Out-of-Network Institutional Fund Deficit Sample Clauses

Out-of-Network Institutional Fund Deficit. For any Agreement Year in which the POS Out-of-Network Institutional Expenses exceeds the POS Out-of-Network Institutional Budget, then, forty percent (40%) of the amount by which the actual costs exceed the total allocation, not to exceed five percent (5%) of POS Capitation Fees, shall be allocated to the Group and handled as follows: (i) Blue Shield shall offset any out-of-network Institutional deficit against any out-of-network Professional surplus, and (ii) any remaining deficit shall be carried forward into future Agreement Years and offset against any Out-of-Network Professional or Institutional Fund Surpluses in future years. In the event the Deficit carried forward exceeds the Surplus in a future year, the remaining deficit shall continue to be carried forward and offset against any Surpluses in subsequent years. * = Medicare Primary *** All references to the POS Fund Allocations have been deleted. * = Medicare Primary *** All references to the POS Fund Allocation have been deleted. A. Commencement of Stop Loss Program: If, as set forth on the Signature Page to the Agreement, Group elects to participate in this Stop Loss Program, this Exhibit H is added to the HMO Medical Agreement (the “Agreement”) between Group and Blue Shield. The Stop Loss Program set forth in this Exhibit I commences with respect to Capitated Professional Services provided to Members on the following date: The Effective Date of the Agreement OR, [Specify Date] , 19 The commencement date for this Stop Loss Program shall not cause either a modification of the Agreement Year, as set forth in the Agreement, nor, if the initial time period covered by the Stop Loss Program is less than a full Agreement Year, a proration of the Attachment Level set forth below. Notwithstanding any provision of the Agreement or this Exhibit H to the contrary, Blue Shield shall have no obligation to permit Group to commence the Stop Loss Program other than as of the first day of an Agreement Year.
Sample 1
AutoNDA by SimpleDocs
Out-of-Network Institutional Fund Deficit. For any Agreement Year in which the POS Out-of-Network Institutional Expenses exceed the POS Out-of-Network Institutional Budget, then *** of the amount by which the actual costs exceed the total allocation, not to exceed *** of POS Capitation, shall be allocated to Group and shall be handled as follows: (I) the excess may be offset against any Out-Of-Network Professional surplus, and, (ii) any remaining amounts shall be carried forward and offset against future Agreement Years Out-of-Network Professional or Institutional Fund Surpluses. In the event the Deficit carried forward exceeds the Surplus in a future year, the remaining deficit shall continue to be carried forward and offset against any Surpluses in subsequent years. Upon non-renewal or termination, such deficits shall not be collected by Blue Shield from Group. Exhibit G-2, Schedule 1 As of 01/01/2003, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are $29.91 for the POS In-network Shared Saving, $15.45 for POS Out-of-network Professional, and $12.82 for the POS Out-of-network Institutional, based on the 08/01/2002 membership. F 0 - 1 $ *** $ *** $ *** F 2 - 6 $ *** $ *** $ *** F 7 - 18 $ *** $ *** $ *** F 19 - 21 $ *** $ *** $ *** F 22 - 24 $ *** $ *** $ *** F 25 - 29 $ *** $ *** $ *** F 30 - 34 $ *** $ *** $ *** F 35 - 39 $ *** $ *** $ *** F 40 - 44 $ *** $ *** $ *** F 45 - 49 $ *** $ *** $ *** F 50 - 54 $ *** $ *** $ *** F 55 - 59 $ *** $ *** $ *** F 60 - 64 $ *** $ *** $ *** F 65 + (NM) $ *** $ *** $ *** F 65 + (M)* $ *** $ *** $ *** M 0 - 1 $ *** $ *** $ *** M 2 - 6 $ *** $ *** $ *** M 7 - 18 $ *** $ *** $ *** M 19 - 21 $ *** $ *** $ *** M 22 - 24 $ *** $ *** $ *** M 25 - 29 $ *** $ *** $ *** M 30 - 34 $ *** $ *** $ *** M 35 - 39 $ *** $ *** $ *** M 40 - 44 $ *** $ *** $ *** M 45 - 49 $ *** $ *** $ *** M 50 - 54 $ *** $ *** $ *** M 55 - 59 $ *** $ *** $ *** M 60 - 64 $ *** $ *** $ *** M 65 + (NM) $ *** $ *** $ *** M 65 + (M)* $ *** $ *** $ *** * = Medicare Primary A. Commencement of Stop Loss Program: If, as set forth on the Signature Page to the Agreement, Group elects to participate in this Stop Loss Program, this Exhibit I is added to the HMO Medical Agreement (the “Agreement”) between Group and Blue Shield. The Stop Loss Program set forth in this Exhibit I commences with respect to Capitated Professional Services provided to Members on the following date: The Effective Date of the Agreement OR, [Specify Date] , 19 The commencem...
Sample 1

Related to Out-of-Network Institutional Fund Deficit

  • Additional Wet Weather Procedure 14.15.1 Remaining On Site a) for more than an accumulated total of four hours of ordinary time in any one day; or b) after the meal break, as provided for in clause 17.1 of the Award, for more than an accumulated total of 50% of the normal afternoon work time; or c) during the final two hours of the normal work day for more than an accumulated total of one hour, the Enterprise will not be entitled to require the employees to remain on site beyond the expiration of any of the above circumstances.

  • Please see the current Washtenaw Community College catalog for up-to-date program requirements Conditions & Requirements

  • Additional Funding If the General Partner determines that it is in the best interests of the Partnership to provide for additional Partnership funds (“Additional Funds”) for any Partnership purpose, the General Partner may (i) cause the Partnership to obtain such funds from outside borrowings, or (ii) elect to have the General Partner or any of its Affiliates provide such Additional Funds to the Partnership through loans or otherwise.

  • Additional Federally Required Orders/Directives Both parties agree that they will comply with the following laws and directives, where applicable: 11.20.1 Executive Order 11061, as amended, which directs the Secretary of HUD to take all action which is necessary and appropriate to prevent discrimination by agencies that utilize federal funds. 11.20.2 Public Law 88-352, Title VI of the Civil Rights Act of 1964, which provides that no person in the United States shall, on the basis of race, color, national origin, or sex, be excluded from participation in, denied the benefits of, or subjected to discrimination under any program or activity which receives federal financial assistance. The Agency hereby extends this requirement to the Contractor and its private contractors. Specific prohibited discriminatory actions and corrective action are described in Chapter 2, Subtitle C, Title V of the Anti-Drug Abuse Act of 1988 (42 U.S.C. 19901 et. seq.). 11.20.3 Public Law 90-284, Title VIII of the Civil Rights Act of 1968., popularly known as the Fair Housing Act, which provides for fair housing throughout the United States and prohibits any person from discriminating in the sale or rental of housing, the financing of housing or the provision of brokerage services, including in any way making unavailable or denying a dwelling to any person because of race, color, religion, sex, or national origin. Pursuant to this statute, the Agency requires that the Contractor administer all programs and activities, which are related to housing and community development in such a manner as affirmatively to further fair housing. 11.20.4 The Age Discrimination Act of 1975, which prohibits discrimination on the basis of age. 11.20.5 Anti-Drug Abuse Act of 1988 (42 U.S.C. 11901 et. seq.). 11.20.6 HUD Information Bulletin 909-23 which is the following: 11.20.6.1 Notice of Assistance Regarding Patent and Copyright Infringement; 11.20.6.2 Clean Air and Water Certification; and,

  • Additional Funds 8.01 In the event that the Fund establishes one or more series of Shares in addition to the Portfolios with respect to which it desires to have the Transfer Agent render services as transfer agent under the terms hereof, it shall so notify the Transfer Agent in writing, and if the Transfer Agent agrees in writing to provide such services, such series of Shares shall become a Portfolio hereunder.

  • Withdrawal of General Partner (a) The General Partner may not Withdraw (other than as a result of an Involuntary Withdrawal) without the Consent of the Special Limited Partner. Withdrawal shall be conditioned upon the agreement of the Special Limited Partner to be admitted as a successor General Partner, or if the Special Limited Partner declines to be admitted as a successor General Partner then on the agreement of one or more Persons who satisfy the requirements of Section 13.5 of this Agreement to be admitted as successor General Partner(s). (b) Each General Partner shall indemnify and hold harmless the Partnership and all Partners from its Withdrawal in violation of Section 13.1(a) hereof. Each General Partner shall be liable for damages to the Partnership resulting from its Withdrawal in violation of Section 13.1(a).

  • Special Permit from Relevant Ministerial/ Government Agencies and Foreign Capital Ownership Limitation Raw Material for Explosives (Ammonium Nitrate) with maximum foreign equity ownership of 49% and a special permit from the Minister of Defense (ISIC 2411) Industry of explosive materials and its components for industry need with maximum foreign equity ownership of 49% and a special permit from the Minister of Defense (ISIC 2429) Sugar Industry (Xxxxx Xxxxxxx Sugar, Refined Crystal Sugar and Raw Crystal Sugar) with maximum foreign equity ownership of 95% and a special permit from the Minister of Industry and the Minister of Agriculture, and it has to be integrated with the sugar plantation. The manufacturing of raw crystal sugar is required for any sugar manufacturer with sugarcane input capacity exceeding 8000 tons per day (ISIC 1542) Processing of plantation product industry (similar capacity or exceeding a certain capacity, according to Regulation of Minister of Agriculture Number 26 of 2007 with maximum foreign capital ownership of 95% with a special permit from Minister of Agriculture. - Fiber and Seed Cotton Industry (ISIC1514, 1711) - Crude oil industry (edible oil) from vegetable and animal, coconut oil industry, palm oil industry, rubber to be sheet, thick latex, crumb rubber industry, raw castor oil industry, sugar, sugar cane and sugar cane residue industry, black tea/green tea industry, dry tobacco leaves industry, Copra, Fiber, Coconut Charcoal, Dust, Nata de coco industry, Coffee sorting, cleaning and peeling industry, Cocoa cleaning, peeling and drying industry, cleaning and peeling seed other than coffee and cacao industry, cashew to be dry seed cashew and Cashew Nut Shell Liquid (CNSL) Industry, Peppercorn to be dry white pepper and dry black pepper industry (ISIC 1514, 2429, 1542, 1549, 1600, 2519, 1531)

  • ADDITIONAL FUNDS AND CLASSES In the event that the Trust establishes one or more series of Shares or one or more classes of Shares after the effectiveness of this Agreement, such series of Shares or classes of Shares, as the case may be, shall become Funds and classes under this Agreement with necessary changes made to Appendix IV; however, either GFS or the Trust may elect not to make any such series or classes subject to this Agreement.

  • Notional Funding Each Bank shall have the right from time to time, without notice to any Borrower, to deem any branch, Subsidiary or Affiliate (which for the purposes of this Section 11.5 shall mean any corporation or association which is directly or indirectly controlled by or is under direct or indirect common control with any corporation or association which directly or indirectly controls such Bank) of such Bank to have made, maintained or funded any Loan to which the Euro-Rate Option applies at any time, provided that immediately following (on the assumption that a payment were then due from the Borrowers to such other office), and as a result of such change, the Borrowers would not be under any greater financial obligation pursuant to Section 5.5 than they would have been in the absence of such change. Notional funding offices may be selected by each Bank without regard to the Bank’s actual methods of making, maintaining or funding the Loans or any sources of funding actually used by or available to such Bank.

  • What Forms of Distribution Are Available from a Xxxxxxxxx Education Savings Account Distributions may be made as a lump sum of the entire account, or distributions of a portion of the account may be made as requested.

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