EPO Plan Sample Clauses

EPO Plan. The Metro Health Select an exclusive provider organization plan, which includes the following general specifications:
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EPO Plan. Members will select a Primary Care Provider (PCP) from the Tier 1 Prime Healthcare Network Directory or the Tier 2 Blue Cross BlueCard PPO Network. Specialty and Facility care will be coordinated through a referral process with the PCP and the Prime Healthcare Utilization Review department. Referrals submitted to Prime UR with all pertinent information (i.e. CPT, Diagnosis codes, clinical information, also known as a clean referral) will be processed within seven business days from the date of receipt. Additional time may be necessary if the referral is missing pertinent data and Prime UR must contact the referring provider for additional information. No referral is necessary for the following services: PCP Office Visit, Pediatric Office Visit, Annual Well Exam, Urgent Care or Emergency Room Visit. If determined by Prime UM, Facility or specialist care not available in Tier 1 RI shall be referred to the Tier 2 Network and be paid out at tier one cost levels.
Sample 1

Related to EPO Plan

  • SEB Plan The parties agree to establish and administer a Supplemental Employment Benefits Plan (the “Plan”) as follows:

  • Deferral Plan The deferral portion of the plan shall involve an employee spreading four (4) years' salary over a five (5) year period, or such other schedule as may be mutually agreed between the employee and the Hospital. In the case of the four (4) years' salary over a five (5) year schedule, during the four (4) years of salary deferral, 20% of the employee's gross annual earnings will be deducted and held for the employee. Such deferred salary will not be accessible to the employee until the year of the leave or upon the collapse of the plan. In the case of another mutually agreed upon deferral schedule, the percentage of salary deferred shall be adjusted appropriately.

  • Deferred Compensation Plan Manager shall be eligible to participate in the First Mid-Illinois Bancshares, Inc. Deferred Compensation Plan in accordance with the terms and conditions of such Plan.

  • WELFARE PLAN Section 1: The Plan There shall be a Welfare Plan pursuant to the terms and conditions of Exhibit "C", which is attached hereto and forms part of this Agreement. Membership in the Plan for all eligible employees shall be a condition of employment on and after July 1, 1973.

  • Benefit Plan If an employee maintains coverage for benefit plans while on maternity or parental leave, the Employer agrees to pay the Employer's share of these premiums.

  • Plan The Award and all rights of the Participant under this Agreement are subject to the terms and conditions of the provisions of the Plan, incorporated herein by reference. The Participant agrees to be bound by the terms of the Plan and this Agreement. The Participant acknowledges having read and understanding the Plan, the Prospectus for the Plan, and this Agreement. Unless otherwise expressly provided in other sections of this Agreement, provisions of the Plan that confer discretionary authority on the Board or the Administrator do not (and shall not be deemed to) create any rights in the Participant unless such rights are expressly set forth herein or are otherwise in the sole discretion of the Board or the Administrator so conferred by appropriate action of the Board or the Administrator under the Plan after the date hereof.

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