Covered Services You will receive Covered Services under the terms and conditions of this Contract only when the Covered Service is: • Medically Necessary; • Provided by a Participating Provider for in-network coverage; • Listed as a Covered Service; • Not in excess of any benefit limitations described in the Schedule of Benefits section of this Contract; and • Received while Your Contract is in force.
Grandfathered Services Services identified in GTE Tariffs as grandfathered in any manner are available for resale only to end user customers that already have such grandfathered service. An existing end user customer may not move a grandfathered service to a new service location. Grandfathered services are subject to a resale discount.
Non-Covered Services The Contractor shall refer Members to Providers enrolled in the Medicaid Fee-for- Service delivery system for all Medically Necessary Services not covered by the Contractor under the MississippiCAN Program. The Contractor shall have written policies and procedures for the referral of Members for non-covered services, which shall provide for the smooth transition to Out-of-network Providers and assistance to Members in obtaining a new PCP, if appropriate. These procedures shall be applicable to the referral of Members to Out-of- network Providers, as necessary, upon Disenrollment, regardless of the reasons for Disenrollment.
EXTENDED SERVICE 156 Upon application, a military leave of absence (without pay) will be granted to employees who are employed in other than temporary positions. This applies to employees who are inducted through a selective service system or voluntary enlistment, or if the employee is called through membership in the National Guard or reserve component into the Armed Forces of the United States.
IN-SERVICE When a nurse attends any in-service programme during her/his regularly scheduled working hours, she/he shall suffer no loss of pay. When a nurse is unable to do so, and attends the in-service programme outside her/his regularly scheduled hours, she/he shall be paid for all time attendance at her/his straight time rate of pay. If attendance is mandatory all applicable premiums will apply.