Enrollee Costs; Disclosure Sample Clauses

Enrollee Costs; Disclosure. Contractor shall, and shall require Participating Providers to, comply with applicable laws, rules and regulations governing liability of Enrollees for Specialized Health Care Services provided to Enrollees, including those relating to holding an Enrollee harmless from liability in the event Contractor fails to pay an amount owing by Contractor to a Participating Provider as required by Federal and State laws, rules and regulations. To the extent that Contractor’s QDPs either (i) provide coverage for out-of-network services or (ii) impose additional fees for such services, Contractor shall disclose to the Enrollee, at the enrollee’s request, the amount or percentage Contractor will pay for covered proposed non-emergency out-of-network services. Contractor shall require its Participating Providers to inform every Enrollee in a manner that allows the Enrollee the opportunity to act upon a Participating Provider’s proposal or recommendation regarding (i) the use of a non-network provider or facility or (ii) the referral of an Enrollee to a non-network provider or facility for proposed non-emergency Covered Services. Contractor shall require Participating Providers to disclose to an Enrollee considering accessing non-emergency services from a network provider if a non- network provider or facility will be used as part of the network provider’s plan of care. The Contractor’s obligation for this provision can be met through routine updates to their provider manual. Participating Providers may rely on Contractor’s provider directory in fulfilling their obligation under this provision.
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Enrollee Costs; Disclosure. Contractor shall, and shall require Participating Providers to, comply with applicable laws, rules and regulations governing liability of Enrollees for Covered Services provided to Enrollees, including, those relating to holding an Enrollee harmless from liability in the event Contractor fails to pay an amount owing by Contractor to a Participating Provider as required by Federal and State laws, rules and regulations. To the extent that Contractor’s QHPs either (i) provide coverage for out-of-network services, or
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Enrollee Costs; Disclosure. Contractor shall, and shall require Participating Providers to, comply with applicable laws, rules and regulations governing liability of Enrollees for Covered Services provided to Enrollees, including, those relating to holding an Enrollee harmless from liability in the event Contractor fails to pay an amount owed by Contractor to a Participating Provider as required by Federal and State laws, rules and regulations. To the extent that Contractor’s QHPs either (i) provide coverage for out-of-network services, or (ii) impose additional fees for such services, Contractor shall disclose to the Covered California Enrollee, at the Covered California Enrollee’s request, the amount Contractor will pay for covered proposed non-emergency out-of-network services. Contractor shall require its Participating Providers to inform every Covered California Enrollee in a manner that allows the Covered California Enrollee the opportunity to act upon a Participating Provider’s proposal or recommendation regarding (i) the use of a non-network provider or facility, or (ii) the referral of a Covered California Enrollee to a non-network provider or facility for proposed non-emergency Covered Services. Contractor shall require Participating Providers to disclose to a Covered California Enrollee considering accessing non-emergency services from a network provider if a non-network provider or facility will be used as part of the network provider’s plan of care. The Contractor’s obligation for this provision can be met through routine updates to its provider manual. Participating Providers may rely on Contractor’s provider directory in fulfilling their obligation under this provision.
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Related to Enrollee Costs; Disclosure

  • PERSONNEL DISCLOSURE 22 26.1 CONTRACTOR shall make available to ADMINISTRATOR a current list of 23 all personnel providing services hereunder, including résumés and job 24 applications. Changes to the list will be immediately provided to 25 ADMINISTRATOR, in writing, along with a copy of a résumé and/or job 26 application. The list shall include:

  • Screening Services Disclosure to Applicant Pursuant to MN Statute 504B.173, the tenant screening service that we use is the following: Rental History Reports 0000 X. 00xx Xxxxxx, #000 Xxxxx, XX 00000 (000) 000-0000 Applicant Screening Criteria, upon which the decision to rent to the Applicant is based, will be applied to the information provided in this application and the information gathered from the screening report and/or background check we obtain. If we reject your rental application pursuant to Minnesota Statutes and local laws, we will notify you within 14 days of such rejection, identifying the criteria you failed to meet. We are not obligated to return your application fee or deposit except as provided in MN Statute 504B.173 and local laws.

  • CHILD AND DEPENDENT ADULT/ELDER ABUSE REPORTING CONTRACTOR shall establish a procedure acceptable to ADMINISTRATOR to ensure that all employees, agents, subcontractors, and all other individuals performing services under this Agreement report child abuse or neglect to one of the agencies specified in Penal Code Section 11165.9 and dependent adult or elder abuse as defined in Section 15610.07 of the WIC to one of the agencies specified in WIC Section 15630. CONTRACTOR shall require such employees, agents, subcontractors, and all other individuals performing services under this Agreement to sign a statement acknowledging the child abuse reporting requirements set forth in Sections 11166 and 11166.05 of the Penal Code and the dependent adult and elder abuse reporting requirements, as set forth in Section 15630 of the WIC, and shall comply with the provisions of these code sections, as they now exist or as they may hereafter be amended.

  • EDD Independent Subrecipient Reporting Requirements Effective January 1, 2001, the County of Orange is required to file in accordance with subdivision (a) of Section 6041A of the Internal Revenue Code for services received from a “service provider” to whom the County pays $600 or more or with whom the County enters into a contract for $600 or more within a single calendar year. The purpose of this reporting requirement is to increase child support collection by helping to locate parents who are delinquent in their child support obligations. The term “service provider” is defined in California Unemployment Insurance Code Section 1088.8, Subparagraph B.2 as “an individual who is not an employee of the service recipient for California purposes and who received compensation or executes a contract for services performed for that service recipient within or without the State.” The term is further defined by the California Employment Development Department to refer specifically to independent Subrecipients. An independent Subrecipient is defined as “an individual who is not an employee of the ... government entity for California purposes and who receives compensation or executes a contract for services performed for that ... government entity either in or outside of California.” The reporting requirement does not apply to corporations, general partnerships, limited liability partnerships, and limited liability companies. Additional information on this reporting requirement can be found at the California Employment Development Department web site located at xxxx://xxx.xxx.xx.xxx/Employer_Services.htm

  • Proposing Integration Activities in the Planning Submission No integration activity described in section 6.3 may be proposed in a CAPS unless the LHIN has consented, in writing, to its inclusion pursuant to the process set out in section 6.3(b).

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