Common use of Health Insurance Providers Fee Clause in Contracts

Health Insurance Providers Fee. Section 9010 of the Patient Protection and Affordable Care Act Pub. L. No. 111-148 (124 Stat. 119 (2010)), as amended by Section 10905 of PPACA, and as further amended by Section 1406 of the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152 (124 Stat. 1029 (2010)) imposes an annual fee on health insurance providers beginning in 2014 (“Annual Fee”). Contractor is responsible for a percentage of the Annual Fee for all health insurance providers as determined by the ratio of Contractor’s net written premiums for the preceding year compared to the total net written premiums of all entities subject to the Annual Fee for the same year. The State shall reimburse the Contractor for the amount of the Annual Fee specifically allocable to the premiums paid during this Contract Term for each calendar year or part thereof, including an adjustment for the full impact of the non-deductibility of the Annual Fee for Federal and state tax purposes, including income and excise taxes (“Contractor’s Adjusted Fee”). The Contractor’s Adjusted Fee shall be determined based on the final notification of the Annual Fee amount Contractor or Contractor’s parent receives from the United States Internal Revenue Service. The State, following its review and acceptance of the Contractor’s Adjusted Fee, will retroactively adjust the Contractor’s capitation rates to provide reimbursement for the Contractor’s Adjusted Fee. To claim reimbursement for the Contractor’s Adjusted Fee the Contractor shall submit a certified copy of its full Annual Fee assessment within sixty (60) days of receipt, together with the allocation of the Annual Fee attributable specifically to its premiums under this Contract. The Contractor shall also submit the calculated adjustment for the impact of non-deductibility of the Annual Fee attributable specifically to its premiums under this Contract, and any other data deemed necessary by the State to validate the reimbursement amount. These materials shall be submitted under the signatures of either its Financial Officer or Executive leadership (e.g., President, Chief Executive Office, Executive Director), certifying the accuracy, truthfulness and completeness of the data provided.

Health Insurance Providers Fee. Section 9010 of the Patient Protection and Affordable Care Act Pub. L. No. 111-148 (124 Stat. 119 (2010)), as amended by Section 10905 of PPACA, and as further amended by Section 1406 of the Health Care and Education Reconciliation Act of 2010, Pub. L. No. No 111-152 (124 Stat. 1029 (2010)) imposes an annual fee on health insurance providers beginning in 2014 (“Annual Fee”). The Contractor is responsible for a percentage of the Annual Fee for all health insurance providers as determined by the ratio of Contractor’s net written premiums for the preceding year compared to the total net written premiums of all entities subject to the Annual Fee for the same year. The State shall reimburse the Contractor for the amount of the Annual Fee specifically allocable to the premiums paid during this the Contract Term for each calendar year or part thereof, including an adjustment for the full impact of the non-deductibility of the Annual Fee for Federal federal and state tax purposes, including income and excise taxes (“Contractor’s Adjusted Fee”). The Contractor’s Adjusted Fee shall be determined based on the final notification of the Annual Fee amount Contractor or Contractor’s parent receives from the United States Internal Revenue ServiceServices. The State, following its review and acceptance of the Contractor’s Adjusted Fee, will retroactively adjust the Contractor’s capitation rates to provide reimbursement for the Contractor’s Adjusted Fee. To claim reimbursement for the Contractor’s Adjusted Fee the Contractor shall must submit a certified copy of its full Annual Fee assessment within sixty (60) days of receipt, together with the allocation of the Annual Fee attributable specifically to its premiums under this the Contract. The Contractor shall must also submit the calculated adjustment for the impact of non-deductibility of the Annual Fee attributable specifically to its premiums under this the Contract, and any other data deemed necessary by the State to validate the reimbursement amount. These materials shall be submitted under the signatures of either its the Contractor’s Financial Officer or Executive leadership (e.g., President, Chief Executive Office, Executive Director), certifying the accuracy, truthfulness and completeness of the data provided.

Health Insurance Providers Fee. Section 9010 of the Patient Protection and Affordable Care Act Pub. L. No. 111-148 (124 Stat. 119 (2010)), as amended by Section 10905 of PPACA, and as further amended by Section 1406 of the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-111- 152 (124 Stat. 1029 (2010)) imposes an annual fee on health insurance providers beginning in 2014 (“Annual Fee”). Contractor is responsible for a percentage of the Annual Fee for all health insurance providers as determined by the ratio of Contractor’s net written premiums for the preceding year compared to the total net written premiums of all entities subject to the Annual Fee for the same year. The State shall reimburse the Contractor for the amount of the Annual Fee specifically allocable to the premiums paid during this Contract Term for each calendar year or part thereof, including an adjustment for the full impact of the non-deductibility of the Annual Fee for Federal and state tax purposes, including income and excise taxes (“Contractor’s Adjusted Fee”). The Contractor’s Adjusted Fee shall be determined based on the final notification of the Annual Fee amount Contractor or Contractor’s parent receives from the United States Internal Revenue Service. The State, following its review and acceptance of the Contractor’s Adjusted Fee, will retroactively adjust the Contractor’s capitation rates to provide reimbursement for the Contractor’s Adjusted Fee. To claim reimbursement for the Contractor’s Adjusted Fee the Contractor shall submit a certified copy of its full Annual Fee assessment within sixty (60) 60 days of receipt, together with the allocation of the Annual Fee attributable specifically to its premiums under this Contract. The Contractor shall also submit the calculated adjustment for the impact of non-non- deductibility of the Annual Fee attributable specifically to its premiums under this Contract, and any other data deemed necessary by the State to validate the reimbursement amount. These materials shall be submitted under the signatures of either its Financial Officer or Executive leadership (e.g., President, Chief Executive Office, Executive Director), certifying the accuracy, truthfulness and completeness of the data provided.

Health Insurance Providers Fee. Section 9010 of the Patient Protection and Affordable Care Act Pub. L. No. 111-148 (124 Stat. 119 (2010)), as amended by Section 10905 of PPACA, and as further amended by Section 1406 of the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-111- 152 (124 Stat. 1029 (2010)) imposes an annual fee on health insurance providers beginning in 2014 (“Annual Fee”). Contractor is responsible for a percentage of the Annual Fee for all health insurance providers as determined by the ratio of Contractor’s net written premiums for the preceding year compared to the total net written premiums of all entities subject to the Annual Fee for the same year. The State shall reimburse the Contractor for the amount of the Annual Fee specifically allocable to the premiums paid during this Contract Term for each calendar year or part thereof, including an adjustment for the full impact of the non-deductibility of the Annual Fee for Federal and state tax purposes, including income and excise taxes (“Contractor’s Adjusted Fee”). The Contractor’s Adjusted Fee shall be determined based on the final notification of the Annual Fee amount Contractor or Contractor’s parent receives from the United States Internal Revenue Service. The State, following its review and acceptance of the Contractor’s Adjusted Fee, will retroactively adjust the Contractor’s capitation rates to provide reimbursement for the Contractor’s Adjusted Fee. To claim reimbursement for the Contractor’s Adjusted Fee the Contractor shall submit a certified copy of its full Annual Fee assessment within sixty (60) days of receipt, together with the allocation of the Annual Fee attributable specifically to its premiums under this Contract. The Contractor shall also submit the calculated adjustment for the impact of non-non- deductibility of the Annual Fee attributable specifically to its premiums under this Contract, and any other data deemed necessary by the State to validate the reimbursement amount. These materials shall be submitted under the signatures of either its Financial Officer or Executive leadership (e.g., President, Chief Executive Office, Executive Director), certifying the accuracy, truthfulness and completeness of the data provided.

Health Insurance Providers Fee. Section 9010 of If the Patient Protection and Affordable Care Act Pub. L. No. 111-148 (124 Stat. 119 (2010)), MCO is identified by the Internal Revenue Service as amended by Section 10905 of PPACA, and as further amended by Section 1406 of being subject to the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152 (124 Stat. 1029 (2010)) imposes an annual health insurer fee on health insurance providers beginning in 2014 (“Annual Fee”). Contractor is responsible for a percentage ) required under Section 9010 of the ACA, the STATE will make a payment in order to satisfy the requirement for actuarial soundness set forth in 42 CFR § 438.4, (c) for amounts paid by the STATE under this Contract.‌ MCO Duties.‌ The MCO shall provide the STATE with a copy of its final Form 8963 and Schedule A at the controlled entity level, as submitted to the IRS, within ten (10) business days of the filing. The MCO shall also provide any corrected Form 8963 filings submitted to the IRS within ten (10) business days of the amended filing. The MCO shall also submit to the STATE: A schedule that reconciles direct premium (Form 8963, Schedule A, item (f)) for the MCO to Line 8 of the Minnesota Supplement Report #1. The dollar amount of revenue for Covered Services that the MCO determined should be excluded from Form 8963, Schedule A, item (f), including but not limited to long-term care, nursing home care, home health care, and community-based care. If applicable, MCO shall provide information needed to calculate the effect of taxes upon the final fee. This may include taxes paid that affect the final total to be reimbursed to the MCO. The MCO shall provide the STATE with the preliminary calculation of the MCO’s Allocated Annual Fee for all health insurance providers (the amount of its Annual Fee allocable to this Contract at the controlled entity level), as determined by the ratio IRS, within ten (10) business days of Contractorreceiving this information from the IRS. The MCO shall provide the STATE with the final calculation of the MCO’s net written premiums for the preceding year compared to the total net written premiums of all entities subject to the Allocated Annual Fee for as determined by the same year. The State shall reimburse the Contractor for the amount IRS, no later than ten (10) business days of the Annual Fee specifically allocable to the premiums paid during receiving this Contract Term for each calendar year or part thereof, including an adjustment for the full impact of the non-deductibility of the Annual Fee for Federal and state tax purposes, including income and excise taxes (“Contractor’s Adjusted Fee”). The Contractor’s Adjusted Fee shall be determined based on the final notification of the Annual Fee amount Contractor or Contractor’s parent receives information from the United States Internal Revenue ServiceIRS, with a data certification pursuant to section 9.10. The StateUpon request, following its review and acceptance of the Contractor’s Adjusted Fee, will retroactively adjust the Contractor’s capitation rates to MCO shall provide reimbursement for the Contractor’s Adjusted Fee. To claim reimbursement for the Contractor’s Adjusted Fee the Contractor shall submit a certified copy of its full Annual Fee assessment within sixty (60) days of receipt, together with the allocation of the Annual Fee attributable specifically to its premiums under this Contract. The Contractor shall also submit the calculated adjustment for the impact of non-deductibility of the Annual Fee attributable specifically to its premiums under this Contract, and any other data deemed necessary documentation required by the State STATE to validate the reimbursement amount. These materials shall be submitted under the signatures of either its Financial Officer MCO’s Allocated Annual Fee or Executive leadership (e.g., President, Chief Executive Office, Executive Director), certifying the accuracy, truthfulness and completeness of the data providedapportionment among Enrollee populations.