Common use of Out-of-Network Institutional Fund Deficit Clause in Contracts

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, Blue Shield shall offset forty percent (40%) of any out-of-network Institutional deficit against any out-of-network Professional surplus. Group shall not be obligated to pay to Blue Shield, from its own funds, all or any portion of Group’s share of the Deficit. If a deficit results, Blue Shield shall carry such deficit forward into future Agreement Years and the deficit carryover shall be 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. In no event however, shall the aggregate total amount carried forward by Blue Shield from the Out-of-Network POS Professional Services Fund and the Out-of-Network POS Institutional Services Fund exceed five percent (5%) of the POS Capitation Fees paid to IPA during the Agreement Year. Exhibit G-2, Schedule 1 HMO IPA/Medical Group Agreement POS FUND ALLOCATIONS Effective Date: 07/01/2003 As of 07/01/2003, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are *** for the POS In-network Shared Saving, *** for POS Out-of-network Professional, and *** for the POS Out-of-network Institutional, based on the 02/01/2003 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations POS Fund Allocation (PMPM) Category IN-NETWORK OUT-OF-NETWORK OUT-OF-NETWORK Sex Age SHARED SAVINGS PROFESSIONAL INSTITUTIONAL 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 *** All references to the POS Fund Allocations have been deleted. Exhibit G-2, Schedule 1 HMO IPA/Medical Group Agreement POS FUND ALLOCATIONS Effective Date: 07/01/2004 As of 07/01/2004, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are ***, for the POS In-network Shared Saving, *** for POS Out-of-network Professional, and *** for the POS Out-of-network Institutional, based on the 02/01/2003 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations Category POS Fund Allocation (PMPM) IN-NETWORK SHARED SAVINGS OUT-OF-NETWORK PROFESSIONAL OUT-OF-NETWORK INSTITUTIONAL Sex Age 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 *** All references to the Pros Fund Allocations have been deleted. Exhibit H HMO IPA/Medical Group Agreement PROFESSIONAL STOP LOSS PROGRAM Name of Group: Prospect Health Source Medical Group Effective Date: 07/01/2003

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, Blue Shield shall offset forty percent (40%) *** of any out-of-network Institutional deficit against any out-of-network Professional surplus. Group shall not be obligated to pay to Blue Shield, from its own funds, all or any portion of Group’s share of the Deficit. If a deficit results, Blue Shield shall carry such deficit forward into future Agreement Years and the deficit carryover shall be 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. In no event however, shall the aggregate total amount carried forward by <<>> [LOGO] Blue Shield from the Out-of-Network POS Professional Services Fund and the Out-of-Network POS Institutional Services Fund exceed five percent (5%) of California An Independent Member of the POS Capitation Fees paid to IPA during the Agreement Year. Blue Shield Association Exhibit G-2, Schedule 1 HMO IPA/Medical Group Agreement POS FUND ALLOCATIONS Name of Group: PROSPECT MEDICAL GROUP, INC. Effective Date: 07/01/2003 As of 07/01/2003/ /2004, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are *** $34.75 for the POS In-network Shared Saving, *** $16.78 for POS Out-of-network Professional, and *** $14.90 for the POS Out-of-network Institutional, based on the 02/01/2003 07/01/2003 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations Category POS Fund Allocation (PMPM) Category Sex Age IN-NETWORK SHARED SAVINGS OUT-OF-NETWORK PROFESSIONAL OUT-OF-NETWORK Sex Age SHARED SAVINGS PROFESSIONAL INSTITUTIONAL 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 *** All references to the POS Fund Allocations have been deleted. Exhibit G-2, Schedule 1 HMO IPA/Medical Group Agreement POS FUND ALLOCATIONS Effective Date: 07/01/2004 As of 07/01/2004/ /2005, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are ***, $38.23 for the POS In-network Shared Saving, *** $17.79 for POS Out-of-network Professional, and *** $16.38 for the POS Out-of-network Institutional, based on the 02/01/2003 07/01/2003 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations Category POS Fund Allocation (PMPM) Sex Age IN-NETWORK SHARED SAVINGS OUT-OF-NETWORK PROFESSIONAL OUT-OF-NETWORK INSTITUTIONAL Sex Age 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 *** All references to the Pros POS Fund Allocations have been deleted. [LOGO] Blue Shield of California An Independent Member of the Blue Shield Association Exhibit H HMO IPA/Medical Group Agreement PROFESSIONAL STOP LOSS PROGRAM Name of Group: Prospect Health Source Medical Group PROSPECT MEDICAL GROUP, INC. Effective Date: 07/01/2003:

Out-of-Network Institutional Fund Deficit. For any Agreement Year in which the POS Out-of-Network Institutional Expenses exceed exceeds the POS Out-of-Network Institutional Budget, Blue Shield shall offset 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. Group , and (ii) any remaining deficit shall not be obligated to pay to Blue Shield, from its own funds, all or any portion of Group’s share of the Deficit. If a deficit results, Blue Shield shall carry such deficit carried forward into future Agreement Years and the deficit carryover shall be 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. In no event however, shall the aggregate total amount carried forward by Blue Shield from the Out-of-Network POS Professional Services Fund and the Out-of-Network POS Institutional Services Fund exceed five percent (5%) of the POS Capitation Fees paid to IPA during the Agreement Year. *** 107 Exhibit G-2, Schedule 1 HMO IPA/Medical Group Agreement POS FUND ALLOCATIONS Fund Allocations for NorthWest Orange County Medical Group Effective Date: 07/01/2003 02/01/2003 As of 07/01/200302/01/2003, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are *** for or the POS In-network Shared Saving, . *** for POS Out-of-network Professional, and *** for the POS Out-of-network Institutional, based on the 02/01/2003 07/01/2002 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations Category POS Fund Allocation (PMPM) Category Sex Age IN-NETWORK SHARED SAVINGS OUT-OF-NETWORK PROFESSIONAL OUT-OF-NETWORK Sex Age SHARED SAVINGS PROFESSIONAL INSTITUTIONAL 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 *** All references to the POS Fund Allocations have been deleted. Exhibit G-2, Schedule 1 108 HMO IPA/Medical Group Agreement POS FUND ALLOCATIONS Fund Allocations for North West Orange County Medical Group Effective Date: 07/01/2004 02/01/2004 As of 07/01/200402/01/2003, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are ***, * for the POS In-network Shared Saving, *** for POS Out-of-network Professional, and *** for the POS Out-of-network Institutional, based on the 02/01/2003 07/01/2002 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations Category POS Fund Allocation (PMPM) Sex Age IN-NETWORK SHARED SAVINGS OUT-OF-NETWORK PROFESSIONAL OUT-OF-NETWORK INSTITUTIONAL Sex Age 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 *** All references to the Pros POS Fund Allocations Allocation have been deleted. Exhibit EXHIBIT H HMO IPA/Medical Group Agreement PROFESSIONAL STOP LOSS PROGRAM Name of Group: Prospect Health Source Medical Group NORTHWEST ORANGE COUNTY MEDICAL GROUP Effective Date: 07/01/2003NA

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, Blue Shield shall offset forty percent (40%) of any out-of-network Institutional deficit against any out-of-network Professional surplus. Group shall not be obligated to pay to Blue Shield, from its own funds, all or any portion of Group’s share then *** of the Deficit. If a deficit resultsamount by which the actual costs exceed the total allocation, Blue Shield not to exceed *** of POS Capitation, shall carry such deficit forward into future Agreement Years be allocated to Group and shall be handled as follows: (I) the deficit carryover shall 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 future yearsSurpluses. 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. In no event howeverUpon non-renewal or termination, such deficits shall the aggregate total amount carried forward not be collected by Blue Shield from the Out-of-Network POS Professional Services Fund and the Out-of-Network POS Institutional Services Fund exceed five percent (5%) of the POS Capitation Fees paid to IPA during the Agreement YearGroup. *** 77 Exhibit G-2, Schedule 1 HMO IPA/Medical Group Agreement POS FUND ALLOCATIONS Fund Allocations for Professional Care IPA - 385U9 Effective Date: 07/01/2003 01/01/2003 As of 07/01/200301/01/2003, 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 02/01/2003 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations POS Fund Allocation (PMPM) Category IN-NETWORK OUT-OF-NETWORK OUT-OF-NETWORK Sex Age SHARED SAVINGS PROFESSIONAL INSTITUTIONAL 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 *** All references to the POS Fund Allocations have been deleted. Exhibit G-2, Schedule 1 HMO IPA/Medical Group Agreement POS FUND ALLOCATIONS Effective Date: 07/01/2004 As of 07/01/2004, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are ***, for the POS In-network Shared Saving, *** for POS Out-of-network Professional, and *** for the POS Out-of-network Institutional, based on the 02/01/2003 08/01/2002 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations Category POS Fund Allocation (PMPM) Sex Age IN-NETWORK SHARED SAVINGS OUT-OF-NETWORK PROFESSIONAL OUT-OF-NETWORK INSTITUTIONAL Sex Age 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 *** All references to the Pros Fund Allocations have been deleted. Exhibit H HMO IPA/Medical Group Agreement PROFESSIONAL STOP LOSS PROGRAM Name of Group: Prospect Health Source Medical Group PROFESSIONAL CARE IPA MEDICAL GROUP Effective Date: 07/01/2003NA