Plan Name definition
Plan Name. Mainstream Base Period: CY '93 Plan Number: Rate Period: 7/95 - 5/96 County: Riverside Capitation Payable: End of Month Aid Code: Aged
Plan Name. Mainstream Base Period: CY '93 Plan Number: Rate Period: 6/96 - 9/97 County: San Bernardino Capitation Payable: End of Month Aid Code: Adult Phys Pharm HIP HOP LTC Other Total Units per 1,000 eligibles 22.752 5.069 3.590 4.465 .000 20.412 Age/sex Adjustment 1.000 1.000 1.000 1.000 1.000 1.000 Aid Code Adjustment 1.000 1.000 1.000 1.000 1.000 1.000 Adjusted Units 22.752 5.069 3.590 4.465 .000 20.412 Average Cost Per Unit 59.80 16.00 960.30 20.51 .00 43.66 Area Adjustment 1.013 1.000 1.000 1.000 1.000 1.000 Adjusted Cost $ 60.58 $ 16.00 $ 960.30 $ 20.51 $ .00 $ 43.66 Interest Adjustment .996 .999 .995 .993 .996 .995 Contract Cost per Eligible $ 1,372.80 $ 81.02 $ 3,430.24 $ 90.94 $ .00 $ 886.73 $ 5,861.73 Benefit Adjustments FY 94/95 1.003 .852 1.035 1.003 1.042 1.013 FY 95/96 1.000 .724 1.018 1.000 1.020 1.000 Trend Adjustment 7/93 - 1/97 1.099 1.023 1.126 1.169 1.000 1.195 Annual Cost Per Eligible $ 1,513.23 $ 51.13 $ 4,069.59 $ 106.63 $ .00 $ 1,073.42 $ 6,814.00 Mental Health Adjustment .1% 2.2% .3% 1.1% .0% .1% Eyewear Adjustment .4% Cost Excluding Mental Health $ 1,511.72 $ 50.01 $ 4,057.38 $ 105.46 $ .00 $ 1,068.06 $ 6,792.63 Preliminary Monthly Rate $ 566.05 Adj. for Fee-for-Service Limitation -2.0% $ -11.32 CHDP .00 Final Rate $ 554.73 Attachment I
Plan Name. Enter the name of the Health Plan.
Examples of Plan Name in a sentence
Sample Plan: Name, Title of person responsible for monitoring contract services, will meet with Contractor before the event to recap and ensure the deliverables are provided satisfactorily and the intended objectives are met.
Except for the following Service:_____________________ Name of Plan: Name of Participating Employer: Gold Banc Corporation, Inc.
Name of Plan: Name of Participating Employer: Gold Banc Corporation, Inc.
Complete the Jurat worksheet by entering the correct information for (Plan Name), (Plan Address), (Contact Name), (Phone Number), (Fax Number) and the correct date for the month being reported.
Enter the Health Plan's basic seven digit Medicaid Provider ID number, i.e., 015---- Plan Name: Enter the name of the Health Plan.
More Definitions of Plan Name
Plan Name shall be HAMPSHIRE GROUP, LIMITED AND SUBSIDIARIES 401(k) RETIREMENT SAVINGS PLAN.
Plan Name. ▇▇▇▇▇▇ Medical Center Plan#: 355 Date: 16-Nov-99 Country: San Bernardino Plan Type: Commercial Plan Base Period: FY 96/97 Aid Code Grouping: Child Adjusted Rate is Effective August 1,1999 Capitation Payments at the to September 30, 1999 Beginning of the Month Coverages -------------------------------------------------------------------------------- CCS Indicated Claims NOT Covered by the Plan -------------------------------------------------------------------------------- Menial Health Outpatient Services NOT Covered by the Plan -------------------------------------------------------------------------------- Mental Health Pharmacy Costs NOT Covered by the Plan -------------------------------------------------------------------------------- Mental Health Hospital Inpatient Services NOT Covered by the Plan -------------------------------------------------------------------------------- Eyewear NOT Covered by the Plan -------------------------------------------------------------------------------- Heroin Detoxification NOT Covered by the Plan -------------------------------------------------------------------------------- AIDS Waiver Services NOT Covered by the Plan -------------------------------------------------------------------------------- Adult Day Health Care NOT Covered by the Plan -------------------------------------------------------------------------------- Chiropractor/Acupuncture NOT Covered by [ha Plan -------------------------------------------------------------------------------- Local Education Authority NOT Covered by the Plan -------------------------------------------------------------------------------- Alphafeto Protein Testing NOT Covered by the Plan -------------------------------------------------------------------------------- Long Term Care for month of entry plus one Covered by the Plan -------------------------------------------------------------------------------- Long Term Care after month of entry plus one NOT Covered by the Plan -------------------------------------------------------------------------------- Special AIDS drugs NOT Covered by the Plan -------------------------------------------------------------------------------- C6 to Contract No. 95-23637 Page 12 of 28
Plan Name. IRA Custodial Account FFN: 50143000000-007 Case: 9070037 EIN: ▇▇-▇▇▇▇▇▇▇ Letter Serial No: D111853b NEW ENGLAND MUTUAL LIFE INSURANCE CO. ▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ DEPARTMENT OF THE TREASURY
Plan Name. The ConAgra 2009 Stock Plan (the “Plan”) Type of Option: Non-qualified Expiration Date: Term of Option:
Plan Name. Trust or Custodial Account Number: __________________________________ Address: ____________________________________________________________ Attn: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ Phone Number: _______________________________________________________ Delivery Technique ___ Mail check to receiving Qualified Plan or IRA. ___ Provide a check to me for delivery to receiving Qualified Plan or IRA. Check will only be negotiable by the receiving Qualified Plan or IRA.
Plan Name. PSW Profit Sharing Plan ("Plan") The Employer should use this form to notify Fidelity of its intention to designate the above-referenced plan as an ERISA Section 404(c) plan. The Employer should refer to the ERISA Section 404(c) Information Guide before making an election below. Check one: |X| The Employer designates the Plan as an ERISA Section 404(c) plan. Fidelity will include the Notice of Limited Liability in the Plan Highlights brochure and Summary Plan Description. |_| The Employer does not designate the Plan as a 404(c) plan. o "Employer" By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇ Date: 9/26/96 Title: President Please return to Fidelity with executed Adoption Agreement. [LOGO] ================================================================================ [Stamp] SEP 27 1996 ================================================================================ The CORPORATEplan FOR RETIREMENT(SM) Request for Waiver of Sales Charge
Plan Name shall be Interpath Communications, Inc. 401(k) Retirement Savings Plan.