Common use of Premium Calculations Clause in Contracts

Premium Calculations. 6 For Kaiser Plans, the premium charges shall be the amount charged by 7 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 8 using sound actuarial principles, and include projected claim costs based on plan 9 experience as required by state regulations, Incurred But Not Reported (IBNR) 10 expenses, federal or state assessments, pharmaceutical claim expenses, stop-loss 11 premiums, third-party benefit plan administration costs, and an appropriate trend 12 factor selected to limit County contributions and employee cost shares while 13 providing adequate funding for plan operations. 14 If a government agency or other taxing authority imposes or increases a 15 tax or other charge upon the County’s Medical and/or Dental benefit plan(s) or any 16 activity of the plan(s), the County may increase the appropriate premium(s) to include 17 the new or increased tax or charge.

Premium Calculations. 6 4 For Kaiser Plans, the premium charges shall be the amount charged by 7 5 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 8 6 using sound actuarial principles, and include projected claim costs based on plan 9 7 experience as required by state regulations, Incurred But Not Reported (IBNR) 10 IBNR expenses, federal Oregon Medical 8 Insurance Pool or other state assessments, pharmaceutical claim expenses, stop-stop- 9 loss 11 premiums, third-party benefit plan administration costs, and an appropriate trend 12 10 factor selected to limit County contributions and employee cost shares while 13 11 providing adequate funding for plan operations. 14 12 If a government agency or other taxing authority imposes or increases a 15 tax or 13 other charge upon the County’s Medical and/or Dental benefit plan(s) or any 16 activity 14 of the plan(s), the County may increase the appropriate premium(s) to include 17 the 15 new or increased tax or charge.

Premium Calculations. 6 7 For Kaiser Plans, the premium charges shall be the amount charged by 7 8 Kaiser to the County. For the Moda ODS plans, the premium charges shall be calculated, 8 using 9 sound actuarial principles, and include projected claim costs based on plan 9 experience as 10 required by state regulations, Incurred But Not Reported (IBNR) 10 IBNR expenses, federal or state Oregon Medical Insurance Pool 11 assessments, pharmaceutical claim expenses, stop-loss 11 premiums, third-party benefit plan 12 administration costs, and an appropriate trend 12 factor selected to limit County contributions 13 and employee cost shares while 13 providing adequate funding for plan operations. 14 If a government agency or other taxing authority imposes or increases a 15 tax or other charge upon the County’s Medical and/or Dental benefit plan(splans(s) or any 16 activity of the plan(s), the County may increase the appropriate premium(s) to include the 17 the new or increased tax or charge.

Premium Calculations. 6 4 For Kaiser Plans, the premium charges shall be the amount charged by 7 5 Kaiser to the County. For the Moda ODS plans, the premium charges shall be calculated, 8 6 using sound actuarial principles, and include projected claim costs based on plan 9 7 experience as required by state regulations, Incurred But Not Reported (IBNR) 10 IBNR expenses, federal or state Oregon Medical 8 Insurance Pool assessments, pharmaceutical claim expenses, stop-loss 11 premiums, 9 third-party benefit plan administration costs, and an appropriate trend 12 factor selected 10 to limit County contributions and employee cost shares while 13 providing adequate 11 funding for plan operations. 14 12 If a government agency or other taxing authority imposes or increases a 15 tax or 13 other charge upon the County’s Medical and/or Dental benefit plan(s) or any 16 activity 14 of the plan(s), the County may increase the appropriate premium(s) to include 17 the 15 new or increased tax or charge.

Premium Calculations. 6 2 For Kaiser Plans, the premium charges shall be the amount charged by 7 3 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 8 4 using sound actuarial principles, and include projected claim costs based on plan 9 5 experience as required by state regulations, Incurred But Not Reported (IBNR) 10 IBNR expenses, federal or state Oregon Medical 6 Insurance Pool assessments, pharmaceutical claim expenses, stop-loss 11 premiums, 7 third-party benefit plan administration costs, and an appropriate trend 12 factor selected 8 to limit County contributions and employee cost shares while 13 providing adequate 9 funding for plan operations. 14 10 If a government agency or other taxing authority imposes or increases a 15 tax or 11 other charge upon the County’s Medical and/or Dental benefit plan(s) or any 16 activity 12 of the plan(s), the County may increase the appropriate premium(s) to include 17 the 13 new or increased tax or charge.

Premium Calculations. 6 5 For Kaiser Plans, the premium charges shall be the amount charged by 7 6 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 8 using 7 sound actuarial principles, and include projected claim costs based on plan 9 experience as 8 required by state regulations, Incurred But Not Reported (IBNR) 10 IBNR expenses, federal or and state Insurance Pool 9 assessments, pharmaceutical claim expenses, stop-loss 11 premiums, third-party benefit plan 10 administration costs, and an appropriate trend 12 factor selected to limit County contributions 11 and employee cost shares while 13 providing adequate funding for plan operations. 14 12 If a government agency or other taxing authority imposes or increases a 15 13 tax or other charge upon the County’s Medical and/or Dental benefit plan(splans(s) or any 16 14 activity of the plan(s), the County may increase the appropriate premium(s) to include 17 the 15 new or increased tax or charge.

Premium Calculations. 6 For Kaiser Plans, the premium charges shall be 24 the amount charged by 7 Kaiser to the County. For the Moda ODS plans, the premium 25 charges shall be calculated, 8 using sound actuarial principles, and include projected 26 claim costs based on plan 9 experience as required by state regulations, Incurred But Not Reported (IBNR) 10 IBNR 27 expenses, federal or state Oregon Medical Insurance Pool assessments, pharmaceutical claim 28 expenses, stop-loss 11 premiums, third-party benefit plan administration costs, and an 29 appropriate trend 12 factor selected to limit County contributions and employee cost 30 shares while 13 providing adequate funding for plan operations. 14 31 If a government agency or other taxing authority imposes or increases a 15 32 tax or other charge upon the County’s Medical and/or Dental benefit plan(s) or any 16 33 activity of the plan(s), the County may increase the appropriate premium(s) to 34 include 17 the new or increased tax or charge.

Premium Calculations. 6 4 For Kaiser Plans, the premium charges shall be the amount charged by 7 5 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 8 6 using sound actuarial principles, and include projected claim costs based on plan 9 7 experience as required by state regulations, Incurred But Not Reported (IBNR) 10 IBNR expenses, federal Oregon Medical 8 Insurance Pool or other state assessments, pharmaceutical claim expenses, stop-stop- 9 loss 11 premiums, third-party benefit plan administration costs, and an appropriate trend 12 10 factor selected to limit County contributions and employee cost shares while 13 11 providing adequate funding for plan operations. 14 12 If a government agency or other taxing authority imposes or increases a 15 13 tax or other charge upon the County’s Medical and/or Dental benefit plan(s) or any 16 14 activity of the plan(s), the County may increase the appropriate premium(s) to include 17 15 the new or increased tax or charge.

Premium Calculations. 6 For Kaiser Plans, the premium charges shall be the amount charged 22 by 7 Kaiser to the County. For the Moda ODS plans, the premium charges shall be calculated, 8 using sound actuarial 23 principles, and include projected claim costs based on plan 9 experience as required by state regulations, Incurred But Not Reported (IBNR) 10 IBNR 24 expenses, federal or state Oregon Medical Insurance Pool assessments, pharmaceutical claim expenses, stop-loss 11 premiums, 25 third-party benefit plan administration costs, and an appropriate trend 12 factor selected to limit County 26 contributions and employee cost shares while 13 providing adequate funding for plan operations. 14 27 28 If a government agency or other taxing authority imposes or increases a 15 tax or other charge 29 upon the County’s Medical and/or Dental benefit plan(s) or any 16 activity of the plan(s), the County may increase 30 the appropriate premium(s) to include 17 the new or increased tax or charge.. 31

Premium Calculations. 6 30 For Kaiser Plans, the premium charges shall be the amount charged by 7 31 Kaiser to the County. For the ODS Moda plans, the premium charges shall be calculated, 8 32 using sound actuarial principles, and include projected claim costs based on plan 9 33 experience as required by state regulations, Incurred But Not Reported (IBNR) 10 IBNR expenses, federal or and state Oregon 34 Medical Insurance Pool assessments, pharmaceutical claim expenses, stop-loss 11 35 premiums, third-party benefit plan administration costs, and an appropriate trend 12 factor 36 selected to limit County contributions and employee cost shares while 13 providing adequate 37 funding for plan operations. 14 38 If a government agency or other taxing authority imposes or increases a 15 39 tax or other charge upon the County’s Medical and/or Dental benefit plan(splans(s) or any 16 40 activity of the plan(s), the County may increase the appropriate premium(s) to include 17 the 41 new or increased tax or charge.. 42 D. Employee Contribution