eValue8 Submission Sample Clauses

eValue8 Submission. During each Contract Year, Contractor shall submit to the Exchange certain information that is a required disclosure under the eValue8 Health Plan Request for Information, as modified by the Exchange in the California Health Benefit Exchange 2012-2013 Initial Qualified Health Plan Solicitation to Health Issuers and Invitation to Respond, as amended December 28, 2012, and may be updated from time to time by the Exchange:
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eValue8 Submission. During each Contract Year, Contractor shall submit to the Exchange certain information that is a required disclosure under the eValue8 reporting system. Such information will be used by the Exchange to evaluate Contractor’s performance under the terms of the Quality, Network Management and Delivery System Standards and/or in connection with the evaluation regarding any extension of the Agreement and/or the recertification process. The timing, nature and extent of such disclosures will be (i) established by the Exchange based on its evaluation of various quality-related factors, including, disclosure requirements included in the Solicitation.. Contractor’s response shall include information relating to all of Contractor’s then-current California-based business and Contractor shall disclose any information that reflects national or regional information that is provided by Contractor due to Contractor’s inability to report on all California business. Contractor shall also provide a break down by products offered in the SHOP and the Individual Exchange in the event that Contractor offers products in both the Individual Exchange and SHOP.
Sample 1
eValue8 Submission. During each Contract Year, Contractor shall submit to the Exchange certain information that is a required disclosure under the eValue8 reporting system. Such information will be used by the Exchange to evaluate Contractor’s performance under the terms of the Quality, Network Management and Delivery System Standards and/or in connection with the evaluation regarding any extension of the Agreement and/or the recertification process. The timing, nature and extent of such disclosures will be (i) established by the Exchange based on its evaluation of various quality-related factors, including, disclosure requirements included in the Solicitation and (ii) set forth in technical specifications included in the Administrative Manual. Contractor’s response shall include information relating to all of Contractor’s then-current California-based business and Contractor shall disclose any information that reflects national or regional information that is provided by Contractor due to Contractor’s inability to report on all California business. Contractor shall also provide a break down by products offered in the SHOP and the Individual Exchange in the event that Contractor offers products in both the Individual Exchange and SHOP.
Sample 1
eValue8 Submission. During each Contract Year, starting in 2015, Contractor shall submit to the Exchange certain information that is a required disclosure under the Covered California eValue8 Health Plan Request for Information, as modified by the Exchange and may be updated from time to time by the Exchange. The Covered California eValue8 Request for Information questions are listed in Appendix 3 to Attachment 7. Contractor is absolved of the responsibility to complete the original eValue8 as outlined in Attachment 14, Group 3, Item 3.5 of the 2014 Qualified Health Plan Contract. For calendar year 2014, the Covered California eValue8 may be optionally submitted to satisfy Quality/Network Management reporting requirements 4.1 through 4.15 as listed in Appendix 2 to Attachment 7. Such information will be used by the Exchange to evaluate Contractor’s performance under the terms of the Quality, Network Management and Delivery System Standards and/or in connection with the evaluation regarding any extension of the Agreement and/or the recertification process. The timing, nature and extent of such disclosures will be established by the Exchange based on its evaluation of various quality-related factors. Contractor’s response shall include information relating to all of Contractor’s then-current California-based business and Contractor shall disclose any information that reflects California-based information that is provided by Contractor due to Contractor’s inability to report on all Exchange-specific business. Contractor shall also report data separately for HMO/POS, PPO and EPO product lines.
Sample 1

Related to eValue8 Submission

  • REPORT SUBMISSION 1. Copies of reporting packages for audits conducted in accordance with 2 CFR Part 200, Subpart F-Audit Requirements, and required by PART I of this form shall be submitted, when required by 2 CFR 200.512, by or on behalf of the recipient directly to the Federal Audit Clearinghouse (FAC) as provided in 2 CFR 200.36 and 200.512

  • BID SUBMISSION All Bids are to be packaged, sealed and submitted to the location stated in the Bid Specifications. Bidders are solely responsible for timely delivery of their Bids to the location set forth in the Bid Specifications prior to the stated Bid opening date/time. A Bid return envelope, if provided with the Bid Specifications, should be used with the Bid sealed inside. If the Bid response does not fit into the envelope, the Bid envelope should be attached to the outside of the sealed box or package with the Bid inside. If using a commercial delivery company that requires use of their shipping package or envelope, Bidder’s sealed Bid, labeled as detailed below, should be placed within the shipper’s sealed envelope to ensure that the Bid is not prematurely opened. All Bids must have a label on the outside of the package or shipping container outlining the following information: “BID ENCLOSED (bold print, all capitals) • Group Number • IFB or RFP Number • Bid Submission date and time” In the event that a Bidder fails to provide such information on the return Bid envelope or shipping material, the receiving entity reserves the right to open the shipping package or envelope to determine the proper Bid number or Product group, and the date and time of Bid opening. Bidder shall have no claim against the receiving entity arising from such opening and such opening shall not affect the validity of the Bid or the procurement. Notwithstanding the receiving agency’s right to open a Bid to ascertain the foregoing information, Bidder assumes all risk of late delivery associated with the Bid not being identified, packaged or labeled in accordance with the foregoing requirements. All Bids must be signed by a person authorized to commit the Bidder to the terms of the Bid Documents and the content of the Bid (offer).

  • Claims Submission We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

  • Preparation and Submission The Recipient will:

  • Updated Information Submission by Developer The updated information submission by the Developer, including manufacturer information, shall occur no later than one hundred eighty (180) Calendar Days prior to the Trial Operation. Developer shall submit a completed copy of the Large Generating Facility data requirements contained in Appendix 1 to the Large Facility Interconnection Procedures. It shall also include any additional information provided to Connecting Transmission Owner for the Interconnection Feasibility Study and Interconnection Facilities Study. Information in this submission shall be the most current Large Generating Facility design or expected performance data. Information submitted for stability models shall be compatible with NYISO standard models. If there is no compatible model, the Developer will work with a consultant mutually agreed to by the Parties to develop and supply a standard model and associated information. If the Developer’s data is different from what was originally provided to Connecting Transmission Owner and NYISO pursuant to an Interconnection Study Agreement among Connecting Transmission Owner, NYISO and Developer and this difference may be reasonably expected to affect the other Parties’ facilities or the New York State Transmission System, but does not require the submission of a new Interconnection Request, then NYISO will conduct appropriate studies to determine the impact on the New York State Transmission System based on the actual data submitted pursuant to this Article 24.3. Such studies will provide an estimate of any additional modifications to the New York State Transmission System, Connecting Transmission Owner’s Attachment Facilities, or System Upgrade Facilities or System Deliverability Upgrades based on the actual data and a good faith estimate of the costs thereof. The Developer shall not begin Trial Operation until such studies are completed. The Developer shall be responsible for the cost of any modifications required by the actual data, including the cost of any required studies.

  • Application Submission Submissions of a rental application does not guarantee approval or acceptance. It does not bind us to accept the application or to sign a Lease contact. APPLICANT SCREENING CRITERIA Fair Housing Statement. Xxxxx Management is an equal housing opportunity & fair housing provider. We do not discriminate against persons on the basis of race, color, religion, national origin, sex, familial status, disability, creed, marital status, public assistance, ancestry, and sexual or affectional orientation. Identification and Application Process. Every person over 18 must give consent to be screened and provide a government issued photo ID. Social Security Number verification may be required for specific housing programs. Application Requirements. Applications must be filled out completely and accurately. Any misstatements or omissions made on your application, whether or not discovered before you move into the building, is grounds for denial of an application or termination of an existing lease. Information must be legible and verifiable. If information given on the application cannot be verified, this is a reason for rejection. Omission of information, such as an address or employer, may be grounds for rejection. Occupancy. The initial maximum number of residents in a unit is equal to two persons per bedroom unless otherwise stated in the property’s Resident Selection Plan, where applicable. Each unit is limited to no more than two (2) unrelated or four (4) related adult persons per unit. Xxxxx Management defines a related adult person as either a child, dependent, or parent of the head of household. General occupancy standards and any federal, state, or local housing ordinances will supersede this policy. Housing History. We require the name and last known telephone number of each landlord/property manager for each address you have had for the last three years. Roommate references are not acceptable. The refusal of a prior landlord to give a reference, or a negative reference, may be grounds for rejection. In the case of first-time renters, or applicants without prior rental history, this requirement may be varied subject to additional requirements of management. Eviction Filings. Unlawful detainers or evictions within the past five (5) years is a basis for denial of an application.

  • AUDIT REPORT SUBMISSION Audit reports must be submitted no later than 150 days following cancellation, termination or expiration of this Agreement.

  • Review The practitioner reviews the treatment plan and discusses, when appropriate, case circumstances and management options with the attending (or referring) physician. The reviewer consults with the requesting physician when more clarity is needed to make an informed coverage decision. The reviewer may consult with board certified physicians from appropriate specialty areas to assist in making determinations of coverage and/or appropriateness. All such consultations will be documented in the review text. If the reviewer determines that the admission, continued stay or service requested is not a covered service, a notice of non-coverage is issued. Only a physician, behavioral health practitioner (such as a psychiatrist, doctoral-level clinical psychologist, certified addiction medicine specialist), dentist or pharmacist who has the clinical expertise appropriate to the request under review with an unrestricted license may deny coverage based on medical necessity.

  • Application and Submission Information In addition to the application and submission language discussed in PART II: Section I, you must include the following in your application:

  • TIMELINESS OF BILLING SUBMISSION The parties agree that timeliness of billing is of the essence to this Contract and recognize that the City is on a fiscal year. All xxxxxxxx for dates of service prior to July 1 must be submitted to the City no later that the first Friday in August of the same year.

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