Common use of POS Shared Risk Reinsurance Clause in Contracts

POS Shared Risk Reinsurance. PPG shall participate in the POS Shared Risk Reinsurance Program which provides reinsurance for In-Network and Out-of-Network services. The cost to PPG for the POS Shared Risk Reinsurance Program shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** of POS Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services shall be reimbursed at *** of cost, and the remaining *** of the cost shall be charged against the POS Shared Risk Budget. (b) In-Network and Out-of-Network POS Shared Risk Services: 1.6 % of POS Shared Risk Budget. The cost of In-Network and Out-of-Network POS Shared Risk Services during the Reconciliation Period shall be charged against the POS Shared Risk Budget as follows: *** of any amount over *** up to *** and *** of any amount over ***.

POS Shared Risk Reinsurance. PPG shall participate in m the POS Shared Risk Reinsurance Program Program, which provides reinsurance for In-Network and Out-of-Network services. The cost to PPG for the POS Shared Risk Reinsurance Program shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** *% of POS Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services shall be reimbursed at *** eighty percent (80%) of cost, and the remaining *** of the cost shall be charged against the POS Shared Risk Budget. (b) In-Network and Out-of-Network POS Shared Risk Services: 1.6 ***% of POS Shared Risk Budget. The cost of In-Network and Out-of-Network POS Shared Risk Services during the Reconciliation Period shall be charged against the POS Shared Risk Budget as follows: *** of any amount over *** up to *** and *** of any amount over ***.

POS Shared Risk Reinsurance. PPG shall participate in the POS Shared Risk Reinsurance Program which provides reinsurance for In-Network and Out-of-Network services. The cost to PPG for the POS Shared Risk Reinsurance Program shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed ServicesServices : *** 1.07% of POS Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services shall be reimbursed at *** of cost, and the remaining *** of the cost shall be charged against the POS Shared Risk Budget. (b) In-Network and Out-of-Network POS Shared Risk Services: 1.6 1.61% of POS Shared Risk Budget. The cost of In-Network and Out-of-Network POS Shared Risk Services during the Reconciliation Period shall be charged against the POS Shared Risk Budget as follows: *** of any amount over *** up to *** *: and *** of any amount over ***.

POS Shared Risk Reinsurance. PPG shall participate in the POS Shared Risk Reinsurance Program which provides reinsurance for In-Network and Out-of-Network services. The cost to PPG for the POS Shared Risk Reinsurance Program shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** of POS Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services shall be reimbursed at *** of cost, and the remaining *** of the cost shall be charged against the POS Shared Risk Budget. (b) In-Network and Out-of-Network POS Shared Risk Services: 1.6 ***% of POS Shared Risk Budget. The cost of In-Network and Out-of-Network POS Shared Risk Services during the Reconciliation Period shall be charged against the POS Shared Risk Budget as follows: *** of any amount over *** up to *** and *** of any amount over ***.

POS Shared Risk Reinsurance. PPG shall participate in the POS Shared Risk Reinsurance Program which provides reinsurance for In-Network and Out-of-Network services. The cost to PPG for the POS Shared Risk Reinsurance Program shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** 6.44% of POS Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services shall be reimbursed at *** of cost, and the remaining *** of the cost shall be charged against the POS Shared Risk Budget. (b) In-Network and Out-of-Network POS Shared Risk Services: 1.6 % *** of POS Shared Risk Budget. The cost of In-Network and Out-of-Network POS Shared Risk Services during the Reconciliation Period shall be charged against the POS Shared Risk Budget as follows: *** of any amount over *** up to *** and *** of any amount over $***.

POS Shared Risk Reinsurance. PPG shall participate in the POS Shared Risk Reinsurance Program which provides reinsurance for In-Network and Out-of-Network services. The cost to PPG for the POS Shared Risk Reinsurance Program shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: Services *** of POS Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services shall be reimbursed at *** of cost, and the remaining *** of the cost shall be charged against the POS Shared Risk Budget. (b) In-Network and Out-of-Network POS Shared Risk Services: 1.6 % *** of POS Shared Risk Budget. The cost of In-Network and Out-of-Network POS Shared Risk Services during the Reconciliation Period shall be charged against the POS Shared Risk Budget as follows: *** of any amount over *** up to *** and *** of any amount over ***.

POS Shared Risk Reinsurance. PPG shall participate in the POS Shared Risk Reinsurance Program which provides reinsurance for In-In Network and Out-of-Network services. The cost to PPG for the POS Shared Risk Reinsurance Program shall be he calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** % of POS Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services shall be reimbursed at *** % of cost, . and the remaining *** of the cost shall be charged against the POS Shared Risk Budget. (b) In-Network and Out-of-Network POS Shared Risk Services: 1.6 *** % of POS Shared Risk Budget. The cost of In-Network and Out-of-Network POS Shared Risk Services during the Reconciliation Period shall be charged against the POS Shared Risk Budget as follows: *** of any amount over *** up to *** *; and *** of any amount over ***.