Reconciliation Amount. If and only if the actual usage during the previous Month was in excess of the Pre-Xxxx Amount from the previous month’s Invoice then the Reconciliation Amount is calculated by the following formula: previous month’s actual EUC times the previous months rate minus previous month’s Pre Xxxx Amount. Pricing Tier BILLABLE LOGINS (Minimum EUC) FEE PER END USER *** *** Tier One *** *** Tier Two *** *** Tier Three *** *** Tier Four *** ***
Reconciliation Amount. If the Actual MLR is greater than or equal to 85.0%, then: There is no Gain Share Reconciliation If the Actual MLR is greater than or equal to 83.0% but less than 85.0%, then: Aetna retains the 2% corridor; there is no gain sharing with Shelby County Government If the Actual MLR < 83.0%, then: Aetna refunds to Shelby County Government: • 100% of the difference betweenthe 83% and the Actual MCR Gain Share Arrangement The incurred Medical Loss Ratio (MLR) will be determined as follows: [Claims + Quality Improvement Expense + Fraud & Abuse Expense] Divided by [CMS Revenue + Supplemental Premium] Claims are on an incurred basis, including fee-for-service (FFS) and non-FFS claims, as well as a provision for Incurred But Not Reported (IBNR) claims. Quality Improvement Expense (QIE) and Xxxxx & Abuse Expense (FAE) include costs as currently defined for federal minimum MLR purposes. If the definition of QIE or FAE under federal minimum MLR rules changes in the future, Aetna reserves the right to review the program parameters. Supplemental Premium includes amounts paid to Aetna by Shelby County Government, excluding any amounts intended to recover taxes, fees, and assessments. The schedule below will apply to these reconciliations, subject to change due to any extenuating or unforeseen circumstances regarding the timing of CMS reimbursement which may materially affect a refund or amount due, for example, CMS Risk Adjustment Data Validation (RADV) Audits. If CMS retroactively adjusts revenues paid to Aetna with respect to Shelby County Government’s Medicare Advantage coverage, impacting the total revenue used in any of Aetna’s reconciliations (either preliminary or final), Aetna reserves the right to provide a revised reconciliation based on corrected CMS revenue data, and Shelby County Government shall reimburse Aetna in an amount necessary to reflect the correction to the reconciliation. Such amounts shall be paid within 90 days of receipt of the reconciliation. The maximum liability of Shelby County Government is limited to the value of refunds paid. Any gain share due to Shelby County Government will be refunded to Shelby County Government based on the schedule shown below. No interest will accrue on any such balances. Upon termination or non-renewal of the agreement with Shelby County Government, any remaining unused premium credits will be retained by Aetna.
Reconciliation Amount. Beginning in November of 2019, and each year thereafter, East Lyme’s Superintendent of Schools, or his designee, shall compare the expenses reported on the ED001 submission, using the same methodology as described in section 4.3, to determine East Lyme High School’s actual per student expenses for the prior year, plus the applicable Services Surcharge for that year, as described in Section 4.6., with the Base Rate charged Salem for that year. At the same time, a reconciliation of the Special Education Rate will be based on actual expenses of providing special education at East Lyme High School, consistent with the methodology described in section 4.5, plus the applicable Services Surcharge for that year, as described in Section 4.6. The difference between total payments actually made by Salem for Base Rate and Special Education Rate with the applicable Services Surcharge for that year, and the total actual costs for all Salem students attending East Lyme, based on calculated costs per student for all regular and special education students with the applicable Services Surcharge for that year, shall be divided by 10, and shall be the monthly Reconciliation Amount to adjust the payments in the following school year.
Reconciliation Amount. 12.10.1 At any time between 20 and 40 Business Days after the end of each Service Year, Council’s Representative will carry out a reconciliation of the Fees and other amounts paid against the Services provided, the Delivered Material delivered to the Disposal Facility and the Service Prices.
Reconciliation Amount. 4.6.1 For each Refund Period during the Term, the Reconciliation Amount is to be calculated as a monetary amount using the following formula: Reconciliation Amount = (RPRP x PRRP x (1 –R%)) – CRSRP Where:
Reconciliation Amount. As defined in Section 3.1(d) of this Agreement.
Reconciliation Amount. At the end of each three-month anniversary during the Term, beginning on the Effective Date, CRD shall calculate the “Reconciliation Amount” as follows: Revenues (as such term is defined in the Employment Agreement), if any, up to, but not in excess of $525,000, plus the Remainder, if any, minus $600,000. By way of example only, if Revenues equal $525,000 and the Remainder equals $800,000, then the Reconciliation Amount shall equal $725,000 ((525,000 + 800,000 = 1,325,000) – 600,000 = 725,000). In the event that the Reconciliation Amount is a negative number, it shall be deemed to be $0 for purposes of this Agreement. Notwithstanding the foregoing, the Parties acknowledge and agree that the Bonus (as such term is defined in the Employment Agreement) is not factored into the calculation of the Reconciliation Amount. In the event that the Employment Agreement is terminated, CRD shall no longer calculate the Reconciliation Amount but shall remit the Remainder to Noor in accordance with the terms of Section 3.2(b) above. Any account amount not paid within ninety (90) days of the billing date shall be deducted in computing the Remainder and added back if later collected.
Reconciliation Amount
