Reconsideration If We did not attempt to consult with Your Provider who recommended the Covered Service before making an adverse determination, the Provider may request reconsideration by the same clinical peer reviewer who made the adverse determination or a designated clinical peer reviewer if the original clinical peer reviewer is unavailable. For Preauthorization and concurrent reviews, the reconsideration will take place within one (1) business day of the request for reconsideration. If the adverse determination is upheld, a notice of adverse determination will be given to You and Your Provider, by telephone and in writing.
Termination of Leave Interruption of pregnancy will terminate the leave. Human Resources may require in such cases forty-five (45) days notice to return.
Expiration of Leave Except as otherwise provided in this Article, twenty (20) days before the expiration of a leave for ninety (90) days or more, or five (5) days before expiration of a leave for twenty (20) days but less than ninety (90) days, the employee should make every effort to notify the Personnel Office of his/her intention to return, or request an extension of leave, if eligible. Unless such notice is given, failure to return to work upon expiration of the leave may be considered resignation from service.
Reconsiderations and Appeals If you experience a problem relating to an authorization review, benefit denial, or other aspect of this plan, we have internal and external procedures to help you resolve your issue. The following sections detail the processes and procedures for filing: • Administrative Appeals; • Medical Reconsiderations and Appeals (including expedited appeals); • Prescription Drug Appeals: and
Duration of Leave An eligible female employee may apply for pregnancy leave, to commence after the 22nd week of pregnancy for a duration of up to 17 weeks. The pregnancy leave of an employee who is not entitled to take parental leave ends on the later of the day that is seventeen weeks after the pregnancy leave began or the day that is six weeks after the birth, still-birth or miscarriage.
Notification of Reemployment Opening 1. Any employee who is laid off and is subsequently eligible for reemployment shall be notified in writing by the District. Such notice shall be sent, with a “Proof of Service by Mail” form, to the last address given the District by the employee.
Extension of Leaves Employees who are entitled to leave pursuant to Articles 20.1 and 20.2 shall be entitled to an extended leave of up to an additional six (6) months for health reasons where a doctor's certificate is presented. Such written request must be received by the Employer at least four weeks prior to the expiration of leave taken pursuant to Article 20.1 and 20.2.
Verification of Leave Upon return from leave the employee will provide the necessary claim form for verification of absence to his/her principal/supervisor within five (5) workdays in accordance with §1012.61, Florida Statutes.
Extension of Leave 4 If an extension of the leave is required, a request for the extension must be 5 submitted on the Leave Request Form at least five days in advance of the leave 6 expiration. Consideration of an extension will be based on the same criteria as 7 the original request. Failure to return to work at the expiration of the leave may 8 result in termination.
Court Leave With Pay Leave with pay shall be given to every employee, other than an employee already on leave without pay, on education leave, or under suspension who is required:
