Member Population definition

Member Population means the group of Attributed Members assigned to the Medical Panel or Program, as applicable; and whose costs under the relevant Anthem products(s) will be used to calculate MCBs, MCTs and MCPs pursuant to the Program (subject to criteria established by Anthem).
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Member Population means the group of Attributed Members assigned to Provider or Medical Panel and whose costs under the relevant Anthem product(s) as described in the Attachment will be used to calculate MPMLRs pursuant to the Program (subject to criteria established by Anthem).
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Member Population means the group of Medicare Advantage Attributed Members assigned to Provider or Medical Panel and whose costs under the relevant Anthem products(s) will be used to calculate MPMLRs pursuant to the Program (subject to criteria established by Anthem).
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Examples of Member Population in a sentence

  • SFHSS produces detailed full-color benefits guides for the following subsets of the SFHSS Member Population.

  • The Lenders hereby authorize the Administrative Agent, at its option and in its discretion, to execute any document, amendment or other agreement necessary to effectuate the foregoing.

  • The formulae for setting the MCT take into account risk adjusted Per Member/Per Month (PMPM) Claims experience within the Attributed Member Population during the Baseline Period, but excluding certain transplant and high cost Claims amounts.

  • MCP”) means the actual cost experience in the defined Member Population during a relevant Measurement Period, expressed in terms of risk-adjusted per member per month (“PMPM”).

  • Additionally, while some MCTs may be established based on Member Population as represented by a Medical Panel, others (when line of business membership is too low at the Medical Panel level to establish statistically meaningful MCTs) may be based on Member Populations as represented by certain counties, regions, or states.

  • Kaiser Permanente Establishes Institute to Address Unique Needs of Member Population.

  • MCP) means the actual cost experience in the defined Member Population during a relevant Measurement Period, expressed in terms of risk adjusted per member per month (PMPM) or percent of premium paid, as applicable, but excluding certain Covered Individuals with transplant or high cost claims amounts.

  • The CARA Processing Fee will be invoiced at the initiation of the respective CARA Process Period and will be based on the Member Population from the Health Plan Data Set processed for the applicable CARA Process.

  • Member Population: 2011 – 2020 Year Ended December 31 Active Members* Inactive Members * Includes ordinary disability members who continue to accrue benefit service and additional liability while on ordinary disability..

  • SFHSS Response:In addition to English, the City’s Language Access Ordinance requires City departments to provide language access services in the following three (3) languages: Chinese (Cantonese and Mandarin), Spanish, and Filipino.1 Moreover, per RFP Section 1.1.3 (SFHSS Member Population), SFHSS Members are diverse in their language needs, with the need for interpretation of a variety of languages including, but are not limited to, Spanish, Japanese, Mandarin, Cantonese, Tagalog, Hindi, and Russian.


More Definitions of Member Population

Member Population means the group of Attributed Members assigned to Provider as applicable; and whose costs and quality performance under the relevant Anthem products(s) will be used to calculate EPHC Essentials Performance Payment pursuant to the Program (subject to criteria established by Anthem).
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Member Population means the group of members comprised of the enrollees within the Medicare Advantage product line of Client for which Services are to be rendered, as designated by Client. Inovalon and Client agree that Inovalon will be the sole third party vendor only for the provision of the contracted Services for the Member Population as outlined in this SOW. With respect to the Member Population, Client may, at its discretion, complement or pursue additional initiatives using other contractors, but, Client agrees to share with Inovalon the results of any such complementary services. For clarity, such complementary services will not be in lieu of or decrease from the Services provided by Inovalon. Additionally, nothing in this definition prevents Client from revoking delegated Services in the event of a breach on the part of Inovalon. Client shall supply Inovalon with identifying information for those individual members included in the Member Population. Client has the right to exclude Medicare Advantage members from the Member Population, subject to the limitations described below. Client will ensure that the Member Population meets the minimum requirements listed below. Client will define the Member Population by providing Inovalon with written notice of a preliminary percentage estimate by October 1st preceding the applicable calendar year, a final percentage by November 1st preceding the applicable calendar year, and the actual members within the Member Population within one week of December 7th preceding the applicable calendar year. The parties acknowledge that the flexibility to define the Member Population may affect the ability of Inovalon to meet certain return on investment provisions in a particular SOW, and this will be taken into consideration when measuring the return on investment requirements. i. For the calendar year 2016, the Member Population shall be comprised of no less than sixty-five percent (65%) of Client’s total then-current Medicare Advantage membership. ii. For the calendar year 2017, the Member Population shall be comprised of no less than fifty-five percent (55%) of Client’s total then-current Medicare Advantage membership
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Member Population means the group of Attributed Members assigned to the Medical Panel, county, region, or state, as applicable; and whose costs under the relevant Empire products(s) will be used to calculate MCTs and MCPs pursuant to the Program (subject to criteria established by Empire.
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Member Population means the group of Medicare Advantage Attributed Members assigned to the Program, as applicable; and whose quality performance under the relevant Anthem products(s) will be used to calculate EPHC Essentials Performance Payment pursuant to the Program (subject to criteria established by Anthem).
Sample 1
Member Population means the group of Medicare Advantage Attributed Members assigned to Provider or Medical Panel and whose costs under the relevant Anthem Blue Cross products(s) will be used to calculate MPMLRs pursuant to the Program (subject to criteria established by Anthem Blue Cross).
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Member Population means the group of Medicare Advantage Attributed Members assigned to Provider or Medical Panel and whose costs under the relevant Empire products(s) will be used to calculate MPMLRs pursuant to the Program (subject to criteria established by Empire).
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Related to Member Population

  • Population means the population as ascertained at the last preceding census of which the relevant figures have been published;

  • Member Services are hereby defined as any products or services now or hereafter provided or sponsored by the Credit Union or otherwise made available to Credit Union members, which services include, but are not limited to: loans, deposit accounts, ATM services, online banking services, and other electronic fund transfer services.

  • Target Population means persons with low incomes who have one or more disabilities, including mental illness, HIV or AIDS, substance abuse, or other chronic health condition, or individuals eligible for services provided pursuant to the Lanterman Developmental Disabilities Services Act (Division 4.5 (commencing with Section 4500) of the Welfare and Institutions Code) and may include, among other populations, adults, emancipated minors, families with children, elderly persons, young adults aging out of the foster care system, individuals exiting from institutional settings, veterans, and homeless people.

  • Person-Centered Service Plan means the details of the supports, desired outcomes, activities, and resources required for an individual to achieve and maintain personal goals, health, and safety, as described in OAR 411-004-0030.

  • Statewide popular election means a general election in which votes are cast for

  • Municipal Separate Storm Sewer System Management Program or "MS4 Program" means a management program covering the duration of a state permit for a municipal separate storm sewer system that includes a comprehensive planning process that involves public participation and intergovernmental coordination, to reduce the discharge of pollutants to the maximum extent practicable, to protect water quality, and to satisfy the appropriate water quality requirements of the CWA and regulations and the Act and attendant regulations, using management practices, control techniques, and system, design and engineering methods, and such other provisions that are appropriate.

  • PCP means Primary Care Provider.

  • Generation Service means the sale of electricity, including ancillary services such as the provision of reserves, to a Customer by a Competitive Supplier.

  • Energy Use Intensity (EUI means the kBTUs (1,000 British Thermal Units) used per square foot of gross floor area.

  • Adult motion picture theater means a commercial establishment where, for any form of consideration, films, motion pictures, video cassettes, slides, or similar photographic reproductions are regularly shown which are characterized by the depiction or description of "specified sexual activities" or "specified anatomical areas."

  • District Level Anti-Ragging Committee means the Committee, headed by the District Magistrate, constituted by the State Government, for the control and elimination of ragging in institutions within the jurisdiction of the district.

  • Stormwater management measure means any practice, technology, process, program, or other method intended to control or reduce stormwater runoff and associated pollutants, or to induce or control the infiltration or groundwater recharge of stormwater or to eliminate illicit or illegal non-stormwater discharges into stormwater conveyances.

  • Continuous parameter monitoring system (CPMS means all of the equipment necessary to meet the data acquisition and availability requirements of the Prevention of Significant Deterioration program, to monitor process and control device operational parameters (for example, control device secondary voltages and electric currents) and other information (for example, gas flow rate, O2 or CO2 concentrations), and to record average operational parameter value(s) on a continuous basis.

  • Staffing service means any person, other than a professional employer organization, that hires its

  • Project Management Plan means the portion of the Project Development Plan providing the information requested in Section 4.2 of Exhibit B to the ITP.

  • Outpatient attendance means treatment received in a hospital emergency department where the patient is not admitted to a bed in the hospital.

  • Participating Prosthetic Provider means a Prosthetic Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Medical service means any medical treatment or any medical, surgical, diagnostic, chiropractic, dental, hospital, nursing, ambulance, and other related services, and drugs, medicine, crutches and prosthetic appliances, braces and supports, and, where necessary, physical restorative services.

  • Cardiopulmonary resuscitation or "CPR" means artificial ventilation or external

  • Network plan means health insurance coverage of a health insurance issuer under which the financing and delivery of medical care including items and services paid for as medical care are provided, in whole or in part, through a defined set of providers under contract with the carrier.

  • Shared Service means any service, other than a Utility Service or a For Profit Affiliate Service, provided on a Cost Recovery Basis by a Utility to an Affiliate or by an Affiliate to a Utility.

  • Participating physician means a physician licensed in Virginia to practice medicine, who practices

  • 911 Service means a universal telephone number which gives the public direct access to the Public Safety Answering Point (“PSAP”). Basic 911 service collects 911 calls from one or more local exchange switches that serve a geographic area. The calls are then sent to the correct authority designated to receive such calls.

  • Image intensifier means a device, installed in its housing, which instantaneously converts an x-ray pattern into a corresponding light image of higher intensity.

  • Declared pregnant woman means a woman who has voluntarily informed the licensee or registrant, in writing, of her pregnancy and the estimated date of conception. The declaration remains in effect until the declared pregnant woman withdraws the declaration in writing or is no longer pregnant.

  • Covered Services means all or a part of those medical and health services set forth in rule 441—86.14(514I).