Risk Corridor Percentage Sample Clauses

Risk Corridor Percentage. For each Demonstration Year, the Contractor‘s Total Adjusted Expenditures divided by the Adjusted Capitation Rate Revenue for the applicable Demonstration Year, rounded to the nearest one tenth of a percent.
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Risk Corridor Percentage. The Risk Corridor Percentage is calculated as the total adjusted medical expenditures divided by the total capitation revenue for all populations. The Risk Sharing Corridor is defined as follows: Risk Corridor Minimum Percentage Risk Corridor Maximum Percentage Contractor Share State / Federal Share 0.0% 88.1% 0.0% 100.0% 88.1% 91.1%* 100.0% 0.0% 91.1%* 94.1% 100.0% 0.0% 94.1% 94.1%+ 0.0% 100.0% *Risk corridor bands reflected in the risk corridor table are +/- 3.0%. The target MLR of 91.1% is based on the weighted average of total non-medical load amounts built into capitated rates for July 1, 2023 to June 30, 2024, based on SFY22 statewide enrollment distribution. In the circumstance that during the contract period the Agency implements programmatic changes that results in a change, (increase or decrease), to the total capitation rate but does not impact the non- medical load the risk corridor target may change to reflect the non-medical load reflected in the adjusted rates; however, the risk corridor bands will remain +/- 3.0% from the revised target. The actual target MLR used for the risk corridor reconciliation may vary slightly based on the actual population distribution for the Contractor during the twelve-month contract period. To the extent the actual target MLR varies from 91.1% using the actual enrollment mix and revised capitation rates during the contract period, the risk corridor bands will still be +/- 3.0% from the revised target. Revision 13. Section E.1.04. Provider Website, the following sentence is hereby added as follows: The Contractor shall update the Provider Relations regional maps at least quarterly, or more frequently as staffing changes occur. Revision 14. Section E.1.30. Provider Recredentialing Performance Metric, is hereby amended as follows: Contractor shall complete recredentialing of all contracted Providers no less than every three (3) years. The agency will conduct an annual audit to ensure compliance with recredentialing requirements. For contracts new to Iowa health Link program the audit will occur on the third year of the contract. Failure to comply with the audit or recredentialing requirements may result in corrective actions in accordance with contract section J.8.08.
Risk Corridor Percentage. The Risk Corridor Percentage is calculated as the total adjusted medical expenditures divided by the total capitation revenue for all populations. The Risk Sharing Corridor is defined as follows: Risk Corridor Minimum Percentage Risk Corridor Maximum Percentage Contractor Share State / Federal Share 0.0% 88.1% 0.0% 100.0% 88.1% 91.1%* 100.0% 0.0% 91.1%* 94.1% 100.0% 0.0% 94.1% 94.1%+ 0.0% 100.0% *Risk corridor bands reflected in the risk corridor table are +/- 3.0%. The target MLR of 91.1% is based on the weighted average of total non-medical load amounts built into capitated rates for July 1, 2023 to June 30, 2024, based on SFY22 statewide enrollment distribution. In the circumstance that during the contract period the Agency implements programmatic changes that results in a change, (increase or decrease), to the total capitation rate but does not impact the non- medical load the risk corridor target may change to reflect the non-medical load reflected in the adjusted rates; however, the risk corridor bands will remain +/- 3.0% from the revised target. The actual target MLR used for the risk corridor reconciliation may vary slightly based on the actual population distribution for the Contractor during the twelve-month contract period. To the extent the actual target MLR varies from 91.1% using the actual enrollment mix and revised capitation rates during the contract period, the risk corridor bands will still be +/- 3.0% from the revised target.

Related to Risk Corridor Percentage

  • Average Contribution Amount For purposes of this Agreement, to ensure that all employees enrolled in health insurance through the City’s HSS are making premium contributions under the Percentage-Based Contribution Model, and therefore have a stake in controlling the long term growth in health insurance costs, it is agreed that, to the extent the City's health insurance premium contribution under the Percentage-Based Contribution Model is less than the “average contribution,” as established under Charter section A8.428(b), then, in addition to the City’s contribution, payments toward the balance of the health insurance premium under the Percentage-Based Contribution Model shall be deemed to apply to the annual “average contribution.” The parties intend that the City’s contribution toward employee health insurance premiums will not exceed the amount established under the Percentage-Based Contribution Model.

  • Reallocation to a Class with a Lower Salary Range Maximum 1. If the employee meets the skills and abilities requirements of the position and chooses to remain in the reallocated position, the employee retains existing appointment status and has the right to be placed on the Employer’s internal layoff list for the classification occupied prior to the reallocation.

  • Carry Forward to a Subsequent Year If you do not withdraw the excess contribution, you may carry forward the contribution for a subsequent tax year. To do so, you under-contribute for that tax year and carry the excess contribution amount forward to that year on your tax return. The six percent excess contribution penalty tax will be imposed on the excess amount for each year that it remains as an excess contribution at the end of the year. You must file IRS Form 5329 along with your income tax return to report and remit any additional taxes to the IRS.

  • Reallocation to a Class with a Higher Salary Range Maximum Upon appointment to the higher class, the employee’s base salary will be increased to a step of the range for the new class that is nearest to five percent (5.0%) higher than the amount of the pre-promotional step, or to the entry step of the new range, whichever is higher.

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