Monthly Premium Payment Calculation Sample Clauses

Monthly Premium Payment Calculation. ‌ The monthly premium payment for each enrollee will be calculated as follows: Additional premium payments include Delivery Case Rates, Low Birth Weight Baby Case Rates and Supplemental Premium Payments, as described in Subsections 5.7 through 5.9 of this Contract. 5.2.1 The Statewide Base Rate will be established by HCA and will vary between the Apple Health Family (AH Family), Apple Health Blind Disabled (AHBD) and Apple Health Adult Coverage – Medicaid Expansion (AHME) populations. The base rates will initially be the same for all contractors, but may vary based on ACA related taxes and/or fees. 5.2.2 The Age/Sex Adjustment factors will be established by HCA and will vary between the AH Family, AHBD and AHME populations. The age/sex factors will be the same for all contractors. 5.2.3 The Geographical Adjustment Factors will be recalculated by HCA annually to reflect changes in the relative cost of providing care in different geographical areas of the State. The Geographical Adjustment Factors and geographic service areas are the same for all contractors but may vary between AH Family, AHBD and AHME populations. 5.2.4 For the period of January 1, 2014 through January 31, 2014, the Risk Adjustment Factors will be as established for the rates effective January 1, 2014 by HCA for the Apple Health Family (“AH Family”) population and the AH Blind and Disabled (“AHBD”) population to reflect differences in the relative health status of the populations enrolled with the Contractors. The Risk Adjustment Factors are calculated by geographical region and by Contractor. 5.2.5 By February 1, 2014, HCA will make a retroactive update to the Risk Adjustment Factors for the AH Family and AHBD populations that were in place effective January 1, 2014. The data collection and calculation method for this adjustment is as follows: 5.2.5.1 The Contractor will provide updated encounter data for SFY 2013 with run-out through October 2013 to an actuary designated by HCA by January 1, 2014. 5.2.5.2 The actuary will collect FFS data and encounter data for other Medicaid managed care programs from HCA for the same period. 5.2.5.3 The actuary will re-compute all risk scores based upon the most recently available enrollment data provided by HCA, the FFS data and additional managed care data provided by HCA, and the updated encounter data provided by the Contractor. 5.2.5.4 The risk score calculation will include historical data for all RAC codes for the enrollees present in the Contra...
AutoNDA by SimpleDocs
Monthly Premium Payment Calculation. 5.2.1 The capitation rates are identified and developed, and payment is made in accordance with generally accepted actuarial principles and practices. 5.2.1.1 The Behavioral Health component of the capitation rate is based on services provided by DOH licensed Behavioral Health Agencies as described on Exhibit I. 5.2.2 The monthly premium payment for each Enrollee under this Contract will equal the capitation rates for each age band. 5.2.2.1 Premium Payment = Capitation Rate (at the age cell level) 5.2.3 Additional premium payments include Wraparound with Intensive Services (WISe), and New Journeys as described in the WISe Payment, and New Journeys subsections in this Contract. 5.2.4 The premium payment formula is established by HCA and will vary between age bands within the AHE population. The base rates will be the same for all Contractors. Risk adjustment and withhold factors will not be applied during the initial program year. 5.2.5 HCA shall make a full monthly payment to the Contractor for the month in which an Enrollee's enrollment is terminated except as otherwise provided in this Contract.
Monthly Premium Payment Calculation. The monthly premium payment for each enrollee will be calculated as follows: Additional premium payments are made for Delivery Case Payment Rates as described in Subsection 5.6 of this Contract.

Related to Monthly Premium Payment Calculation

  • Payment Calculation District shall pay Contractor at a rate of $ per . District shall pay Contractor as described in attached Exhibit A

  • Monthly Payment City shall make monthly payments, based on invoices received, for services satisfactorily performed, and for authorized reimbursable costs incurred. City shall have 30 days from the receipt of an invoice that complies with all of the requirements above to pay Consultant.

  • Payment Due Date Unless City notifies the Contractor that a dispute exists, Payment shall be made within [Enter number of days, generally ≥ 30] calendar days, measured from (1) the delivery of goods and/or the rendering of services or (2) the date of receipt of the invoice, whichever is later. Payment is deemed to be made on the date on which City has issued a check to Contractor or, if Contractor has agreed to electronic payment, the date on which City has posted electronic payment to Contractor.

  • Premium Payment The Bank shall pay any premiums due on the Policy.

  • Interim payment At the end of each of the periods indicated in Annex I the Contractor shall submit to the Agency a formal request for payment accompanied by those of the following documents which are provided for in the Special Conditions: ➢ an interim technical report in accordance with the instructions laid down in Xxxxx X; ➢ the relevant invoices indicating the reference number of the Contract and of the order or specific contract to which they refer;

  • Subsequent Recalculation In the event the Internal Revenue Service adjusts the computation of the Company under Section 5.2 herein so that the Executive did not receive the greatest net benefit, the Company shall reimburse the Executive for the full amount necessary to make the Executive whole, plus a market rate of interest, as determined by the Committee, within 30 days after such adjustment.

  • Monthly Payments On or before each Transfer Date, the Servicer shall instruct the Trustee in writing (which writing shall be substantially in the form of Exhibit B hereto) to withdraw and the Trustee, acting in accordance with such instructions, shall withdraw on such Transfer Date or the related Distribution Date, as applicable, to the extent of available funds, the amounts required to be withdrawn from the Finance Charge Account, the Principal Account, the Principal Funding Account and the Distribution Account as follows: (a) A n amount equal to the Class A Available Funds deposited into the Finance Charge Account for the related Monthly Period will be distributed on each Transfer Date in the following priority: (i) an amount equal to Class A Monthly Interest for such Transfer Date, plus the amount of any Class A Deficiency Amount for such Transfer Date, plus the amount of any Class A Additional Interest for such Transfer Date, shall be deposited by the Servicer or the Trustee into the Distribution Account; (ii) an amount equal to the Net Swap Payment, if any, for such Transfer Date, plus the amount of any Net Swap Payments previously due but not paid to the Swap Counterparty shall be distributed to the Swap Counterparty; (iii) an amount equal to the Class A Servicing Fee for such Transfer Date plus the amount of any Class A Servicing Fee due but not paid to the Servicer on any prior Transfer Date shall be distributed to the Servicer; (iv) an amount equal to the Class A Investor Default Amount, if any, for the preceding Monthly Period shall be treated as a portion of Investor Principal Collections and deposited into the Principal Account on such Transfer Date; and (v) the balance, if any, shall constitute Excess Spread and shall be allocated and distributed as set forth in Section 4.11. (b) An amount equal to the Class B Available Funds deposited into the Finance Charge Account for the related Monthly Period will be distributed on each Transfer Date in the following priority: (i) an amount equal to the Class B Monthly Interest for such Transfer Date, plus the amount of any Class B Deficiency Amount for such Transfer Date, plus the amount of any Class B Additional Interest for such Transfer Date, shall be deposited by the Servicer or the Trustee into the Distribution Account; (ii) an amount equal to the Class B Servicing Fee for such Transfer Date, plus the amount of any Class B Servicing Fee due but not paid to the Servicer on any prior Transfer Date for such Transfer Date shall be distributed to the Servicer; and (iii) the balance, if any, shall constitute Excess Spread and shall be allocated and distributed as set forth in Section 4.11. (c) An amount equal to the Collateral Available Funds deposited into the Finance Charge Account for the related Monthly Period will be distributed on each Transfer Date in the following priority: (i) if the Seller or The Bank of New York is no longer the Servicer, an amount equal to the Collateral Interest Servicing Fee for such Transfer Date plus the amount of any Collateral Interest Servicing Fee due but not paid to the Servicer on any prior Transfer Date shall be distributed to the Servicer; and (ii) the balance, if any, shall constitute Excess Spread and shall be allocated and distributed as set forth in Section 4.11. (d) During the Revolving Period, an amount equal to the Available Investor Principal Collections deposited into the Principal Account for the related Monthly Period will be distributed on each Transfer Date in the following priority: (i) an amount equal to the lesser of (A) the product of (1) a fraction, the numerator of which is equal to the Available Investor Principal Collections for such Transfer Date and the denominator of which is equal to the sum of the Available Investor Principal Collections available for sharing as specified in the related Series Supplement for each Series in Group One and (2) the Cumulative Series Principal Shortfall and (B) Available Investor Principal Collections, shall remain in the Principal Account to be treated as Shared Principal Collections and applied to Series in Group One other than this Series 1999-G; and (ii) an amount equal to the excess, if any, of (A) the Available Investor Principal Collections for such Transfer Date over (B) the applications specified in subsection 4.09(d)(i) above shall be paid to the Holder of the Seller Interest; provided, however, that the amount to be paid to the Holder of the Seller Interest pursuant to this subsection 4.09(d)(ii) with respect to such Transfer Date shall be paid to the Holder of the Seller Interest if, and only to the extent that, the Seller Interest on such Date of Processing is equal to or greater than the Minimum Seller Interest (after giving effect to the inclusion in the Trust of all Receivables created on or prior to such Transfer Date and the application of payments referred to in subsection 4.03(b)) and otherwise shall be considered as Unallocated Principal Collections and deposited into the Principal Account in accordance with subsection 4.05(e).

  • Payment Due Payment for services provided by BellSouth, including disputed charges, is due on or before the next xxxx date. Information required to apply payments must accompany the payment. The information must notify BellSouth of Billing Account Numbers (BAN) paid; invoices paid and the amount to be applied to each BAN and invoice (Remittance Information). Payment is considered to have been made when the payment and Remittance Information are received by BellSouth. If the Remittance Information is not received with payment, BellSouth will be unable to apply amounts paid to Freedom’s accounts. In such event, BellSouth shall hold such funds until the Remittance Information is received. If BellSouth does not receive the Remittance Information by the payment due date for any account(s), late payment charges shall apply.

  • Payment Due Dates Notwithstanding the provisions of Sections II and III above, payment due date shall be at least invoice date plus 30 days. If the County is late in issuing an invoice, the contracting entity would always have at least invoice date plus 30 days to pay. If the County is early in issuing an invoice, the contracting entity would still have a payment due date of either 60 days after the beginning of the quarter (quarterly invoices) or 30 days after the beginning of the service month (monthly invoices).

  • Premium Payments If an employee with at least three years of service in the employ of the Shaker Heights Board of Education should exhaust his/her sick leave within the time specifications of this contract and is granted a leave of absence by the Board, the Board shall continue to pay his/her premiums in accordance with his/her work assignment for the following fringe benefits for a period not to exceed twelve (12) months. The payment of such premiums will cease on the effective date an employee retires, resigns, goes on disability retirement or his/her contract is terminated. 1. PPO medical coverage 2. Prescription drug coverage

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!