Adjustments in Service Area or Enrollment Sample Clauses

Adjustments in Service Area or Enrollment a. If Contractor experiences a Material Change, or is engaged in the termination or loss of a Provider or group or affected by other factors which have significant impact on access in that Service Area and which may result in transferring a substantial number of Members to other Providers employed or subcontracted with Contractor, Contractor shall provide OHA with a written plan for transferring the Members and an updated Provider Report, Exhibit G, at least 90 days prior to the date of such action. Contractor shall remain responsible for maintaining sufficient capacity and solvency, and providing all Covered Services through the end of the 90 day period. OHA will not approve a transfer of Members if the Provider’s contract with the transferring Contractor is terminated for reasons related to quality of care, competency, Fraud or other reasons described in OAR 410-141-3080. If Contractor must terminate a Provider or group due to circumstances that could compromise Member care, less than the required notice to OHA may be provided with the approval of OHA.
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Adjustments in Service Area or Enrollment a. If Contractor is engaged in the termination or loss of a Provider or group or affected by other factors which have significant impact on access in that Service Area and which may result in transferring a substantial number of Members to other Providers employed by or subcontracted with Contractor, Contractor shall provide, via Administrative Notice, to OHA’s Provider Services Unit a written plan for transferring the Members and an updated DSN Provider Report, as required under Exhibit G of this Contract, at least 90 days prior to the date of the implementation of such plan .
Sample 1
Adjustments in Service Area or Enrollment a. If RAE reasonably anticipates losing a substantial number of Members from its enrollment, or experiencing a reduction in its network or capacity due to: (i) the occurrence of a Material Change or other significant change; (ii) engaging in the termination or loss of Participating Providers; or (iii) decreased access in RAE’s Service Area, RAE shall notify TCMC at least 120 days, or as soon as reasonably practicable, prior to the date of such anticipated loss or reduction.
Sample 1
Adjustments in Service Area or Enrollment a. If Contractor experiences a Material Change, or is engaged in the termination or loss of a Provider or group or affected by other factors which have significant impact on access in that Service Area and which may result in transferring a substantial number of Members to other Providers employed or subcontracted with Contractor, Contractor shall provide OHA with a written plan for transferring the Members and an updated Provider Report, Exhibit G, at least 90 days prior to the date of such action, notwithstanding the Contract renewal date. Contractor shall remain responsible for maintaining sufficient capacity and solvency, and providing all Coordinated Care Services through the end of the 90-day period.
Sample 1

Related to Adjustments in Service Area or Enrollment

  • Initial Enrollment Upon retirement, each new retiree who is eligible to enroll in plans under the Health Benefits Program shall receive uninterrupted coverage under the plan in which he or she was enrolled as an active employee, provided the employee submits all necessary applications and other required documentation in a timely fashion.

  • Rollovers of Xxxx Elective Deferrals Xxxx elective deferrals distributed from a 401(k) cash or deferred arrangement, 403(b) tax-sheltered annuity, 457(b) eligible governmental deferred compensation plan, or federal Thrift Savings Plan, may only be rolled into your Xxxx XXX.

  • Re-enrollment Any eligible employees who wish to join the Sick Leave Bank after their first year of eligibility will contribute two (2) days upon joining. Such membership may only be made during the month of October using the appropriate forms. The two (2) required days of leave shall be donated from their account upon enrollment in the Classified Employee Council (CEC).

  • Maximum Enrollment The maximum number of students who may be enrolled in the School shall be 550 students, unless the School and District mutually agree to increase this number. This maximum enrollment was determined pursuant to negotiations between the District and the Network for the School and is consistent with facilitating the academic success of students enrolled in the School and facilitating the School’s ability to achieve the other objectives specified in this Contract. If the School wishes to enroll more than the maximum number of students listed above, the Network for the School must submit a written request to the District, in form and substance acceptable to the District, for review and consideration as an amendment to this Contract. The District shall approve any reasonable requests as determined by the District. This maximum enrollment should not exceed the capacity of the School facility. Each year, the School will be asked to affirm an annual maximum enrollment that will be used to determine mid-year enrollment and School Choice numbers.

  • Method of Salary Payment Section One. Workers'

  • Medicaid Enrollment Treatment Grantees shall enroll as a provider with Texas Medicaid and Healthcare Partnership (TMHP) and all Medicaid Managed Care organizations in Grantee’s service region within the first quarter of this procurement term and maintain through the procurement term.

  • Reporting Total Compensation of Recipient Executives 1. Applicability and what to report. You must report total compensation for each of your five most highly compensated executives for the preceding completed fiscal year, if—

  • Reallocation to a Class with an Equal Salary Range Maximum 1. If the employee meets the skills and abilities requirements of the position, the employee remains in the position and retains existing appointment status.

  • Benefit Level Two Health Care Network Determination Issues regarding the health care networks for the 2017 insurance year shall be negotiated in accordance with the following procedures:

  • Disenrollment Adverse Benefit Determination taken by the Division, or its Agent, to remove a Member's name from the monthly Member Listing report following the Division's receipt and approval of a request for Disenrollment or a determination that the Member is no longer eligible for Enrollment in the Contractor.

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