Plan Features Sample Clauses

Plan Features. Only Generic Substitutes for prescribed drugs will be covered unless otherwise specified by the prescribing physician.
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Plan Features. Effective July 1, 2014, all plans offered by the City shall have the following features:
Plan Features. You understand and agree to the features, fees, restrictions, terms and conditions of the EBB Plan as stated in this Agreement, the Better Banking Guide for Business and other relevant agreements or schedules executed by you for the EBB Plan. Additional services and amendments to your EBB Plan may be identified in schedules or other documents provided to you by us from time to time, as part of the EBB Plan.
Plan Features. 2.1. Provide repair or replacement in respect of the Mobile Device above caused due to breakdown from manufacturing defects arising during the Contract period.
Plan Features. The selection of Plan options must be consistent with the requirements for the types of Employer Contributions permitted under the Plan. For example: ADP Test Safe Harbor: Any Employer ADP Test Safe Harbor Contribution must be allocated to all Eligible Employees who have reached age 21 and have at least one Year of Service consisting of 1000 hours during any Eligibility Computation Period.
Plan Features. The Maxim Stock Incentive Plan authorizes the issuance of up to 9,000,000 shares of Maxim Common Stock pursuant to the grant or exercise of stock options (including ISOs), SARs, restricted stock and performance units, but not more than 3,000,000 shares may be issued as restricted stock. No single participant may be granted awards pursuant to the Maxim Stock Incentive Plan covering in excess of 600,000 shares of Maxim Common Stock in any one calendar year and no participant may be granted performance units in any one calendar year payable in cash in an amount that would exceed $2,000,000. Subject to the foregoing limits, the shares available under the Maxim Stock Incentive Plan can be allocated among the various types of awards and among the participants as the Maxim Compensation Committee deems appropriate. The shares subject to grant under the Maxim Stock Incentive Plan are to be made available from authorized but unissued shares or from treasury shares as determined from time to time by the Maxim Board. Awards may be granted for such terms as the Maxim Compensation Committee may determine, except that the term of an ISO may not 103 exceed ten years from its date of grant. No awards outstanding on the termination date of the Maxim Stock Incentive Plan shall be affected or impaired by such termination. Awards will not be transferable, except by will and the laws of descent and distribution and, in the case of nonqualified stock options and any related SARs, as a gift to an optionee's children. The Maxim Compensation Committee will have broad authority to fix the terms and conditions of individual agreements with participants. As indicated above, several types of stock-related grants can be made under the Maxim Stock Incentive Plan. A summary of these grants is set forth below: STOCK OPTIONS. The Maxim Stock Incentive Plan authorizes the Maxim Compensation Committee to grant options to purchase Maxim Common Stock at an exercise price (the "option price") to be determined by the Committee. The Maxim Stock Incentive Plan permits optionees, with the approval of the Maxim Compensation Committee, to pay the exercise price of options in cash, stock (valued at its fair market value on the date of exercise) or a combination thereof. As noted above, options may be granted either as ISOs or nonqualified options. The principal difference between ISOs and nonqualified options is their tax treatment. See "-- Certain Federal Income Tax Consequences."
Plan Features. The Maxim MIC Plan provides for the payment of incentive awards to participants designated by the Maxim Compensation Committee, which payments may be conditioned upon the attainment of pre-established performance goals or upon such other factors or criteria as the Maxim Compensation Committee shall determine. Such performance goals may be different for each participant. Bonus amounts are determined by multiplying a participant's "Target Incentive Award" by a percentage which varies depending on the extent to which the performance goals or other factors or criteria are satisfied. A participant's Target Incentive Award, in turn, is determined by multiplying such participant's base salary as of the last day of the applicable Incentive Period by a percentage designated by the Maxim Compensation Committee, in its sole discretion, which percentage need not be the same for each participant (and which may exceed 100%). The Maxim Compensation Committee may, in its sole discretion, increase or decrease the amount of any incentive awards payable to a participant and may, in recognition of special circumstances, pay incentive awards even if not earned, provided that the Maxim Compensation Committee cannot increase the amount of any incentive awards payable to certain designated "Covered Employees." Incentive awards payable under the Maxim MIC Plan to certain designated "Covered Employees" are subject to special restrictions described in the following section. Incentive awards are payable in cash, shares of Maxim Common Stock or in such other form as the Maxim Compensation Committee may determine.
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Plan Features. Retirement Division ⬝ As per the current retirement division. Major Medical (Extended Health Care) Premium Cost Sharing ⬝ As per the Collective Agreement. Waiting Period ⬝ Full-time: 1st of the month following date of hire. ⬝ Part-time: as per the Collective Agreement. Participation Basis ⬝ Employee coverage: compulsory (except for opting out provisions as set out in the benefits contract). ⬝ Dependent coverage: not compulsory. Required Number of Hours ⬝ As per the Collective Agreement. Deductible ⬝ $15 single / $25 family for drug expenses. ⬝ Nil for all other expenses. Combined Maximum ⬝ Unlimited. Coinsurance: ⬝ Drugs ⬝ Hospital ⬝ Vision ⬝ Other Eligible Expenses ⬝ 100%. ⬝ 100%. ⬝ 100%. ⬝ 80% professional and paramedical services, 100% for all other expenses. ⬝ Drug Features ⬝ Drugs available only by prescription (plus certain life- sustaining drugs that do not legally require a subscription). ⬝ Pay direct drug card. ⬝ Includes claims management features such as dynamic maintenance, generic drug substitution and reasonable and customary pharmacy mark-up and dispensing fee maximums by province. ⬝ Hospital Room ⬝ Private or semi-private. ⬝ Nursing Care ⬝ Max $25,000 per person every 3 years. ⬝ Paramedical: ⮡ Psychologist/Social Worker/Psychotherapist ⮡ Chiropractor ⮡ Osteopath ⮡ Naturopath ⮡ Podiatrist ⮡ Speech TherapistMassage Therapist ⮡ Acupuncture ⮡ Physiotherapist - 80% paramedical services to applicable maximum ⬝ Max $1,500 per person per year. ⬝ Max $500 per person per year. ⬝ Max $500 per person per year.* ⬝ Max $500 per person per year.* ⬝ Max $500 per person per year.* ⬝ Max $500 per person per year. ⬝ Max $500 per person per year. ⬝ Max $500 per person per year. ⬝ Max $500 per person per year.

Related to Plan Features

  • In-Service Programs The parties to this collective agreement recognize the value of in-service education both to the employee and the Employer.

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

  • Incentive Programs During the Term of Employment, the ------------------ Executive shall be entitled to participate in any annual and long-term incentive programs adopted by the Company and which cover employees in positions comparable to that of the Executive.

  • Value-Based Programs If you receive covered healthcare services under a Value-Based Program inside a Host Blue’s service area, you will not be responsible for paying any of the Provider Incentives, risk-sharing, and/or Care Coordinator Fees that are a part of such an arrangement, except when a Host Blue passes these fees to us through average pricing or fee schedule adjustments. The following defined terms only apply to the BlueCard section only: • Care Coordinator Fee is a fixed amount paid by us to providers periodically for Care Coordination under a Value-Based Program. • Care Coordination is organized, information-driven patient care activities intended to facilitate the appropriate responses to an enrolled member’s healthcare needs across the continuum of care. • Value-Based Program (VBP) is an outcomes-based payment arrangement and/or a coordinated care model facilitated with one or more local providers that is evaluated against cost and quality metrics/factors and is reflected in provider payment. • Provider Incentive is an additional amount of compensation paid to a healthcare provider by us, based on the provider’s compliance with agreed-upon procedural and/or outcome measures for a particular group of covered persons. Inter-Plan Programs: Federal/State Taxes/Surcharges/Fees Federal or state laws or regulations may require a surcharge, tax or other fee that applies to insured accounts. If applicable, we will include any such surcharge, tax or other fee as part of the claim charge passed on to you. Nonparticipating Providers Outside Our Service Area • Enrolled Member Liability Calculation When covered healthcare services are provided outside of BCBSRI service area by nonparticipating providers, the amount an enrolled member pays for such services will generally be based on either the Host Blue’s nonparticipating provider local payment or the pricing arrangements required by applicable law. In these situations, the enrolled member may be responsible for the difference between the amount that the nonparticipating provider bills and the payment BCBSRI will make for the covered services as set forth in this paragraph. Federal or state law, as applicable, will govern payments, including but not limited to, emergency services, air ambulance services, and certain covered healthcare services rendered by a nonparticipating provider. • Exceptions In some exception cases, BCBSRI may pay claims from nonparticipating healthcare providers outside of BCBSRI service area based on the provider’s billed charge. This may occur in situations where an enrolled member did not have reasonable access to a participating provider, as determined by BCBSRI. In other exception cases, BCBSRI may pay such claims based on the payment BCBSRI would pay to a local nonparticipating provider (as described in the above subsection “How Non-network Providers Are Paid”). This may occur where the Host Blue’s corresponding payment would be more than BCBSRI in-service area nonparticipating provider payment. BCBSRI may choose to negotiate a payment with such a provider on an exception basis. Unless otherwise stated, in any of these exception situations, the enrolled member may be responsible for the difference between the amount that the nonparticipating healthcare provider bills and payment BCBSRI will make for the covered services as set forth in this paragraph. Blue Cross Blue Shield Global® Core If you are outside the United States (hereinafter “BlueCard service area”), you may be able to take advantage of the Blue Cross Blue Shield Global Core when accessing covered healthcare services. The Blue Cross Blue Shield Global Core is unlike the BlueCard Program available in the BlueCard service area in certain ways. For instance, although the Blue Cross Blue Shield Global Core assists you with accessing a network of inpatient, outpatient and professional providers, the network is not served by a Host Blue. As such, when you receive care from providers outside the BlueCard service area, you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services. • Inpatient Services: In most cases, if you contact the service center for assistance, hospitals will not require you to pay for covered inpatient services, except for your cost-share amounts/deductibles, coinsurance, etc. In such cases, the hospital will submit your claims to the service center to begin claims processing. However, if you paid in full at the time of service, you must submit a claim to receive reimbursement for covered healthcare services. • Outpatient Services: Physicians, urgent care centers and other outpatient providers located outside the BlueCard service area will typically require you to pay in full at the time of service. You must submit a claim to obtain reimbursement for covered healthcare services. Preauthorization may be required for outpatient services. • Submitting a Blue Cross Blue Shield Global Core Claim: When you pay for covered healthcare services outside the BlueCard service area, you must submit a claim to obtain reimbursement. For institutional and professional claims, you should complete a Blue Cross Blue Shield Global Core claim form and send the claim form with the provider’s itemized bill(s) to the service center (the address is on the form) to initiate claims processing. Following the instructions on the claim form will help ensure timely processing of your claim. The claim form is available from BCBSRI, the service center or online at xxx.xxxxxxxxxxxxxx.xxx. If you need assistance with your claim submission, you should call the service center at 0.000.000.XXXX (2583) or call collect at 0.000.000.0000, 24 hours a day, seven days a week.

  • Prescription Drug Plan Effective January 1, 2022, retail and mail order prescription drug copays for bargaining unit employees shall be as follows: Type of Drug Prescriptions for 1-45 Days (1 copay) Prescriptions for 46-90 Days (2 copays) Generic drug $10 $20 Preferred brand name drug $25 $50 Non- referred brand name drug $40 $80 Effective January 1, 2022, for each plan year the Prescription Drug annual out-of-pocket copay maximum shall be $1,000 for individual coverage and $1,500 for employee and spouse, employee and child, or employee and family coverage.

  • Incentive Program Members who are rated as either Level I, Level II or Level III in every phase of the Physical Fitness Test are eligible to participate in the Incentive Program.

  • Drug Plan 42.01 The parties agree to the continuation of the Drug Care plan as follows:

  • Prescription Plan The PPO plan will include a comprehensive prescription 37 program: 38

  • System for Award Management (XXX) and Data Universal Numbering System (DUNS) Requirements.

  • The Program The Program is a comprehensive commercial energy efficiency program that offers financial incentives and financing for qualifying energy efficiency measures in commercial buildings to customers who are property owners, tenants or managers (customers) of ACE in New Jersey. Customers must receive ACE electric delivery service and be in good standing. Incentives are available to customers for the purchase and installation of qualifying energy-efficiency measures at the location where the qualifying project is to be installed. XXX will not offer financial incentives for the same eligible measure to those customers who have received financial incentives or rebates from other ACE energy efficiency programs.

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