Common use of Rate Methodology Clause in Contracts

Rate Methodology. Contractor shall provide, upon the Exchange’s request, in connection with any contract negotiation or recertification process as reasonably requested by the Exchange, detailed documentation on the Exchange-specific rate development methodology. Contractor shall provide justification, documentation and support used to determine rate changes, including providing adequately supported cost projections. Cost projections include factors impacting rate changes, assumptions, transactions and other information that affects the Exchange specific rate development process. Information pertaining to the key indicators driving the medical factors on trends in medical, pharmacy or other healthcare Provider costs may also be requested to support the assumptions made in forecasting and may be supported by information from the Plan’s actuarial systems pertaining to the Exchange-specific account.

Rate Methodology. Contractor shall provide, upon the Exchange’s request, in connection with any contract negotiation or recertification process as reasonably requested by the Exchange, detailed documentation on the Exchange-specific rate development methodology. Contractor shall provide justification, documentation documentation, and support used to determine rate changes, including providing adequately supported cost projections. Cost projections include factors impacting rate changes, assumptions, transactions transactions, and other information that affects the Exchange specific rate development process. Information pertaining to the key indicators driving the medical factors on trends in medical, pharmacy pharmacy, or other healthcare Provider costs may also be requested to support the assumptions made in forecasting and may be supported by information from the Plan’s actuarial systems pertaining to the Exchange-specific account.

Rate Methodology. ‌ Contractor shall provide, upon the Exchange’s request, in connection with any contract negotiation or recertification process as reasonably requested by the Exchange, detailed documentation on the Exchange-specific rate development methodology. Contractor shall provide justification, documentation and support used to determine rate changes, including providing adequately supported cost projections. Cost projections include factors impacting rate changes, assumptions, transactions and other information that affects the Exchange specific rate development process. Information pertaining to the key indicators driving the medical factors on trends in medical, pharmacy or other healthcare Provider costs may also be requested to support the assumptions made in forecasting and may be supported by information from the Plan’s actuarial systems pertaining to the Exchange-specific account.

Rate Methodology. ‌ Contractor shall provide, upon the Exchange’s request, in connection with any contract negotiation or recertification process as reasonably requested by the Exchange, detailed documentation on the Exchange-specific rate development methodology. Contractor shall provide justification, documentation documentation, and support used to determine rate changes, including providing adequately supported cost projections. Cost projections include factors impacting rate changes, assumptions, transactions transactions, and other information that affects the Exchange specific rate development process. Information pertaining to the key indicators driving the medical factors on trends in medical, pharmacy pharmacy, or other healthcare Provider costs may also be requested to support the assumptions made in forecasting and may be supported by information from the Plan’s actuarial systems pertaining to the Exchange-specific account.