Common use of Shared Risk Budget Clause in Contracts

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 *** zero percent (0 %) 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 *** five percent (5%) 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 *** five percent (5%) or 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 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 *** five percent (5%) 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 *** zero percent (0 %) 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 *** forty-four and nine one hundredths percent (44.09%) 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 *** or 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 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 *** five percent (5%) of PPG’s Capitation for Medicare HMO Members and place such amount in the Withhold Fund as described in this Agreement.