Completion adjustment. The capitation rates are based on CY 2016 experience. Encounter data is paid through March 31, 2017. Completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability. First, we stratified the data by category of service and population groupings. Claims for each of these population-service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCP reported IBNP liability estimates in the CY 2016 MCP Cost Reports. The completion factors selected were developed by blending MCP reported IBNP with our IBNP estimates. The monthly completion factors were applied to CY 2016 non-sub-capitated experience to estimate the remaining claims liability for the calendar year. Results were aggregated into annual completion factors for each calendar year. For the AFK population, completion factors were developed through a review of historical fee-for-service claims experience.
Completion adjustment. On the date falling seven (7) Business Days prior to the Completion Date (the "Pro Forma Completion Accounts Date"), the Seller shall provide the Buyer and APG with:
Completion adjustment. The adjustments (if any) to be made after Completion to the 3 Italia Estimates and the Wind Estimates shall be calculated on the basis set out in Part 1 of Schedule 10.
Completion adjustment. The capitation rates are based on SFY 2022 Opt-In program experience. Encounter data is paid through December 31, 2022. In recognition of the 6 months of available runout to the SFY 2022 incurred period, we asked the MCOPs to provide updated IBNP estimates for this period paid through June 30, 2023 as part of the 2024 MCOP Survey process. In addition, completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using Xxxxxxxx’x Robust Time- Series Reserve Analysis System (RTS)1. First, we stratified the data by category of service. Claims for each of these population-service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCOP reported IBNP liability estimates in the MCOP surveys. The updated IBNP liabilities provided by the MCOPs as part of the 2024 MCOP Survey submissions provided an additional six months of claims runout that is typically not available for rate development. Based on our review of historical claim payment patterns and consideration of additional claims runout provided by the MCOPs, we applied completion adjustments based on the IBNP liabilities provided by the MCOPs. The monthly completion factors were applied to SFY 2022 experience to estimate the remaining claims liability for the calendar year. In addition to the completion adjustment, we considered the decreased utilization of MyCare services observed during the COVID-19 pandemic on the SFY 2022 base data period and the impact of experience through the remainder of CY 2022 on prospective trend assumptions for CY 2024. To account for material changes in utilization patterns throughout the base period and the remainder of CY 2022 as a result of the COVID-19 pandemic, an adjustment was applied to the SFY 2022 base data for the Nursing Facility service category for the Community Well rate cells and the Adult Day Care service category for the Community Waiver 65+ and Community Waiver 45- 64 rate cells.
Completion adjustment. The capitation rates are based on CY 2019 Opt-In program experience. Encounter data is paid through June 30, 2021. In recognition of the 18 months of available runout to the CY 2019 incurred period, we asked the MCOPs to provide updated IBNP estimates for this period as part of the MCOP survey process. Additionally, completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using Milliman’s Robust Time-Series Reserve Analysis System (RTS)2. First, we stratified the data by category of service. Claims for each of these population-service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCOP reported IBNP liability estimates in the MCOP surveys. Based on our review of historical claim payment patterns and prior rate development analyses, we elected to apply completion adjustments based on IBNP liabilities reported by the MCOPs.
Completion adjustment. The capitation rates are based on CY 2016 experience. Cost report data is paid through March 31, 2017. Completion factors were developed by summarizing cost report data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability. First, we stratified the data by category of service. Claims for each of these population-service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCOP reported IBNP liability estimates in the CY 2016 MCOP Cost Reports. Although the completion adjustments were similar, we elected to apply completion adjustments based on our calculated IBNP liabilities rather than the IBNP liabilities reported by the MCOPs. The monthly completion factors were applied to CY 2016 non-sub-capitated experience to estimate the remaining claims liability for the calendar year.
Completion adjustment. The capitation rates are based on CY 2019 Opt-In program experience. Encounter data is paid through March 31, 2020. Completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using Xxxxxxxx’x Robust Time-Series Analysis System (RTS)2. First, we stratified the data by category of service. Claims for each of these population-service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCOP reported IBNP liability estimates in the CY 2019 MCOP Cost Reports. Based on our review of historical claim payment patterns and prior rate development analyses, we elected to apply completion adjustments based on our calculated IBNP liabilities rather than the IBNP liabilities reported by the MCOPs. The monthly completion factors were applied to CY 2019 experience to estimate the remaining claims liability for the calendar year.
Completion adjustment. The capitation rates are based on SFY 2021 Experience Adjusted data. The unadjusted encounter data used to develop the Experience Adjustment was adjudicated through December 31, 2021. As part of the Experience Adjustment, completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of IBNP liability, using Milliman’s Robust Time-Series Analysis System (RTS)6. First, we stratified the data by category of service in the population groupings. Claims for each of these population-service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed using encounter data were compared to MCO- reported IBNP liability estimates in the CY 2020 and Q4 2021 MCO Cost Reports for reasonableness. The monthly completion factors were applied to unadjusted SFY experience to estimate the remaining claims liability for the period.
Completion adjustment. 3.3.1 The Buyer and the Seller shall agree and/or there shall be determined the Completion Adjustment in accordance with Schedule 7.
3.3.2 If the Completion Adjustment is less than zero:
(a) the Seller shall subscribe for one ordinary share in the Target Company at a premium equal to the absolute value of the amount of the Completion Adjustment (or its equivalent) (the "SELLER'S ADDITIONAL CAPITAL");
(b) the Buyer shall procure that the Target Company issues the Seller's Additional Capital to the Seller upon payment. Immediately upon issue of the Seller's Additional Capital the Seller shall transfer the Seller's Additional Capital to the Buyer in consideration for the payment by the Buyer to the Seller of $1.00; and
(c) the Buyer shall procure that the Target Company subscribes for one ordinary share in the Target Subsidiary at a premium equal to the total amount received by the Target Company for the Seller's Additional Capital.
3.3.3 If at any time following the Completion Date the Outstanding Completion Balance is greater than zero and:
(a) the Target Subsidiary pays a Management Fee, then the Buyer shall, subject to Clause 3.3.4, within 5 business days of the receipt by the Manager of the Management Fee, pay to the Seller an amount equal to 50 per cent. of the Management Fee; and/or
(b) the Target Subsidiary pays a Trigger Distribution, then the Buyer shall, subject to Clause 3.3.4, within 5 business days of such payment, pay to the Seller an amount equal to the Relevant Percentage of such Trigger Distribution;
(c) the Buyer or any of its Affiliates disposes of a controlling interest in the Target Company (other than pursuant to clause 13 or clause 14) then the Buyer shall, within 5 business days of the receipt of the consideration, pay 100 per cent. of the consideration received for any such controlling interest; and/or
(d) the Target Company or any of its Affiliates:
(i) disposes of a controlling interest in the Target Subsidiary; and/or
(ii) disposes of all or substantially all of its assets; and/or
(iii) procures that the Target Subsidiary disposes of all or substantially all of its assets, (in each case other than pursuant to clause 13 or clause 14) then the Buyer shall, within 5 business days of the receipt of the consideration, whether by the Buyer, the Target Company or the Target Subsidiary, pay to the Seller 100 per cent. of the consideration received for any such controlling interest or assets, provided that, the aggregate of the payments ma...
