO must provide a Participant handbook, or other written materials, with information on Participant rights and protections and how to access services, in the appropriate language or alternate format to Participants within five (5) business days of a Participant’s effective date of Enrollment. The CHC-MCO may provide the Participant handbook in formats other than hard copy. If this option is exercised, the CHC-MCO must inform Participants what formats are available and how to access each format. The CHC- MCO must maintain documentation verifying that the Participant handbook is reviewed for accuracy at least once a year, and that all necessary modifications have been made. The CHC-MCO must notify all Participants on an annual basis of any changes made, and the formats and methods available to access the handbook. Upon request, the CHC-MCO must provide a hard copy version of the Participant handbook to the Member.‌
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Related to Participant Handbook

  • Participant Information My address is: My Social Security Number is:

  • Participant Bound by Plan Participant hereby acknowledges receipt of a copy of the Plan and agrees to be bound by all the terms and provisions thereof.

  • Employee Handbook (A) If the Contractor has an employee handbook, the Contractor shall include the following information:

  • Member Handbook The Contractor shall develop a member handbook for its members. The Contractor’s member handbook shall be submitted annually for OMPP’s review. The member handbook shall include the Contractor’s contact information and Internet website address and describe the terms and nature of services offered by the Contractor, including the following information required under 42 CFR 438.10(f), which enumerates certain required information. The member handbook may be offered in an electronic format as long as the Contractor complies with 42 CFR 438.10(c)(6). The Hoosier Healthwise MCE Policies and Procedures Manual outlines the member handbook requirements. The Hoosier Healthwise member handbook shall include the following:  Contractor’s contact information (address, telephone number, TDD number, website address);  The amount, duration and scope of services and benefits available under the Contract in sufficient details to ensure that participants are informed of the services to which they are entitled, including, but not limited to the differences between the benefit options;  The procedures for obtaining benefits, including authorization requirements;  Contractor’s office hours and days, including the availability of a 24-hour Nurse Call Line;  Any restrictions on the member’s freedom of choice among network providers, as well as the extent to which members may obtain benefits, including family planning services, from out-of-network providers;  The extent to which, and how, after-hours and emergency coverage are provided, as well as other information required under 42 CFR 438.10(f), such as what constitutes an emergency;  The post-stabilization care services rules set forth in 42 CFR 422.113(c);  The extent to which, and how, urgent care services are provided;  Applicable policy on referrals for specialty care and other benefits not provided by the member’s PMP, if any;  Information about the availability of pharmacy services and how to access pharmacy services;  Member rights and protections, as enumerated in 42 CFR 438.100, which relates to enrollee rights. See Section 4.8 for further detail regarding member rights and protections;  Responsibilities of members;  Special benefit provisions (for example, co-payments, deductibles, limits or rejections of claims) that may apply to services obtained outside the Contractor’s network;  Procedures for obtaining out-of-network services;  Standards and expectations to receive preventive health services;  Policy on referrals to specialty care;  Procedures for notifying members affected by termination or change in any benefits, services or service delivery sites;  Procedures for appealing decisions adversely affecting members’ coverage, benefits or relationship with the Contractor;  Procedures for changing PMPs;  Standards and procedures for changing MCEs, and circumstances under which this is possible, including, but not limited to providing contact information and instructions for how to contact the enrollment broker to transfer MCEs due to one of the “for cause” reasons described in 42 CFR 438.56(d)(2)(iv), including, but not limited to, the following:  Receiving poor quality of care;  Failure to provide covered services;  Failure of the Contractor to comply with established standards of medical care administration;  Lack of access to providers experienced in dealing with the member’s health care needs;  Significant language or cultural barriers;  Corrective action levied against the Contractor by the office;  Limited access to a primary care clinic or other health services within reasonable proximity to a member’s residence;  A determination that another MCE’s formulary is more consistent with a new member’s existing health care needs;  Lack of access to medically necessary services covered under the Contractor’s contract with the State;  A service is not covered by the Contractor for moral or religious objections, as described in Section 6.3.3;  Related services are required to be performed at the same time and not all related services are available within the Contractor’s network, and the member’s provider determines that receiving the services separately will subject the member to unnecessary risk;  The member’s primary healthcare provider disenrolls from the member’s current MCE and reenrolls with another MCE; or  Other circumstances determined by the office or its designee to constitute poor quality of health care coverage.  The process for submitting disenrollment requests. This information shall include the following:  Hoosier Healthwise members may change MCEs after the first ninety (90) calendar days of enrollment only for cause;  Members are required to exhaust the MCE’s internal grievance and appeals process before requesting an MCE change ;  Members may submit requests to change MCEs to the Enrollment Broker verbally or in writing, after exhausting the MCE’s internal grievance and appeals process; and  The MCE shall provide the Enrollment Broker’s contact information and explain that the member must contact the Enrollment Broker with questions about the process. This information shall include how to obtain the Enrollment Broker’s standardized form for requesting an MCE change.  The process by which an American Indian/ Alaska Native member may elect to opt-out of managed care pursuant to 42 USC § 1396u–2(a)(2)(C) and transfer to fee-for-service benefits through the State;  Procedures for making complaints and recommending changes in policies and services;  Grievance, appeal and fair hearing procedures as required at 42 CFR 438.10(g)(2)(xi), including the following:  The right to file grievances and appeals;  The requirements and timeframes for filing a grievance or appeal;  The availability of assistance in the filing process;  The toll-free numbers that the member can use to file a grievance or appeal by phone;  The fact that, if requested by the member and under certain circumstances: (1) benefits will continue if the member files an appeal or requests a State fair hearing within the specified timeframes; and (2) the member may be required to pay the cost of services furnished during the appeal if the final decision is adverse to the member.  For a State hearing describe (i) the right to a hearing, (ii) the method for obtaining a hearing, and (iii) the rules that govern representation at the hearing.  Information about advance directives;  How to report a change in income, change in family size, etc.;  Information about the availability of the prior claims payment program for certain members and how to access the program administrator;  Information on alternative methods or formats of communication for visually and hearing-impaired and non-English speaking members and how members can access those methods or formats;  Information on how to contact the Enrollment Broker;  Statement that Contractor will provide information on the structure and operation of the health plan; and  In accordance with 42 CFR 438.10(f)(3), that upon request of the member, information on the Contractor’s provider incentive plans will be provided.

  • Handbook A. The Contractor shall provide beneficiaries with a copy of the handbook and provider directory when the beneficiary first accesses services and thereafter upon request. (Cal. Code Regs., tit. 9, § 1810.360.)

  • Participant Acceptance Participant must accept the terms and conditions of this Agreement either electronically through the electronic acceptance procedure established by the Company or through a written acceptance delivered to the Company in a form satisfactory to the Company. In no event shall any Shares be issued (or other securities or property distributed) under this Agreement in the absence of such acceptance.

  • Participant Loans This Section 10.03[E] specifically authorizes the Trustee to make loans on a nondiscriminatory basis to a Participant or to a Beneficiary in accordance with the loan policy established by the Advisory Committee, provided: (1) the loan policy satisfies the requirements of Section 9.04; (2) loans are available to all Participants and Beneficiaries on a reasonably equivalent basis and are not available in a greater amount for Highly Compensated Employees than for other Employees; (3) any loan is adequately secured and bears a reasonable rate of interest; (4) the loan provides for repayment within a specified time; (5) the default provisions of the note prohibit offset of the Participant's Nonforfeitable Accrued Benefit prior to the time the Trustee otherwise would distribute the Participant's Nonforfeitable Accrued Benefit; (6) the amount of the loan does not exceed (at the time the Plan extends the loan) the present value of the Participant's Nonforfeitable Accrued Benefit; and (7) the loan otherwise conforms to the exemption provided by Code Section 4975(d)(1). If the joint and survivor requirements of Article VI apply to the Participant, the Participant may not pledge any portion of his Accrued Benefit as security for a loan made after August 18, 1985, unless, within the 90 day period ending on the date the pledge becomes effective, the Participant's spouse, if any, consents (in a manner described in Section 6.05 other than the requirement relating to the consent of a subsequent spouse) to the security or, by separate consent, to an increase in the amount of security. If the Employer is an unincorporated trade or business, a Participant who is an Owner-Employee may not receive a loan from the Plan, unless he has obtained a prohibited transaction exemption from the Department of Labor. If the Employer is an "S Corporation," a Participant who is a shareholder-employee (an employee or an officer) who, at any time during the Employer's taxable year, owns more than 5%, either directly or by attribution under Code Section 318(a)(1), of the Employer's outstanding stock may not receive a loan from the Plan, unless he has obtained a prohibited transaction exemption from the Department of Labor. If the Employer is not an unincorporated trade or business nor an "S Corporation," this Section 10.03[E] does not impose any restrictions on the class of Participants eligible for a loan from the Plan. [F] INVESTMENT IN QUALIFYING EMPLOYER SECURITIES AND QUALIFYING EMPLOYER REAL PROPERTY. The investment options in this Section 10.03[F] include the ability to invest in qualifying Employer securities or qualifying Employer real property, as defined in and as limited by ERISA. If the Employer's Plan is a Nonstandardized profit sharing plan, it may elect in its Adoption Agreement to permit the aggregate investments in qualifying Employer securities and in qualifying Employer real property to exceed 10% of the value of Plan assets.

  • Participant Undertaking Participant hereby agrees to take whatever additional action and execute whatever additional documents the Corporation may deem necessary or advisable in order to carry out or effect one or more of the obligations or restrictions imposed on either Participant or the Purchased Shares pursuant to the provisions of this Agreement.

  • Sharing of Participant Information 22 7.4 REPORTING AND DISCLOSURE AND COMMUNICATIONS TO PARTICIPANTS............................22 7.5 NON-TERMINATION OF EMPLOYMENT; NO THIRD-PARTY BENEFICIARIES............................23 7.6

  • Participant See Section 7(a) hereof.

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