Benefit manager definition

Benefit manager means a person who performs one or more of
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Benefit manager means a person who has access to and reviews patient health information, including information related to patient prescription dispensing records, for the purpose of administering a health care program operated by a health benefit plan, including utilization review and determination of coverage issues. The term includes a third-party administrator.
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Benefit manager means the manager designated as the benefit manager of a sustainable business limited liability company under section ‑7.
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Examples of Benefit manager in a sentence

  • Safety checks – Before the Member’s prescription is filled, Our pharmacy Benefit manager or We perform quality and safety checks for usage precautions, drug duplication, and frequency of refills (e.g. refill prior to seventy-five percent (75%) day supply used).

  • Some pharmacies have contracted with Us or with Our pharmacy Benefit manager to accept a negotiated amount as payment in full for the covered Prescription Drugs that they dispense.

  • When a Member purchases covered Prescription Drugs from a pharmacy that has not contracted with Us or with Our pharmacy Benefit manager to accept a negotiated amount as payment in full for the covered Prescription Drugs that it dispenses, the Allowable Charge is the negotiated amount that Participating Pharmacies have agreed to accept for drugs dispensed.

  • The Company's published rate schedules state the conditions under which each is available for electric service.

  • Prescription Drugs approved for self-administration (e.g., oral or self-injectable drugs) are excluded when obtained from a Physician or other Provider unless the provider is contracted with Our pharmacy Benefit manager.

  • For information on how to file Claims for foreign Prescription Drug purchases, the Member should contact Us or Our pharmacy Benefit manager at the telephone number indicated on the Member’s ID card.

  • Most Members receive information from Us by accessing the pharmacy section of Our website, www.bcbsla.com/pharmacy, or request a copy by mail by calling Our pharmacy Benefit manager at the telephone number identified on Your ID card You may also contact Us at the telephone number on Your ID card to ask whether a specific drug is included in Your formulary.

  • Most Plan Participants receive information by accessing the pharmacy section of the Claims Administrator’s website, www.bcbsla.com/pharmacy or request a copy by mail by calling the pharmacy Benefit manager at the telephone number indicated on the Plan Participant’s ID card.

  • Prescription Drugs subject to the Step Therapy program when the Step Therapy program was not utilized or the drug was not approved by Us or Our pharmacy Benefit manager; bb.

  • The Claim form should then be sent to Our pharmacy Benefit manager, whose number is on Your ID card.

Related to Benefit manager

  • Pharmacy benefit manager means a person, business or other

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Pharmacy benefits management means the administration or management of prescription drug

  • Managing Employee means a general manager, business manager, administrator, director, or other individual who exercises operational or managerial control over, or who directly or indirectly conducts the day-to-day operation of an institution, organization, or agency.

  • Benefits Committee means the Employee Benefits Committee of Textron.

  • Disability benefit recipient means a member who is receiving a disability benefit.

  • Health benefits plan means a benefits plan which pays or

  • Medical Benefits Schedule means the Medicare Schedule of Benefits produced by the Department of Health to which all fees and benefits relate for inpatient hospital services.

  • Designated Employer Representative (DER) means a designated school district representative authorized to take immediate action to remove employees from safety-sensitive duties, to make required decisions in the testing and evaluation process, and to receive test results and other communications for the school district.

  • Retirement Committee means a committee consisting of the Company’s Vice President of Human Resources, the Director of HR Operations and the Compensation & Benefits Manager.

  • Retirement board or "board" means the retirement system's governing board provided for in 2-15-1010.

  • Medical benefit plan means a plan established and maintained by a carrier, a voluntary employees' beneficiary association described in section 501(c)(9) of the internal revenue code of 1986, 26 USC 501, or by 1 or more public employers, that provides for the payment of medical benefits, including, but not limited to, hospital and physician services, prescription drugs, and related benefits, for public employees or elected public officials. Medical benefit plan does not include benefits provided to individuals retired from a public employer or a public employer's contributions to a fund used for the sole purpose of funding health care benefits that are available to a public employee or an elected public official only upon retirement or separation from service.

  • Societal benefits charge means a charge imposed by an electric

  • SERP has the meaning assigned thereto in Section 5(c) hereof.

  • Exit Manager the person appointed by each Party pursuant to Paragraph 3.3 of this Schedule 8 (Exit Arrangements) for managing the Provider’s obligations under Schedule 8 (Exit Arrangements);

  • Mutual benefit corporation means a nonprofit corporation:

  • CME Term SOFR Administrator means CME Group Benchmark Administration Limited as administrator of the forward-looking term Secured Overnight Financing Rate (SOFR) (or a successor administrator).

  • Affected employee means an employee who would be affected by the grant or denial of a variance, or any one of the employee’s authorized representatives, such as the collective bargaining agent.

  • Medical Benefits means the monthly fair market value of benefits provided to the Employee and the Employee’s dependents under the major medical, dental and vision benefit plans sponsored and maintained by the Company, at the level of coverage in effect for such persons immediately prior to the Employee’s termination of employment date. The “monthly fair market value” of such benefits shall be equal to the monthly cost as if such persons elected COBRA continuation coverage at such time at their own expense.

  • Compensation and Benefits Programs means all compensation and benefit plans, policies, and programs of the Debtors, and all amendments and modifications thereto, applicable to the Debtors’ employees, former employees, retirees, and non-employee directors and the employees, former employees and retirees of their subsidiaries, including all savings plans, retirement plans, health care plans, disability plans, and incentive plans, deferred compensation plans, and life, accidental death, and dismemberment insurance plans.

  • Supervisory employee means an employee, regardless of job description, having authority in the interest of the employer to hire, transfer, suspend, lay off, recall, promote, discharge, assign, reward, or discipline other employees, or the responsibility to assign work to and direct them, or to adjust their grievances, or effectively recommend that action, if, in connection with the foregoing functions, the exercise of that authority is not of a merely routine or clerical nature, but requires the use of independent judgment.

  • Accrued Professional Compensation means, at any given moment, all accrued, contingent and/or unpaid fees and expenses (including, without limitation, success fees) for legal, financial advisory, accounting and other services and reimbursement of expenses that are awardable and allowable under section 328, 330(a) or 331 of the Bankruptcy Code and were rendered before the Effective Date by any Retained Professional in the Chapter 11 Cases, or that are awardable and allowable under section 503 of the Bankruptcy Code, that have not been denied by a Final Order, all to the extent that any such fees and expenses have not been previously paid (regardless of whether a fee application has been filed for any such amount). To the extent that the Bankruptcy Court or any higher court denies or reduces by a Final Order any amount of a Retained Professional’s fees or expenses, then those reduced or denied amounts shall no longer constitute Accrued Professional Compensation.

  • Individual service plan means the written description of services, supports, and activities to be provided to an individual.

  • Retirement Plan means a plan which provides retirement benefits to you and which is not funded wholly by your contributions. The term shall not include a profit-sharing plan, informal salary continuation plan, registered retirement savings plan, stock ownership plan, 401(K) or a non-qualified plan of deferred compensation.

  • Ongoing employee means an employee who has been employed for at least one complete standard measurement period.

  • Planning Director means the Planning Director of the City of Santa Xxxxxx, or his or her designee.