Shared Risk Budget. HMO shall fund the Shared Risk Budget for Members, with normalized rates. These normalized rates shall be adjusted for PPG’s assigned Members by the age, sex and benefit plan factors as set forth in Addendum B. Actual Shared Risk Budget shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates.
Shared Risk Budget. Each month from January to June 1998, HMO shall fund the Shared Risk Budget for Individual HMO Members, at the flat PMPM rate as set forth below. Starting in July 1998, HMO shall fund the Shared Risk Budget for Members, with normalized rates. These normalized rates shall be adjusted for PPG’s assigned Members by the age, sex and benefit plan factors as set forth in Addendum B. Actual Shared Risk Budget shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. January 1, 1998 to June 30, 1998 $ *** PMPM July 1, 1998 to August 31,1998 $ PMPM (See Section A7 above) September 1, 1998 $ PMPM (See Section A8 above)
Shared Risk Budget. The amount allocated per Member per month (“PMPM”) for the cost of Shared Risk Services established by FHS as set forth in the applicable Addendum.
Shared Risk Budget. In July 1998, PPGs Shared Risk Budgets shall be converted from a flat PMPM amount to an age, sex and benefit plan adjusted structure. Such conversion shall be revenue neutral (before Division of Financial Responsibility change.
Shared Risk Budget. As a contingency for any PPG liability under the Shared Risk Program, HMO shall deduct *** of PPG’s Capitation and place such amount in the Withhold Fund as described in this Agreement. Each month, HMO shall fund the Shared Risk Budget for each eligible Medicare HMO Member at *** of Monthly Revenue. In the event the claims for Shared Risk Services exceed Shared Risk Revenue at the interim settlement date., HMO may, at its sole discretion, deduct up to *** of PPG’s Capitation for Medicare HMO Members and place such amount in the Withhold Fund as described in this Agreement, and may continue such withhold until the final Shared Risk settlement. The Withhold fund shall accrue interest which shall be the lower of *** the prime interest rate as stated in the Wall Street Journal, on the last business day in December of the contract year. If, upon final Shared Risk settlement, (i) a Shared Risk gain exists, HMO shall refund the Withhold Fund, plus accrued interest, to PPG together with the PPG’s share of the gain or (ii) a Shared Risk deficit exists, subject to Section 4.3, of the Agreement, HMO shall offset the Withhold Fund against PPG’s outstanding liability or any other amounts payable to HMO. Any amount in the Withhold Fund not offset against such PPG liability shall be refunded to PPG at the final Risk Sharing settlement. However, as a contingency for any PPG liability under this Shared Risk Program, HMO shall continue, at its sole discretion, to deduct up to *** of PPG’s Capitation for Medicare HMO Members and place such amount in the Withhold Fund as described in this Agreement
Shared Risk Budget. As a contingency for any PPG liability under the Shared Risk Program. HMO shall deduct five percent (5%) of PPG’s Capitation and place such amount in the Withhold Fund as described in this Agreement. In the event the interim settlement results in a deficit, HMO may, at its sole discretion, withhold from PPG’s Capitation up to *** of PPG’s Capitation and may continue such withhold until the deficit amount is recovered. Each month, HMO shall fund the Shared Risk Budget for each eligible Medicare HMO Member at *** of CMS Premium
Shared Risk Budget. HEALTH NET shall fund the Shared Risk Budget for Members, with normalized rates. These normalized rates shall be adjusted for PPG’s assigned Members by the age, sex and benefit plan factors as set forth in Addendum 1.1. Actual Shared Risk Budget shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan and fluctuates.
Shared Risk Budget. HMO shall fund the Shared Risk Budget for Members, with normalized rates. These normalized rates shall be adjusted for PPG’s assigned Members by the age, sex and benefit plan factors as set forth in Addendum B. Actual Shared Risk Budget shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. ? Addendum C MEDICARE HEALTH MAINTENANCE ORGANIZATION (HMO) AND MEDICARE POINT OF SERVICE (POS) BENEFIT PROGRAMS Section A DEFINITIONS item A HCFA is deleted in its entirety and replaced as follows: amended to add the following new Section F.
Shared Risk Budget. The sum of all of the individual Medi-Cal HMO Member Shared Risk Targets. The Shared Risk Budget will be compared to Shared Risk Claims to determine whether PPG is eligible for a Shared Risk payment.
Shared Risk Budget. A budgeted amount (“Shared Risk Budget”) shall be established. The Shared Risk Budget shall be 38.4 % of the total capitation paid to Health Plan on behalf of Enrollees assigned to Physician Group and Hospital. Initials
