Common use of Professional Out-of-Network Risk Sharing Program Clause in Contracts

Professional Out-of-Network Risk Sharing Program. The budget for this Program shall be equal to the sum of the following two components: 1) The Professional Out-of-Network Withhold as described in Section 4 above, and 2) an amount equal to *** of the Commercial POS Professional Capitation prior to withhold. Each year, HMO shall settle the risk sharing program by calculating the difference between the budget and the actual claims. If a surplus remains, PPG’s share shall be *** subject to Section 4.3. PPG shall not be subject to any downside.

Professional Out-of-Network Risk Sharing Program. The budget for this Program shall be equal to the sum of the following two components: 1) The Professional Out-of-Network Withhold as described in Section 4 above, and 2) an amount equal to *** of the Commercial POS Professional Capitation prior to withhold. Each year, . HMO shall settle the risk sharing program by calculating the difference between the budget and the actual claims. If a surplus remains, . PPG’s share shall be *** he fifty percent subject to Section 4.3. 4.3 PPG shall not be subject to any downside.

Professional Out-of-Network Risk Sharing Program. The budget for this Program shall be equal to the sum of the following two components: 1) The Professional Out-of-Network Withhold Withhold, as described in Section 4 above, and 2) an amount equal to *** 10% of the Commercial POS Professional Capitation prior to withhold. Each year, HMO shall settle the risk risk-sharing program by calculating the difference between the budget and the actual claims. If a surplus remains, PPG’s share shall be fifty percent (50%), not to exceed *** of PPG’s annual gross capitation, subject to Section 4.3. PPG shall not be subject to any downside.

Professional Out-of-Network Risk Sharing Program. The budget for this Program shall be equal to the sum of the following two components: 1) The Professional Out-of-Network Withhold as described in Section 4 above, and 2) an amount equal to *** of the Commercial POS Professional Capitation prior to withhold. Each year, HMO shall settle the risk sharing program by calculating the difference between the budget and the actual claims. If a surplus remains, PPG’s share shall be fifty percent not to exceed *** of PPG’s annual gross capitation, subject to Section 4.3. PPG shall not be subject to any downside.

Professional Out-of-Network Risk Sharing Program. The budget for this Program shall be equal to the sum of the following two components: 1) The Professional Out-of-Network Withhold as described in Section 4 above, and 2) an amount equal to *** 10% of the Commercial POS Professional Capitation prior to withhold. Each year, HMO shall settle the risk sharing program by calculating the difference between the budget and the actual claims. If a surplus remains, PPG’s share shall be *** fifty percent subject to Section 4.3. PPG shall not be subject to any downside.

Professional Out-of-Network Risk Sharing Program. The budget for this Program shall be equal to the sum of the following two components: components 1) The Professional Out-of-Network Withhold as described in Section 4 above, and 2) an amount equal to *** of the Commercial POS Professional Capitation prior to withhold. Each year, HMO shall settle the risk sharing program by calculating the difference between the budget and the actual claims. If a surplus remains, PPG’s share shall be *** fifty percent subject to Section 4.3. PPG shall not be subject to in any downside.

Professional Out-of-Network Risk Sharing Program. The budget for this Program shall be equal to the sum of the following two components: 1) The Professional Out-of-Network Withhold as described in Section 4 above, and 2) an amount equal to *** 10% of the Commercial POS Professional Capitation prior to withhold. Each year, HMO shall settle the risk sharing program by calculating the difference between the budget and the actual claims. If a surplus remains, PPG’s share shall be *** fifty percent not to exceed twenty per cent (20%) of PPG’s annual gross capitation, subject to Section 4.3. PPG shall not be subject to any downside.

Professional Out-of-Network Risk Sharing Program. The budget for this Program shall be equal to the sum of the following two components: 1) The Professional Out-of-Network Withhold Withhold, as described in Section 4 above, and 2) an amount equal to *** 10% of the Commercial POS Professional Capitation prior to withhold. Each year, HMO shall settle the risk risk-sharing program by calculating the difference between the budget and the actual claims. If a surplus remains, PPG’s share shall be ***, not to exceed *** of PPG’s annual gross capitation, subject to Section 4.3. PPG shall not be subject to any downside.