Member Cost Sample Clauses

Member Cost. Sharing Effective July 1, 2010, federal regulations at 42 CFR 447.78 place aggregate limits on cost-sharing and prohibit total member cost-sharing per family—including POWER Account contributions, premiums, co-payments and co-insurance—from exceeding five percent (5%) of the family’s income, as determined by the State, in a monthly or quarterly period. To ensure a family’s total cost-sharing does not exceed five percent (5%) of the family’s income on a quarterly basis, the Contractor shall accept family income data from the State’s fiscal agent and track the POWER Account contributions, premiums, tobacco surcharge, co-payments, member debt collected and/or other cost-sharing information available to the Contractor against the total family income data provided by the State. Any service not specifically listed as a covered benefit in the applicable HIP alternative benefit plan may not be applied against the member’s five percent (5%) contribution calculation. The time period for tracking data shall be defined by the State. When a family’s total cost-sharing expenditures come close to exceeding five percent (5%) of the family’s income in the quarterly period, the Contractor shall be required to notify the State. The Contractor shall also coordinate with the State to notify providers and the family that additional cost-sharing during the period is reduced or waived. Members with tobacco surcharge will still be responsible for the $1.50 POWER Account contribution once they meet the five percent (5%) limit. In monitoring the quarterly five percent (5%) member cost-sharing limit, the Contractor EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK shall comply with all policies and procedures set forth in this section and the HIP MCE Policies and Procedures Manual.
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Member Cost. Sharing Effective July 1, 2010, federal regulations at 42 CFR 447.78 place aggregate limits on cost - sharing and prohibit total member cost-sharing per family—including POWER Account contributions, premiums, co-payments and co-insurance—from exceeding five percent (5%) of the family’s income, as determined by the State, in a monthly or quarterly period. To ensure a family’s total cost-sharing does not exceed five percent (5%) of the family’s income on a quarterly basis, the Contractor shall accept family income data from the State’s fiscal agent and track the POWER Account contributions, premiums, tobacco surcharge, co-payments, member debt collected and/or other cost-sharing information available to the Contractor against the total family income data provided by the State. Any service not specifically listed as a covered benefit in the applicable HIP alternative benefit plan may not be applied against the member’s five EXHIBIT 2.I
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Member Cost. Sharing Effective July 1, 2010, federal regulations at 42 CFR 447.78 place aggregate limits on cost-sharing and prohibit total member cost-sharing per family—including POWER Account contributions, premiums, co-payments and co-insurance—from exceeding five percent (5%) of the family’s income, as determined by the State, in a monthly or quarterly period. To ensure a family’s total cost-sharing does not exceed five percent (5%) of the family’s income on a quarterly basis, the Contractor shall accept family income data from the State’s fiscal agent and track the POWER Account contributions, premiums, co-payments, member debt collected and/or other cost-sharing information available to the Contractor against the total family income data provided by the State. Any service not specifically listed as a covered benefit in the applicable HIP alternative benefit plan may not be applied against the member’s five percent (5%) contribution calculation. The time period for tracking data shall be defined by the State. When a family’s total cost-sharing expenditures come close to exceeding five percent (5%) of the family’s income in the quarterly period, the Contractor shall be required to notify the State. The Contractor shall also coordinate with the State to notify providers and the family that additional cost-sharing during the period is reduced or waived. In monitoring the quarterly 5% member cost-sharing limit, the Contractor shall comply with the policies and procedures set forth in this section and the HIP MCE Policies and Procedures Manual.
Sample 1

Related to Member Cost

  • Project Cost a. The estimated cost of the Project is $ 97,740.00. This amount is based upon the Schedule of Financial Assistance in Exhibit "B", attached to and incorporated in this Agreement. Exhibit “B” may be modified by mutual execution of an amendment as provided for in paragraph 5.i.

  • Estimated Cost Estimated costs by construction phases for Specified Roads listed in A7 are stated by segments in the Schedule of Items. Such estimated costs are subject to adjustment under B3.3, B5.2, B5.21, B5.212, B5.25, and B5.26. Appropriately adjusted costs shall be made a part of a revised Schedule of Items and shown as adjustments to Timber Sale Account. The revised Schedule of Items shall supersede any prior Schedule of Items when it is dated and signed by Contracting Officer and a copy is furnished to Purchaser.

  • GMP Cost Limitation The Guaranteed Maximum Price shall not be in excess of the GMP Cost Limitation.

  • DIRECT PERSONNEL EXPENSE 4.1. Direct Personnel Expense of employees engaged on the Project by the ARCHITECT/ENGINEER includes ARCHITECT/ENGINEERS, other engineers, designers, job captains, draftsmen, specification writers and typists, in consultation, research and design in producing Drawings, Specifications and other documents pertaining to the Project, and in services during construction at the site.

  • Certification as Small Contractor or Minority Business Enterprise This paragraph was intentionally left blank.

  • Travel Expense Any EMPLOYEE who must use his personal automobile or otherwise provide his own transportation when on school district business shall be reimbursed by the BOARD according to the amount established by current BOARD policy.

  • Indirect Cost Except as otherwise authorized by this contract, no indirect costs shall be reimbursed.

  • Labor Costs 6.2.1 Wages of construction workers directly employed by the Construction Manager to perform the construction of the Work at the site or, with the Owner’s prior approval, at off-site workshops.

  • Divestment costs etc 34.5.1 The Concessionaire shall bear and pay all costs incidental to divestment of all of the rights, title and interest of the Concessionaire in the Project in favour of the Authority upon Termination, save and except that all stamp duties payable on any deeds or Documents executed by the Concessionaire in connection with such divestment shall be borne by the Authority.

  • Total Cost It is estimated that the total cost to Princeton University for the performance of this Contract shall not exceed the Not-to-Exceed Price set forth in the Contract and the Contractor agrees to use its best efforts to perform the Work specified in the Contract and all obligations under this Contract within such Not-to- Exceed Price. If at any time the Contractor has reason to believe that the hourly rate payments and material costs that will accrue in performing this Contract in the next succeeding thirty (30) days, if added to all other payments and costs previously accrued, will exceed eighty-five percent (85%) of the Not-to-Exceed Price in the Contract, the Contractor shall notify Princeton University giving a revised estimate of the total price for performing this Contract with supporting reasons and documentation. If at any time during performing this Contract, the Contractor has reason to believe that the total price to Princeton University for performing this Contract will be substantially greater or less than stated Not-to-Exceed Price, the Contractor shall so notify Princeton University, giving a revised estimate of the total price for performing this Contract, with supporting reasons and documentation. If at any time during performance of this Contract, Princeton University has reason to believe that the cost required to perform the Work of this Contract will be substantially greater or less than the stated Not-to-Exceed Price, Princeton University will so advise the Contractor, giving the then- revised estimate of the total amount of effort to be required under the Contract.

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