Medicare Coordinated Coverage. Individual rate must be justified by experience and may not exceed the calculated rate in the utilization data submission without written justification. It may not exceed 50% of the single rate for regular coverage, unless the BOARD’s consulting actuary determines that percentage to be lower. Medicare family 2 eligible rate shall be 2 times the individual Medicare coordinated rate; Medicare family 1 rate (1 under Medicare, 1 or more not eligible), shall be the sum of the individual rate (regular coverage) and individual rate (Medicare eligible).
Appears in 5 contracts
Samples: Health Benefit Program Agreement, etf.wi.gov, etf.wi.gov
