Administrative Allocation. The Agency may make monthly payments to the Health Plan as an allocation for administrative activities undertaken by the Health Plan. a. The amount of the administrative allocation is a PMPM amount for each person enrolled in the Health Plan for the month. The administrative allocation is a percentage of the per capita capitated benchmark (PCCB) as defined below in sub- item 2 and as specified in Attachment I, , E. Method of Payment, sub-item 2., Administrative Allocation. b. The administrative allocation is separate from the monthly primary care case management fees paid to the Health Plan. c. The Health Plan is at risk for a maximum of fifty percent (50%) of each administrative allocation due from the Agency as indicated in Attachment II, Exhibit 13, Method of Payment, Item E., Annual Reconciliations, below. d. The Agency reserves the right to adjust the administrative allocation on an as needed basis. e. For Health Plans serving Reform populations, the Agency may provide an advance of the administrative allocation not to exceed $300,000. The agreed-upon advance amount would be paid by the Agency after Contract execution. This advance amount will be amortized over the life of the Contract and deducted in equal installments from the monthly administrative allocation. If the Contract ends prior to the advance being repaid, the Health Plan shall refund the remainder of the advance owed within an Agency agreed-upon timeframe not to exceed the life of the Contract had the Contract not ended early.
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Samples: Health Plan Contract, Health Plan Contract
Administrative Allocation. The Agency may make monthly payments to the Health Plan as an allocation for administrative activities undertaken by the Health Plan.
a. The amount of the administrative allocation is a PMPM amount for each person enrolled in the Health Plan for the month. The administrative allocation is a percentage of the per capita capitated benchmark (PCCB) as defined below in sub- item 2 and as specified in Attachment I, , E. Method of Payment, sub-item 2., Administrative Allocation.
b. The administrative allocation is separate from the monthly primary care case management fees paid to the Health Plan.
c. The Health Plan is at risk for a maximum of fifty percent (50%) of each administrative allocation due from the Agency as indicated in Attachment II, Exhibit 13, Method of Payment, Item E., Annual Reconciliations, below.
d. The Agency reserves the right to adjust the administrative allocation on an as needed basis.
e. For Health Plans serving Reform populations, the Agency may provide an advance of the administrative allocation not to exceed $300,000. The agreed-upon advance amount would be paid by the Agency after Contract execution. This advance amount will be amortized over the life of the Contract and deducted in equal installments from the monthly administrative allocation. If the Contract ends prior to the advance being repaid, the Health Plan shall refund the remainder of the advance owed within an Agency agreed-upon timeframe not to exceed the life of the Contract had the Contract not ended early.
Appears in 1 contract
Samples: Health Plan Contract