PLAN PROVIDERS Sample Clauses
PLAN PROVIDERS. 2.1 All references to Plan Providers, Plan Medical Groups, Plan Hospitals, and Plan Physicians refer to providers and facilities in the selected Plan Network(s), as identified on the Execution Page of this Agreement.
PLAN PROVIDERS. A list of the names and locations of Plan Providers in the selected Plan Network is contained in the Provider Directory, which may be obtained by calling Plan at ▇▇▇-▇▇▇-▇▇▇▇ or ▇-▇▇▇-▇▇▇-▇▇▇▇.
PLAN PROVIDERS. Except for Emergency Services and Out-of-Area Urgent Care Services, each Member must receive Benefits from Plan Providers affiliated with the PMG selected by or for the Member. In the event Benefits are not available from such Plan Providers, the Member will be referred to another Plan Provider to receive such Benefits. If services for the medically necessary treatment of a mental health or substance use disorder are not available in network within the geographic and timely access standards set by law or regulation, the health care service plan shall arrange coverage to ensure the delivery of medically necessary out-of-network services and any medically necessary follow-up services that, to the maximum extent possible, meet those geographic and timely access standards. As used in this subdivision, to “arrange coverage to ensure the delivery of medically necessary out-of-network services” includes, but is not limited to, providing services to secure medically necessary out-of-network options that are available to the enrollee within geographic and timely access standards. The enrollee shall pay no more than the same cost sharing that the enrollee would pay for the same covered services received from an in-network provider.
PLAN PROVIDERS. Except for Emergency Services and Out-of-Area Urgent Care Services, each Member must receive Benefits from Plan Providers affiliated with the Plan Medical Group selected by or for the Member. In the event Benefits are not available from such Plan Providers, the Member will be referred to another Plan Provider to receive such Benefits.
PLAN PROVIDERS. B.1.1 The parties agree that contracts issued by Program Providers are a part of the “terms and conditions” of staff employment and are enforceable by the Union through Article 15 of this agreement.
B.1.2 After ratification of this agreement, or when signed by the provider whichever occurs last, PCC will provide a copy of the signed contracts between PCC and the provider to the Union upon request.
PLAN PROVIDERS. The parties agree that contracts issued by Program Providers are a part of the “terms and conditions” of staff employment and are enforceable by the Union through Article 15 of this agreement.
PLAN PROVIDERS. A list of the names and locations of Plan Providers in the selected Plan Network is contained in the provider directory which may be obtained by calling the Plan at 858-499-8300 or ▇-▇▇▇-▇▇▇-▇▇▇▇.
PLAN PROVIDERS. B.1.1 The parties agree that contracts issued by Program Providers are a part of the “terms and conditions” of staff employment and are enforceable by the Union through Article 15 of this agreement.
B.1.2 After ratification of this agreement, or when signed by the provider whichever occurs last, PCC will provide a copy of the signed contracts between PCC and the provider to the Union upon request.
B.2 DELI-HELPER CLERKS CASHIERING Deli-Helper Clerks (DHC) covered by this Agreement may perform incidental checking within the Deli departments (including Juice/Espresso Bars) for items from the Deli Department and such incidental products (e.g. candy bar, luncheon snack) as a customer may bring to a Deli register in conjunction with a Deli purchase. DHC’s may not check out baskets of items from other (non-Deli) departments and may not check at any time outside the Deli Department. {Note: PCC has agreed to review with the Union the duties of DHC}
B.3 EMPLOYEES WHOSE HOURS ARE LIMITED BY LAW When PCC cannot lawfully offer 4 hours of work to minor employees whose hours are limited by State Law, Section 5.6.4 shall be amended for such employee such that PCC does not incur a liability when it complies with the limit on hours in the State Law.
B.4 HEALTH CARE PLANS Beginning with January 2018, PCC will offer two Plans, one is called our Base Plan and one is called a Buy Up. Deductible (In/Out) $250/$500 (2x fam) $150/$300 (2x fam) OOP Max incl. Deductible (In/Out) $1,000/$2,000 (2x fam) $650/$1,300 (2x fam) Copays Apply to OOP Max? Yes Yes Coinsurance (In/Out) 85/50% 85/60% Office Visit $25 copay (dw) $20 copay (dw) Prescription Drug Copay $10/$20/$40 $10/$20/$40 Chiropractic / Spinal Manip. $25 copay (dw), 20 visits $20 copay (dw), 20 visits Acupuncture $25 copay (dw), no limit $20 copay (dw), no limit Naturopathic Services $25 copay (dw), no limit $20 copay (dw), no limit Vision Exam $25 copay (dw)/12 mos $20 copay (dw)/12 mos Vision Hardware Allowance $200/12 mos $200/12 mos Employee 25.00 30.00 Employee + Spouse 55.00 60.00 Employee + Child(ren) 35.00 45.00 Employee + Spouse & Child(ren) 60.00 70.00 Employee 40.00 55.00 Employee + Spouse 90.00 105.00 Employee + Child(ren) 70.00 85.00 Employee + Spouse & Child(ren) 115.00 130.00 Spousal Surcharge for Spouse with access to coverage elsewhere 250.00 250.00 MEMORANDUM OF UNDERSTANDING #1 1. MANUFACTURER'S REPRESENTATIVES, BOOK OR ADVANCE SALESPEOPLE "Manufacturer's Representatives" and "Book or Advance Salespeople" w...
PLAN PROVIDERS. B.1.1 The parties agree that contracts issued by Program Providers are a part of the “terms and conditions” of staff employment and are enforceable by the Union through Article 15 of this agreement.
B.1.2 After ratification of this agreement, or when signed by the provider whichever occurs last, PCC will provide a copy of the signed contracts between PCC and the provider to the Union upon request.
B.2 DELI-HELPER CLERKS CASHIERING Deli-Helper Clerks (DHC) covered by this Agreement may perform incidental checking within the Deli departments (including Juice/Espresso Bars) for items from the Deli Department and such incidental products (e.g. candy bar, luncheon snack) as a customer may bring to a Deli register in conjunction with a Deli purchase. DHC’s may not check out baskets of items from other (non-Deli) departments and may not check at any time outside the Deli Department. {Note: PCC has agreed to review with the Union the duties of DHC}
B.3 EMPLOYEES WHOSE HOURS ARE LIMITED BY LAW When PCC cannot lawfully offer 4 hours of work to minor employees whose hours are limited by State Law, Section 5.6.4 shall be amended for such employee such that PCC does not incur a liability when it complies with the limit on hours in the State Law.
B.4 HEALTH CARE PLANS Beginning with January 2018, PCC will offer two Plans, one is called our Base Plan and one is called a Buy Up. Deductible (In/Out) $250/$500 (2x fam) $150/$300 (2x fam) OOP Max incl. Deductible (In/Out) $1,000/$2,000 (2x fam) $650/$1,300 (2x fam) Copays Apply to OOP Max? Yes Yes Coinsurance (In/Out) 85/50% 85/60% Office Visit $25 copay (dw) $20 copay (dw) Prescription Drug Copay $10/$20/$40 $10/$20/$40 Chiropractic / Spinal Manip. $25 copay (dw), 20 visits $20 copay (dw), 20 visits Acupuncture $25 copay (dw), no limit $20 copay (dw), no limit Naturopathic Services $25 copay (dw), no limit $20 copay (dw), no limit Vision Exam $25 copay (dw)/12 mos $20 copay (dw)/12 mos Vision Hardware Allowance $200/12 mos $200/12 mos Employee 25.00 30.00 Employee + Spouse 55.00 60.00 Employee + Child(ren) 35.00 45.00 Employee + Spouse & Child(ren) 60.00 70.00 Employee 40.00 55.00 Employee + Spouse 90.00 105.00 Employee + Child(ren) 70.00 85.00 Employee + Spouse & Child(ren) 115.00 130.00 Spousal Surcharge for Spouse with access to coverage elsewhere 250.00 250.00 MEMORANDUM OF UNDERSTANDING #1 1. MANUFACTURER'S REPRESENTATIVES, BOOK OR ADVANCE SALESPEOPLE "Manufacturer's Representatives" and "Book or Advance Salespeople" w...