Common use of Shared Risk Reinsurance Clause in Contracts

Shared Risk Reinsurance. PPG shall participate in the Shared Risk Reinsurance Program. The cost to PPG for such participation shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** of Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services are reimbursed at *** of allowed amount, and the remaining *** shall be charged against the Shared Risk Budget. (b) In-Area Shared Risk Services: *** of Shared Risk Budget. The cost of in-area Shared Risk services utilized by a Member in a Reconciliation Period shall be charged against the Shared Risk Budget as follows: twenty percent (20%) of any amount over *** up to ***; and *** of any amount over ***. (c) Transfer Reinsurance: $ 0.15 PMPM, shall be deducted from the Shared Risk Budget. Ten percent (10%) of eligible charges shall be charged against the Shared Risk Budget.

Shared Risk Reinsurance. PPG shall participate in the Shared Risk Reinsurance Program. The cost to PPG for such participation shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** of Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services are reimbursed at *** eighty percent (80%) of allowed amount, and the remaining *** shall be charged against the Shared Risk Budget. (b) In-Area Shared Risk Services: Services *** of Shared Risk Budget. The cost of in-area Shared Risk services utilized by a Member in a Reconciliation Period shall be charged against the Shared Risk Budget as follows: twenty percent (20%) *** of any amount over *** up to ***; * and *** of any amount over ***. (c) Transfer Reinsurance: $ 0.15 *** PMPM, shall be deducted from the Shared Risk Budget. Ten percent (10%) of eligible charges shall be charged against the Shared Risk Budget.

Shared Risk Reinsurance. PPG shall participate in the Shared Risk Reinsurance Program. The cost to PPG for such participation shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** of Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services are reimbursed at *** of allowed amount, and the remaining (*** *) shall be charged against the Shared Risk Budget. (b) In-Area Shared Risk Services: *** 2.97% of Shared Risk Budget. The cost of in-area Shared Risk services Services utilized by a Member in a Reconciliation Period shall be charged against the Shared Risk Budget as follows: twenty percent (20%) *** of any amount over *** up to ***; * and *** of any amount over ***. (c) Transfer Reinsurance: $ 0.15 Reinsurance *** PMPM, shall be deducted from the Shared Risk Budget. Ten percent (10%) Budget *** of eligible charges shall be charged against the Shared Risk Budget.

Shared Risk Reinsurance. PPG shall participate in the Shared Risk Reinsurance Program. The cost to PPG for such participation shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: Services *** of Shared Risk Budget. Budget Out-of-Area Emergency and Urgently Needed Services are reimbursed at *** of allowed amount, amount and the remaining *** shall be charged against the Shared Risk Budget. (b) In-Area Shared Risk Services: *** 4.59% of Shared Risk Budget. The cost of inIn-area Area Shared Risk services Services utilized by a Member in a Reconciliation Period shall be charged against the Shared Risk Budget as follows: twenty percent (20%) of any amount over *** up to ***; and follows *** of any amount over ***. (c) Transfer Reinsurance: $ 0.15 PMPM, *** PMPM shall be deducted from the Shared Risk Budget. Ten percent (10%) of eligible charges shall be charged against the Shared Risk Budget.

Shared Risk Reinsurance. PPG shall participate in the Shared Risk Reinsurance Program. The cost to PPG for such participation shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: Services *** of Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services are reimbursed at *** of allowed amount, and the remaining *** shall be charged against the Shared Risk Budget. (b) In-Area Shared Risk Services: *** 5.45% of Shared Risk Budget. The cost of in-area Shared Risk services utilized by a Member in a Reconciliation Period shall be charged against the Shared Risk Budget as follows: twenty percent (20%) of any amount over *** up to ***; and *** of any amount over ***. (c) Transfer Reinsurance: $ 0.15 *** PMPM, shall be deducted from the Shared Risk Budget. Ten percent (10%) of eligible charges shall be charged against the Shared Risk Budget.

Shared Risk Reinsurance. PPG shall participate in the Shared Risk Reinsurance Program. The cost to PPG for such participation shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** 4.58% of Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services are reimbursed at *** of allowed amount, and the remaining *** shall be charged against the Shared Risk Budget. (b) In-Area Shared Risk Services: *** 2.97 % of Shared Risk Budget. The cost of in-area Shared Risk services Services utilized by a Member in a Reconciliation Period shall be charged against the Shared Risk Budget as follows: twenty percent (20%) *** of any amount over *** up to ***; and *** of any amount over ***. (c) Transfer Reinsurance: $ $0.15 PMPM, . shall be deducted from the Shared Risk Budget. Ten percent (10%) of eligible charges shall be charged against the Shared Risk Budget.

Shared Risk Reinsurance. PPG shall participate in the Shared Risk Reinsurance Program. The cost to PPG for such participation shall be calculated as follows: (a) Out-of-Area Emergency and Urgently Needed Services: *** of Shared Risk Budget. Out-of-Area Emergency and Urgently Needed Services are reimbursed at *** eighty percent (80%) of allowed amount, and the remaining *** shall be charged against the Shared Risk Budget. (b) In-Area Shared Risk Services: *** of Shared Risk Budget. The cost of in-area Shared Risk services Services utilized by a Member in a Reconciliation Period shall be charged against the Shared Risk Budget as follows: twenty percent (20%) of any amount over *** up to ***; and *** of any amount over ***. (c) Transfer Reinsurance: $ 0.15 *** PMPM, shall be deducted from the Shared Risk Budget. Ten percent (10%) *** of eligible charges shall be charged against the Shared Risk Budget.