Two Year Limit to Assert Claim Sample Clauses

Two Year Limit to Assert Claim. (1) The STATE shall not assert any claim for, seek the reimbursement of, or make any adjustment for any alleged overpayment made by the STATE to the MCO under this Contract more than two (2) years after the date such payment was actually received by the MCO from the STATE.
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Two Year Limit to Assert Claim. (1) The STATE shall not assert any claim for, seek the reimbursement of, or make any adjustment for any alleged overpayment made by the STATE to the MCO under section 4.1 of this Contract more than two (2) years after the date such payment was actually received by the MCO from the STATE. This two year limitation does not apply to duplicate payments made because of multiple identification numbers for the same Enrollee, payments for full months for an Enrollee while Incarcerated, payments for full months after the death of the Enrollee, and in the event that CMS or the state or federal Office of the Inspector General requires the STATE to recover payments.
Two Year Limit to Assert Claim. A. The STATE shall not assert any claim for or seek the payment of or make any adjustment for any alleged overpayment made by the STATE to the HEALTH PLAN pursuant to Section 4.2. of this contract, more than two years after the date such payment was actually received by the HEALTH PLAN from the STATE.

Related to Two Year Limit to Assert Claim

  • Payment in the Event Losses Fail to Reach Expected Level On the date that is 45 days following the last day (such day, the “True-Up Measurement Date”) of the Final Shared Loss Month, or upon the final disposition of all Shared Loss Assets under this Single Family Shared-Loss Agreement at any time after the termination of the Commercial Shared-Loss Agreement, the Assuming Institution shall pay to the Receiver fifty percent (50%) of the excess, if any, of (i) twenty percent (20%) of the Intrinsic Loss Estimate less (ii) the sum of (A) twenty-five percent (25%) of the asset premium (discount) plus (B) twenty-five percent (25%) of the Cumulative Shared-Loss Payments plus (C) the Cumulative Servicing Amount. The Assuming Institution shall deliver to the Receiver not later than 30 days following the True-Up Measurement Date, a schedule, signed by an officer of the Assuming Institution, setting forth in reasonable detail the calculation of the Cumulative Shared-Loss Payments and the Cumulative Servicing Amount.

  • Notification of the Amount of Fair Share Fee Notice of the amount of the annual fair share fee, which shall not be more than 100% of the unified dues of the employee organization, shall be transmitted by the employee organization to the Board Treasurer on or about September 15 of each year during the term of this Agreement for the purpose of determining amounts to be payroll-deducted, and the Board agrees to promptly transmit all amounts deducted to the employee organization.

  • Contribution Deadline The deadline for making an IRA contribution is your tax return due date (not including extensions). You may designate a contribution as a contribution for the preceding taxable year in a manner acceptable to us. For example, if you are a calendar year taxpayer, and you make your IRA contribution on or before April 15, your contribution is considered to have been made for the previous tax year if you designate it as such. If you are a member of the Armed Forces serving in a combat zone, hazardous duty area, or contingency operation, you may have an extended contribution deadline of 180 days after the last day served in the area. In addition, your contribution deadline for a particular tax year is also extended by the number of days that remained to file that year’s tax return as of the date you entered the combat zone. This additional extension to make your IRA contribution cannot exceed the number of days between January 1 and your tax filing deadline, not including extensions.

  • Dollar Limits Per Service Agreement Cost to diagnose, repair and/or replace - Geothermal and water source systems $1,500 Water cooled air conditioners, high velocity and hydronic systems $1,500 Concrete encased or concealed ductwork $500 Refrigerant lines $500 Appliances l Standard/Seller Coverage S Supreme Coverage l S Appliance color matchSM l S Built-in microwave l S Dishwasher l S Garbage disposal l S Range, oven, cooktop and vent hood l S Refrigerator - INCLUDING ICE MAKER! S Washer and dryer S Range, oven, cooktop, hood: handles, hinges, clocks, rotisseries, racks, knobs and dials, interior lining, glass/ceramic cooktops, self cleaning mechanisms and latch assemblies S Kitchen Refrigerator: handles, hinges, ice crusher, beverage dispenser and respective equipment S Built-in microwave: handles, hinges, interior lining, clocks and shelves, turntable platforms and rollers S Dishwasher: handles, hinges, racks, baskets, rollers, tub and interior lining, springs, latch assemblies and soap dispensers S Permits up to $250 per Service Agreement S Modifications up to $250 per Service Agreement S Haul away/disposal fees S Items under manufacturer’s warranty Excluded Items: ✖ Appliances not located in the primary kitchen (except washer and dryer) and duplicate appliances, unless additional refrigerator option(s) are purchased. ✖ Meat probe assemblies, door glass, sensi-heat burners will only be replaced with standard burners for range, oven, cooktop. ✖ Multimedia center including technology convenience items like LCD screens, Wi-Fi and cameras. ✖ Racks, hinges, shelves, interior thermal shells, food spoilage and freezers which are not an integral part of the kitchen refrigerator. ✖ Door glass, portable or counter top units, trim kits, meat probe assemblies, rotisseries for built-in microwave. ✖ Damage to clothing, plastic mini-tub, soap dispensers, filter screens, knobs, dials, hinges and lint screen for washer or dryer. ✖ Gas supply line to stove.

  • Claims Payment The Reinsurer will be liable to the Company for its share of the benefits owed under the express contractual terms of the Reinsured Policies and as specified under the terms of this Agreement. The Reinsurer will not participate in any ex gratia payments made by the Company (i.e., payments the Company is not required to make under the Reinsured Policy terms.) The payment of death benefits by the Reinsurer will be in one lump sum regardless of the mode of settlement under the Reinsured Policy. Benefit payments from the Reinsurer will be due within 30 days of the claim satisfying the requirements established under this Agreement. The Reinsurer’s share of any interest payable under the terms of a Reinsured Policy or applicable law which is based on the death benefits paid by the Company, will be payable provided that the Reinsurer will not be liable for interest accruing on or after the date of the Company’s payment of benefits. The Reinsurer will make payment to the Company for each such claim. For Waiver of Premium claims, the Company will continue to pay premiums for reinsurance, except premiums for disability reinsurance. The Reinsurer will pay its proportionate share of the gross premium waived by the Company on the Reinsured Policy, including its share of the premiums for benefits that remain in effect during disability. For claims on Accelerated Benefit riders reinsured under this Agreement, the benefit amount payable by the Reinsurer will be calculated by multiplying the total accelerated death benefit rider payout by the ratio of the reinsured Net Amount at Risk, as defined in Exhibit C-1, to the face amount of the Reinsured Policy.

  • Adverse Benefit Determination An adverse benefit determination is any of the following:  Denial of a benefit (in whole or part),  Reduction of a benefit,  Termination of a benefit,  Failure to provide or make a payment (in whole or in part) for a benefit, and  Rescission of coverage, even if there is no adverse effect on any benefit. An appeal of an adverse benefit determination can be made either as an administrative appeal or as a medical appeal, as defined further in this section. Our Customer Service Department phone number is (000) 000-0000 or 0-000-000-0000.

  • Indemnity Limitation for TIPS Sales Texas and other jurisdictions restrict the ability of governmental entities to indemnify others. Vendor agrees that if any "Indemnity" provision which requires the TIPS Member to indemnify Vendor is included in any TIPS sales agreement/contract between Vendor and a TIPS Member, that clause must either be stricken or qualified by including that such indemnity is only permitted, "to the extent permitted by the laws and constitution of [TIPS Member's State]” unless the TIPS Member expressly agrees otherwise. Any TIPS Sale Supplemental Agreement containing an "Indemnity" clause that conflicts with these terms is rendered void and unenforceable.

  • Requiring Minimum Compensation for Covered Employees a. Contractor agrees to comply fully with and be bound by all of the provisions of the Minimum Compensation Ordinance (MCO), as set forth in San Francisco Administrative Code Chapter 12P (Chapter 12P), including the remedies provided, and implementing guidelines and rules. The provisions of Sections 12P.5 and 12P.5.1 of Chapter 12P are incorporated herein by reference and made a part of this Agreement as though fully set forth. The text of the MCO is available on the web at xxx.xxxxx.xxx/xxxx/xxx. A partial listing of some of Contractor's obligations under the MCO is set forth in this Section. Contractor is required to comply with all the provisions of the MCO, irrespective of the listing of obligations in this Section.

  • Reemployment in Same Class Following Layoff An employee who has acquired permanent status in a position and who is laid off because of lack of work or funds and is re-employed in the same class after such layoff shall be paid the salary step attained prior to layoff.

  • Liability Calculation Method Per Claim Unless subject to a fixed dollar copayment, the calculation of Member liability on claims for Out-of-Area Covered Health Care Services processed through the BlueCard Program will be based on the lower of the provider’s billed charges or the negotiated price made available to Blue Shield by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s health care provider contracts. The negotiated price made available to Blue Shield by the Host Blue may be represented by one of the following:

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