Application of Risk Corridor to MCOs Sample Clauses

Application of Risk Corridor to MCOs. All MCOs shall be subject to the same risk corridors (“Band Labels” in the table above) based on the Combined Ratio. For example, if the Combined Ratio percentage is ninety-nine-point five percent (99.5%) (within Corridor A), no corridor adjustments are applied and MCOs retain their individual profits or losses. However, if the Combined Ratio were ninety-six percent (96%) (within Corridor B+), an individual MCO’s profits greater than three-point two percent (3.2%) will be allocated fifty percent (50%) to the MCO and fifty percent (50%) to State and Federal governments (per table above). The allocations of each MCO’s profits or losses, either to the MCO or to the State and Federal Government, shall depend on (1) the corridor into which the Combined Ratio falls, which determines the risk corridor bands that can apply to an MCO’s profits or losses, and (2) the risk corridor in which that portion of the MCO’s profit or loss percentage falls: a. For Corridor A, the MCO shall be allocated one hundred percent (100%) of the first three-point two percent (3.2%) of profits. b. For Corridor B+, profits after three-point two percent (3.2%) to four-point seven percent (4.7%) shall be allocated fifty percent (50%) to the MCO (50%) and fifty percent (50%) to the State and Federal Government. For Corridor B-, the initial one-point five percent (1.5%) of revenue losses shall be allocated fifty percent (50%) to the MCO and fifty percent (50%) to the State and Federal Government. c. For Corridor C+, profits over four-point seven percent (4.7%) of revenue shall be allocated ten percent (10%) to the MCO and ninety percent (90%) to the State and Federal Government. For Corridor C-, revenue losses exceeding one-point five percent (1.5%) shall be allocated ten percent (10%) to the MCO and the ninety percent (90%) to the State and Federal Government.
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