CALCULATION OF SAVINGS AND LOSSES Sample Clauses

CALCULATION OF SAVINGS AND LOSSES. The inpatient hospital component of the budget is stated assuming [ ** ] of Subscribers enroll in benefit plans with hospital service copayments, coinsurance and deductible obligations ("Co-Pay Plans"). It is also assumed that [ ** ] of Subscribers enroll in non-Co-Pay Plans ("Regular Plans"). The Budget will be adjusted to reflect the actual number of Subscribers who enroll in the Co-Pay Plans and Regular Plans based upon PacifiCare's Member Month Moving Analysis Report for the period (MB0530). The MB0530 Report is a report that reflects actual eligible Subscribers by benefit plan for the period, as adjusted for retroactive eligibility terminations and additions reported during the period as of the report's run date. The Budget, when adjusted as described above, shall be referred to as the Earned Budget. The Earned Budget may be greater or less than the Total Budget PMPM indicated in Section 2 above.
Sample 1
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CALCULATION OF SAVINGS AND LOSSES. The inpatient hospital component of the budget is stated assuming [ ** ] of the Subscribers enrolled in the 880 Plan and [ ** ] of the Subscribers in all other plans. The earned budget will be adjusted to reflect the actual number of Subscribers who enrolled in the 880 and non-880 plans based upon PacifiCare's Member Month Moving Analysis Report for the period (MB0530). The MB0530 Report is a report that reflects actual eligible Subscribers by benefit plan for the period as adjusted for retroactive eligibility terminations and additions reported during the period as of the report's run date. Therefore, the actual earned budget may be greater or less than the net budget indicated in this Attachment.
Sample 1
CALCULATION OF SAVINGS AND LOSSES. If actual costs are less than the earned budget, then Medical Group will be paid fifty percent (50%) of the amount saved. If actual costs are greater than the earned budget, then Medical Group will be liable for fifty percent (50%) of the deficit. An interim calculation of the HCP results will be made by PacifiCare for each quarter based on estimated incurred costs. The calculations will be computed on a contract year-to-date basis. The results will be reported to the Medical Group within sixty (60) days of the end of each quarter. If there are deficits in the HCP, the Medical Group will be required to make a payment to PacifiCare in the amount the calculation indicates. Medical Group shall submit all requests to reconcile the quarterly risk settlement no later than sixty (60) days after receipt of each quarterly risk settlement report. PacifiCare shall respond to reconciliation requests within sixty (60) days of receipt of request. No later than August 31 after the end of the prior year can the Medical Group submit request for claims readjudication under risk settlement for the prior year. Final payment will be made within one hundred and fifty (150) days of the end of the contract period.
Sample 1
CALCULATION OF SAVINGS AND LOSSES. If actual costs are less than the earned budget, then Medical Group will be paid according to the attached schedule. Interim settlements on the Hospital Control Program shall be made on a quarterly basis commencing with the second quarter. Payment shall equal 75% of the amount due to Medical Group. Payment is due within 60 days after the end of the reporting period. Medical Group shall submit all requests to reconcile the quarterly risk settlement no later than sixty (60) days after receipt of each quarterly risk settlement report. PacifiCare shall respond to reconciliation requests within sixty (60) days of receipt of request. No later than August 31 after the end of the prior year can the Medical Group submit request for claims readjudication under risk settlement for the prior year. Final payment will be made within one hundred and fifty (150) days of the end of the contract period.
Sample 1
CALCULATION OF SAVINGS AND LOSSES. The earned budget detailed on the previous page will be adjusted to reflect the actual number of members who are enrolled in the 880 Plan. The inpatient hospital component of the budget is stated assuming [ ** ] of the members enrolled in the 880 Plan and [ ** ] of the members in all other plans. In the event that actual costs are less than the earned budget, then the IPA shall receive the share of savings relative to the bed days per thousand members per year indicated in the following sliding scale schedule: Bed Days/Outpt. Surgery Per Thousand Mbrs/Year IPA % Sharing ------------------------ -------------- [ ** ] [ ** ] [ ** ] [ ** ] [ ** ] [ ** ] [ ** ] [ ** ] For the purposes of this calculation, "Bed Days/Outpt. Surgery" shall be defined as acute inpatient days plus outpatient surgeries, net of any acute inpatient days or outpatient surgeries which are covered under reinsurance or are paid through a third party recovery or through coordination of benefits. If actual costs are greater than the earned budget, then the IPA will be liable for [ ** ] of the amount lost up to the maximum payment specified below. [ ** ] ATTACHMENT A5 continued On a quarterly basis, cumulative calculations of the Hospital Control Program results will be made and interim payments will be made based on these results. Calculations will be made in accordance with the contractual terms above and the amount of PacifiCare's payment will be [ ** ] of the amount due to the IPA based on the above referenced calculation. The reduced payment amount is to adjust for the incurred, but not reported, claims. In the event that the interim calculation reflects a cumulative loss for the IPA, no interim payment will be made to or due from the IPA in the first quarter a loss results. If a cumulative loss is reflected for two consecutive quarters, the IPA will make an interim payment of [ ** ] of the cumulative amount due to PacifiCare. The calculations will be made based on calendar quarters and the interim payments made within sixty (60) days thereof. No interim calculation will be made in the fourth calendar quarter. If the IPA reflects a loss for two consecutive quarters and, therefore, is required to make a payment to PacifiCare, such payment will be due within fifteen (15) days of the IPA's receipt of such notice form PacifiCare. A calendar year-end calculation of the Hospital Control Program shall be made by PacifiCare and payment to the appropriate party shall be made within 120 days of t...
Sample 1

Related to CALCULATION OF SAVINGS AND LOSSES

  • Allocation of Profits and Losses The Company’s profits and losses shall be allocated to the Member.

  • Calculation of Sale Gain or Loss For Shared-Loss Loans that are not Restructured Loans, gain or loss on the sales under Section 4.1 or Section 4.2 will be calculated as the sale price received by the Assuming Institution less the unpaid principal balance of the remaining Shared-Loss Loans. For any Restructured Loan included in the sale gain or loss on sale will be calculated as (a) the sale price received by the Assuming Institution less (b) the net present value of estimated cash flows on the Restructured Loan that was used in the calculation of the related Restructuring Loss plus (c) Loan principal payments collected by the Assuming Institution from the date the Loan was restructured to the date of sale. (See Exhibits 2d(1)-(2) for example calculations).

  • Profits and Losses Distributions The Member shall treat all of the profits and losses of the Company as its own. All distributions shall be made to the Member at times and in amounts determined by the Member or the Board of Managers. The Company shall not make distributions to the Member if such distribution would violate Section 18-607 of the Act.

  • Net Termination Gains and Losses After giving effect to the special allocations set forth in Section 6.1(d), all items of income, gain, loss and deduction taken into account in computing Net Termination Gain or Net Termination Loss for such taxable period shall be allocated in the same manner as such Net Termination Gain or Net Termination Loss is allocated hereunder. All allocations under this Section 6.1(c) shall be made after Capital Account balances have been adjusted by all other allocations provided under this Section 6.1 and after all distributions of Available Cash provided under Sections 6.4 and 6.5 have been made; provided, however, that solely for purposes of this Section 6.1(c), Capital Accounts shall not be adjusted for distributions made pursuant to Section 12.4.

  • Allocation of Net Income and Net Loss Net Income or Net Loss of the Partnership shall be determined as of the end of each calendar year and as of the end of any interim period extending through the day immediately preceding any (i) disproportionate Capital Contribution, (ii) disproportionate distribution, (iii) Transfer of a Partnership Interest in accordance with the terms of this Agreement, or (iv) Withdrawal Event. If a calendar year includes an interim period, the determination of Net Income or Net Loss for the period extending through the last day of the calendar year shall include only that period of less than twelve (12) months occurring from the day immediately following the last day of the latest interim period during the calendar year and extending through the last day of the calendar year. For all purposes, including income tax purposes, Net Income, if any, of the Partnership for each calendar year or interim period shall be allocated among the Partners in proportion to their respective Partnership Percentages for the calendar year or interim period. In the event of a Net Loss for a particular calendar year or interim period, then, for such calendar year or interim period, the Net Loss for such calendar year or interim period shall be allocated among the Partners in proportion to their respective Partnership Percentages for the calendar year or interim period.

  • Net Losses After giving effect to the special allocations set forth in Section 6.1(d), Net Losses for each taxable period and all items of income, gain, loss and deduction taken into account in computing Net Losses for such taxable period shall be allocated as follows:

  • Profits and Losses For financial accounting and tax purposes, the Company’s net profits or net losses shall be determined on an annual basis in accordance with the manner determined by the Board. In each year, profits and losses shall be allocated entirely to the Member.

  • Determination of Net Asset Value, Net Income and Distributions Subject to applicable federal law including the 1940 Act and Section 3.6 hereof, the Trustees, in their sole discretion, may prescribe (and delegate to any officer of the Trust or any other Person or Persons the right and obligation to prescribe) such bases and time (including any methodology or plan) for determining the per Share or net asset value of the Shares of the Trust or any Series or Class or net income attributable to the Shares of the Trust or any Series or Class, or the declaration and payment of dividends and distributions on the Shares of the Trust or any Series or Class and the method of determining the Shareholders to whom dividends and distributions are payable, as they may deem necessary or desirable. Without limiting the generality of the foregoing, but subject to applicable federal law including the 1940 Act, any dividend or distribution may be paid in cash and/or securities or other property, and the composition of any such distribution shall be determined by the Trustees (or by any officer of the Trust or any other Person or Persons to whom such authority has been delegated by the Trustees) and may be different among Shareholders including differences among Shareholders of the same Series or Class.

  • Allocation of Net Profits and Net Losses As of the last day of each Fiscal Period, any Net Profits or Net Losses for the Fiscal Period shall be allocated among and credited to or debited against the Capital Accounts of the Members in accordance with their respective Investment Percentages for such Fiscal Period.

  • Allocations of Profits and Losses Except as otherwise provided in this Agreement, Profits and Losses (and, to the extent necessary, individual items of income, gain or loss or deduction of the Partnership) shall be allocated in a manner such that the Capital Account of each Partner after giving effect to the Special Allocations set forth in Section 5.05 is, as nearly as possible, equal (proportionately) to (i) the distributions that would be made pursuant to Article IV if the Partnership were dissolved, its affairs wound up and its assets sold for cash equal to their Carrying Value, all Partnership liabilities were satisfied (limited with respect to each non-recourse liability to the Carrying Value of the assets securing such liability) and the net assets of the Partnership were distributed to the Partners pursuant to this Agreement, minus (ii) such Partner’s share of Partnership Minimum Gain and Partner Nonrecourse Debt Minimum Gain, computed immediately prior to the hypothetical sale of assets. For purposes of this Article V, each Unvested Unit shall be treated as a Vested Unit. Notwithstanding the foregoing, the General Partner shall make such adjustments to Capital Accounts as it determines in its sole discretion to be appropriate to ensure allocations are made in accordance with a partner’s interest in the Partnership.

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