EGWP Benefit definition

EGWP Benefit means the prescription drug benefit to be administered by MCLIC under this Agreement, as defined in the Recitals above and as further described in the Client Group Health Plan document, its summary plan description, and its summary of benefits, the latter of which is attached hereto as Exhibit A, as may be amended from time to time in accordance with the terms of this Agreement.
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EGWP Benefit means the prescription drug benefit to be administered by MCLIC under this EGWP Addendum, as defined in the Recitals above and as further described in the Sponsor plan document, its summary plan description, and its summary of benefits, as may be amended from time to time in accordance with the terms of this EGWP Addendum.
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EGWP Benefit means the prescription drug benefit to be administered by Express Scripts under this Agreement, as defined in the Description of Goods and Services in Exhibit A and as further described in the TRB Group Health Plan document, its summary plan description, and its summary of benefits, as may be amended from time to time in accordance with the terms of this Agreement.
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Examples of EGWP Benefit in a sentence

  • The Employer Group Waiver Plan (EGWP) Benefit, which serves as the State’s Medicare Part D prescription drug plan administered for eligible retirees.

  • The individual who is (a) eligible for Part D in accordance with the Medicare Drug Rules, (b) not enrolled in a Part D plan (other than the EGWP Benefit), and (c) eligible to participate in Program benefits.

  • Without limiting the generality of the foregoing, the parties acknowledge that, for the purposes of HIPAA compliance, each of Express Scripts and the TRB Group Health Plan is a Covered Entity, and that, with respect to the EGWP Benefit, Express Scripts and the TRB Group Health Plan shall be deemed to be an Organized Health Care Arrangement.

  • In accordance with the Medicare Drug Rules, Express Scripts hereby delegates the premium collection function to the Agency and hereby directs the Agency, on behalf of Express Scripts, to collect all monthly premium payments due from EGWP Enrollees for participation in the EGWP Benefit.

  • For all Part D Eligible Retirees that have been included by the Agency in the Enrollment File, but who are ultimately determined to be ineligible for participation in the EGWP Benefit, Express Scripts or its Affiliate shall notify the individual of his or her ineligibility in the EGWP Benefit and take all other action as required by applicable law.

  • Express Scripts will work with the Agency to determine if such individual has been rejected due to an administrative or clerical error (e.g., data field standards errors, rejections related to information input by Express Scripts related to the EGWP Benefit into the CMS system, etc.), or an error requiring individual retiree contact, and if so in either case, Express Scripts will take appropriate action and attempt to correct such error and resubmit the individual through the CMS system.

  • The Agency acknowledges and agrees that neither Express Scripts nor its Affiliate shall be responsible to the Agency for non-payment by any EGWP Enrollee of any monthly premium amount due by such EGWP Enrollee for participation in the EGWP Benefit.

  • If an EGWP Enrollee makes a voluntary request to be disenrolled from the EGWP Benefit (the “Voluntary Disenrollee”) to the Agency, then the Agency shall notify Express Scripts at least sixty (60) days prior to the effective date of such Voluntary Disenrollee’s disenrollment, in a manner and format agreed upon by the parties.

  • If CMS determines that an EGWP Enrollee is no longer eligible to participate as an EGWP Enrollee in the EGWP Benefit, upon notification to Express Scripts, such Ineligible Enrollee shall be notified and disenrolled in accordance with the Medicare Drug Rules.

  • The Agency’s submission to Express Scripts of an inaccurate or incomplete Enrollment File (e.g., missing date of birth, last name, first name, etc.) or otherwise of incomplete information with respect to any individual Part D Eligible Retiree may result in a rejection of the Part D Eligible Retiree’s enrollment in the EGWP Benefit.

Related to EGWP Benefit

  • Accrued Benefit have the meanings specified in ERISA.

  • Plan Benefit means the benefit payable to a Participant as calculated in Article V.

  • Retirement Benefit means the benefit set forth in Article 5.

  • Death Benefit means the insurance amount payable under the Certificate at death of the Insured, subject to all Certificate provisions dealing with changes in the amount of insurance and reductions or termination for age or retirement. It does not include any amount that is only payable in the event of Accidental Death.

  • Termination Benefit means the benefit set forth in Article 7.