Experience Adjustment Sample Clauses

Experience Adjustment. In the event that the actual medical loss ratio (MLR) that the INSURER achieves for this Contract is better than eighty five percent (85%), calculated in the same manner as the premium development and allocation methodology utilized in INSURER’s ITN response. INSURER shall return to FHKC a share of the dollar difference between the INSURER’s actual MLR for said period and the projected minimum MLR of eighty five percent (85%) based on the following tiered Experience Adjustment schedule: A. Tier I: MLR of 84.99 to 82.00 Percent: 50% to FHKC (84.99% to 82.00%) B. Tier II: MLR of 81.99 Percent or Less: 100% to FHKC (81.99% or less) If INSURER’s actual MLR is less than eighty-five percent (85%) during a Contract Year, but not lower than eighty-two percent (82%), INSURER shall return to FHKC fifty percent (50%) of the difference between the actual MLR and the projected minimum MLR of eighty-five percent (85%), pursuant to sub- paragraph 3-20-3A Tier I. If INSURER’S actual MLR is less than eighty-two percent (82%) during any Contract Year, INSURER shall return to FHKC the sum of the Tier I and Tier II experience adjustment pursuant to sub- paragraph 3-20-3A and B, as follows: 1) fifty percent (50%) of the difference between INSURER’s actual MLR of eighty-two percent (82%) and the minimum MLR of eighty-five percent (85%), and 2) one hundred percent (100%) of the difference between INSURER’s actual MLR and the Tier II maximum MLR of eighty-two percent (82%). INSURER shall provide FHKC with a written copy of its findings for each Contract year by April 1st (first). If any payments are due under this provision, INSURER shall forward such payment within thirty (30) days of its written notification. INSURER may be subject to audit or verification by FHKC or its designated agents. FHKC shall determine the adequacy of the information supplied under this section and whether or not the calculation has been accurately performed. The calculation shall be reported in a format approved by FHKC and FHKC may also request supporting documentation. After receipt of INSURER’S submission, FHKC may request that the calculation also be provided on a county by county basis. INSURER’S submission must include the following minimum information: Insurer Name: Contract Year: Counties Included in Calculation: Total Premiums Paid to INSURER during Contract Year: $ Actual Incurred Claims for Contract Year: $ Medical Loss Ratio Achieved: % Apply adjustment percentage in accordance with Section...
Sample 1
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Experience Adjustment. In addition to the annual base rate adjustment provided in Paragraph A of this Section III, Landlord reserves the right to increase or decrease the annual base rate per square foot from time to time by the issuance of a revised rate schedule based on Landlord's accumulated experience compiled from the operation of the central cold air distribution system, including increased costs of materials and supplies, costs incurred for governmental impositions and to meet governmental requirements, unusual or extraordinary costs in maintaining or repairing the central plant equipment and distribution system, costs experienced for purchase and installation of new equipment and renovation of existing equipment and the distribution system and costs incurred to utilize and add to the plant equipment and distribution system new technological features. LANDLORD'S TENANT'S INITIALS INITIALS ---------- -------- J.E.S. DD H.T.S. [GRAPH OF BASE RATE CURVE SHEET @4060 HRS. - SCHEDULE A] LANDLORD'S TENANT'S INITIALS INITIALS ---------- -------- J.E.S. DD H.T.S. [GRAPH OF ADJUSTED RATE CURVE SHEET - SCHEDULE B] LANDLORD'S TENANT'S INITIALS INITIALS ---------- -------- J.E.S. DD H.T.S. SOUTH COAST PLAZA DETAILED DESIGN CRITERIA AND STANDARDS FOR LANDLORD'S WORK AND FOR TENANT'S WORK*
Sample 1
Experience Adjustment. HEALTH PLANS Effective Dates: October 1, 2003 - September 30, 2005 In the event that the actual experience is less than 85 percent, in the aggregate for both Well Care and HealthEase, HEALTH PLAN shall pay to FHKC one-half of the difference. HEALTH PLAN shall annually provide FHKC with an aggregate experience report no later than March 1st for the prior calendar year. If any payments are due under this provision, HEALTH PLAN shall forward such payment with its written notification. HEALTH PLAN may be subject to audit or verification by FHKC or its designated agents. FHKC is not under any further obligation if the actual loss ratio exceeds 85%. HEALTH PLANS Effective Dates: October 1, 2003 - September 30, 2005 Page 29 of 50 EXHIBIT B ENROLLMENT PROCEDURES 1 All FHKC eligible participants will be provided with necessary enrollment materials and forms from FHKC or its assignee.
Sample 1
Experience Adjustment. To reflect the impact of population morbidity, program changes, fee schedule changes, and COVID-19 impacts that have occurred since CY 2019, we applied an experience adjustment to the CY 2019 encounter data so that the data reflects utilization and cost levels consistent with a SFY 2021 incurred period. This experience adjustment was developed based on a direct comparison of CY 2019 incurred encounters to SFY 2021 incurred encounters. This process was established to enable use of an experience period closer to the rating period and promote transparency related to the impacts of COVID-19 on emerging experience. The SFY 2021 Experience Adjusted data serves as the primary source for modeling the impact of retrospective and prospective program changes. Below we have outlined the steps of our methodology for developing the Experience Adjustment.
Sample 1
Experience Adjustment. In the event that the medical loss ratio. for this Agreement is better than eighty five percent (85%) calculated in the same manner as the premium development and allocation methodology utilized in AMERIGROUP’s response to the Request for Proposals (RFP), AMERIGROUP shall share equally with FHKC the dollar difference between the actual loss ratio for said period and the predicted eighty five percent (85%). AMERIGROUP shall provide FHKC with a written copy of its findings for each Agreement year by February 1st (first). If any payments are due under this provision, AMERIGROUP shall forward such payment with its written notification. AMERIGROUP may be subject to audit or verification by FHKC or its designated agents. FHKC shall determine the adequacy of the information supplied under this section and whether or not the calculation has been accurately performed in the manner prescribed below. The Calculation shall be illustrated in the following manner:
Sample 1
Experience Adjustment. In the event that the medical loss ratio for this Agreement is better than eighty-five percent (85%) in the aggregate for both WellCare and HealthEase calculated in the same manner as the premium development and allocation methodology utilized in the insurer’s original rate proposal in its response to the RFP, INSURER shall share equally with FHKC the dollar difference between the actual loss ratio for said period and the predicted eighty-five percent (85%). The INSURER shall provide annually FHKC with a written copy of its findings each year during the term of this Agreement by February 1st. If any payments are due under this provision, INSURER shall forward such payment with its written notification. The INSURER may be subject to audit or verification by FHKC or its designated agents. FHKC shall determine the adequacy of the information supplied under this section and whether or not the calculation has been accurately performed in the manner prescribed below. The Calculation shall be illustrated in the following manner: A. Total Premiums Paid During Year: $ B. Target Incurred Claims’: 85% of A C. Actual Incurred Claims for Year: $ D. Difference Between Target Incurred Claims and Actual Incurred Claims: $ (Subtract Line C from Line B) E. Amount Due FHKC (50% of Line D): $ ’ The target medical loss ratio for this Agreement and for this calculation is 85%. HEALTHEASE AND STAYWELL HMO Effective Date: October 1, 2005 1 All FHKC eligible Participants will be provided with necessary enrollment materials and forms from FHKC or its assignee.
Sample 1

Related to Experience Adjustment

  • FORCE ADJUSTMENT General 11.01 When any condition arises which reduces the work load to the extent that, in the Company's opinion, force adjustment is warranted, the following shall apply: (a) If the contemplated adjustment to the force would involve the lay-off of 50 or more Regular employees from the bargaining unit within a period of 30 days, or alternatively the spreading of the equivalent work by part-timing, the Company shall endeavour to reach agreement with the Union as to whether a plan of part-timing, lay-offs, or a combination of the two shall be put into effect. (b) If the contemplated adjustment to the work force is less extensive than that described in subsection 11.01 (a), the Company shall not resort to lay-off of Regular employees or part-timing of Regular Full-Time employees, except with the agreement of the Union. 11.02 In the event that an agreement as to a plan cannot be reached under subsection 11.01 (a) within a period of 30 calendar days after the matter has been submitted to the Union, the Company may proceed on a plan of lay-off to the extent it deems necessary. 11.03 It is expressly understood, however, that if the Company proceeds on a plan of lay-off at the expiration of the 30 day period or later as prescribed in this Article, negotiations toward an agreement relating to a force adjustment plan shall be resumed at any time at the request of either party. Similarly, after agreement has been reached as to a plan of force adjustment either party may resume negotiations at any time in an effort to obtain agreement upon modifications of the plan then in effect.

  • Performance Adjustment One-twelfth of the annual Performance Adjustment Rate will be applied to the average of the net assets of the Portfolio (computed in the manner set forth in the Fund's Declaration of Trust or other organizational document) determined as of the close of business on each business day throughout the month and the performance period.

  • Performance Adjustment Rate Except as otherwise provided in sub-paragraph (e) of this paragraph 3, the Performance Adjustment Rate is 0.02% for each percentage point (the performance of the Portfolio and the Index each being calculated to the nearest .01%) that the Portfolio's investment performance for the performance period was better or worse than the record of the Index as then constituted. The maximum performance adjustment rate is 0.20%. For purposes of calculating the performance adjustment of the portfolio, the portfolio's investment performance will be based on the performance of the retail class. The performance period will commence with the first day of the first full month following the retail class's commencement of operations. During the first eleven months of the performance period for the retail class, there will be no performance adjustment. Starting with the twelfth month of the performance period, the performance adjustment will take effect. Following the twelfth month a new month will be added to the performance period until the performance period equals 36 months. Thereafter the performance period will consist of the current month plus the previous 35 months. The Portfolio's investment performance will be measured by comparing (i) the opening net asset value of one share of the retail class of the Portfolio on the first business day of the performance period with (ii) the closing net asset value of one share of the retail class of the Portfolio as of the last business day of such period. In computing the investment performance of the retail class of the Portfolio and the investment record of the Index, distributions of realized capital gains, the value of capital gains taxes per share paid or payable on undistributed realized long-term capital gains accumulated to the end of such period and dividends paid out of investment income on the part of the Portfolio, and all cash distributions of the securities included in the Index, will be treated as reinvested in accordance with Rule 205-1 or any other applicable rules under the Investment Advisers Act of 1940, as the same from time to time may be amended.

  • Equitable Adjustment Trading volume amounts, price/volume amounts and similar figures in the Transaction Documents shall be equitably adjusted (but without duplication) to offset the effect of stock splits, similar events and as otherwise described in this Agreement and Warrants.

  • Adjustment of Conversion Rate The Conversion Rate shall be adjusted from time to time by the Company if any of the following events occurs, except that the Company shall not make any adjustments to the Conversion Rate if Holders participate (other than in the case of (x) a share split or share combination or (y) a tender or exchange offer), at the same time and upon the same terms as holders of the Common Stock and solely as a result of holding the Notes, in any of the transactions described in this Section 9.04, without having to convert their Notes as if they held a number of shares of Common Stock equal to the Conversion Rate, multiplied by the Principal Amount (expressed in thousands) of Notes held by such Holder. (a) If the Company exclusively issues shares of the Common Stock as a dividend or distribution on shares of the Common Stock, or if the Company effects a share split or share combination, the Conversion Rate shall be adjusted based on the following formula: where, CR0 = the Conversion Rate in effect immediately prior to the close of business on the Record Date of such dividend or distribution, or immediately prior to the open of business on the Effective Date of such share split or share combination, as applicable; CR1 = the Conversion Rate in effect immediately after the close of business on such Record Date or immediately after the open of business on such Effective Date, as applicable; OS0 = the number of shares of the Common Stock outstanding immediately prior to the close of business on such Record Date or immediately prior to the open of business on such Effective Date, as applicable (before giving effect to any such dividend, distribution, split or combination); and OS1 = the number of shares of the Common Stock outstanding immediately after giving effect to such dividend, distribution, share split or share combination. Any adjustment made under this Section 9.04(a) shall become effective immediately after the close of business on the Record Date for such dividend or distribution, or immediately after the open of business on the Effective Date for such share split or share combination, as applicable. If any dividend or distribution of the type described in this Section 9.04(a) is declared but not so paid or made, the Conversion Rate shall be immediately readjusted, effective as of the date the Board of Directors determines not to pay such dividend or distribution, to the Conversion Rate that would then be in effect if such dividend or distribution had not been declared. (b) If the Company distributes to all or substantially all holders of the Common Stock any rights, options or warrants (other than pursuant to a stockholder rights plan) entitling them, for a period of not more than 45 calendar days after the announcement date of such distribution, to subscribe for or purchase shares of the Common Stock at a price per share that is less than the average of the Closing Sale Prices of the Common Stock for the 10 consecutive Trading Day period ending on, and including, the Trading Day immediately preceding the date of announcement of such distribution, the Conversion Rate shall be increased based on the following formula: where, CR0 = the Conversion Rate in effect immediately prior to the close of business on the Record Date for such distribution; CR1 = the Conversion Rate in effect immediately after the close of business on such Record Date; OS0 = the number of shares of the Common Stock outstanding immediately prior to the close of business on such Record Date;

  • Adjustment Events In the event the General Partner (i) declares or pays a dividend on any Class of its outstanding REIT Shares in REIT Shares or makes a distribution to all holders of any Class of its outstanding REIT Shares in REIT Shares, (ii) subdivides any Class of its outstanding REIT Shares, or (iii) combines any Class of its outstanding REIT Shares into a smaller number of REIT Shares with respect to any Class of REIT Shares, then a corresponding adjustment to the number of outstanding Partnership Units of the applicable Class necessary to maintain the proportionate relationship between the number of outstanding Partnership Units of such Class to the number of outstanding REIT Shares of such Class shall automatically be made. Additionally, in the event that any other entity shall become General Partner pursuant to any merger, consolidation or combination of the General Partner with or into another entity (the “Successor Entity”), the number of outstanding Partnership Units of each Class shall be adjusted by multiplying such number by the number of shares of the Successor Entity into which one REIT Share of such Class is converted pursuant to such merger, consolidation or combination, determined as of the date of such merger, consolidation or combination. Any adjustment to the number of outstanding Partnership Units of any Class shall become effective immediately after the effective date of such event retroactive to the record date, if any, for such event; provided, however, that if the General Partner receives a Notice of Redemption after the record date, but prior to the effective date of such dividend, distribution, subdivision or combination, or such merger, consolidation or combination, the number of outstanding Partnership Units of any Class shall be determined as if the General Partner had received the Notice of Redemption immediately prior to the record date for such dividend, distribution, subdivision or combination or such merger, consolidation or combination. If the General Partner takes any other action affecting the REIT Shares other than actions specifically described above and, in the opinion of the General Partner such action would require an adjustment to the number of Partnership Units to maintain the proportionate relationship between the number of outstanding Partnership Units to the number of outstanding REIT Shares, the General Partner shall have the right to make such adjustment to the number of Partnership Units, to the extent permitted by law, in such manner and at such time as the General Partner, in its sole discretion, may determine to be appropriate under the circumstances.

  • Workplace adjustment An employer wishing to employ a person under the provisions of this clause shall take reasonable steps to make changes in the workplace to enhance the employee’s capacity to do the job. Changes may involve re-design of job duties, working time arrangements and work organisation in consultation with other employees in the area.

  • Price Adjustment Civil works contracts of long duration (more than 18 months) shall contain an appropriate price adjustment clause.

  • Supervisory Differential Adjustment The Appointing Officer shall adjust the compensation of a supervisory employee whose compensation grade is set herein subject to the following conditions:

  • True-Up Adjustments From time to time, until the Retirement of the Recovery Bonds, the Servicer shall identify the need for True-Up Adjustments and shall take all reasonable action to obtain and implement such True-Up Adjustments, all in accordance with the following:

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