Examples of Reinsurance payment in a sentence
In formula:Reinsurance DIR = (Gross Drug Cost Above the Out-of-Pocket Threshold /Total Gross Drug Cost) * covered Part D DIRAllowable reinsurance costs= (incurred reinsurance costs – reinsurance DIR) Reinsurance payment = (allowable reinsurance costs*0.80) ExampleA plan had $1,000,000 in incurred reinsurance costs and total allowed costs of $6,100,000.
Reinsurance DIR = ($1m/$6.1m)*$610,000 = $100,000 Allowable reinsurance costs = ($1m - $100,000) = $900,000 Reinsurance payment = ($900,000)*0.80 = $720,000 The resulting reinsurance payment amount ($720,000 in the example) will be reconciled with prospective reinsurance payment amounts made to plans during the coverage year (see Section 13).
At the time of publi- cation of risk adjustment factors under§ 422.312(a)(1)(ii) of this chapter, CMS publishes the risk adjusters established under this paragraph of this section for the upcoming calendar year.(c) Reinsurance payment amount—(1) General rule.
Therefore, Contractors are prohibited from performing online encounter voids during the monthly Reinsurance payment cycle.
On March 23, 2016, Colorado HealthOP received a Reinsurance payment of $14,154,424 from CMS.