Common use of Age, Sex and Benefit Plan Factors for PPG Capitation and Shared Risk Budgets Clause in Contracts

Age, Sex and Benefit Plan Factors for PPG Capitation and Shared Risk Budgets. A.1 Age, Sex Factors for PPG Capitation and Hospital Capitation Shared Risk Budgets Effective January 1, 1998 through August 31,1998 Sex Age Prof Factor Inst Factor Female 0 1.774 3.843 1 0.664 0.463 2 - 4 0.493 0.370 5 - 9 0.436 0.382 10 - 14 0.399 0.390 15 - 19 0.421 0.418 20 - 24 0.902 0.999 25 - 29 1.525 1.664 30 - 34 1.543 1.478 35 - 39 1.547 1.281 40 - 44 1.567 1.272 45 - 49 1.630 1.293 50 - 54 1.712 1.448 00 - 00 0.000 0.000 00 - 00 2.161 2.260 65 + 2.251 2.025 Medicare Eligible 1.000 1.000 Male 0 1.774 3.843 1 0.664 0.463 2 - 4 0.493 0.370 5 - 9 0.436 0.382 10 - 14 0.399 0.390 15 - 19 0.421 0.418 20 - 24 0.432 0.447 25 - 29 0.492 0.486 30 - 34 0.569 0.536 35 - 39 0.667 0.673 40 - 44 0.780 0.800 45 - 49 0.933 0.975 50 - 54 1.251 1.415 00 - 00 0.000 0.000 00 - 00 2.177 2.928 65 + 2.276 2.658 Medicare Eligible 1.000 1.000

Age, Sex and Benefit Plan Factors for PPG Capitation and Shared Risk Budgets. A.1 A. 1 Age, Sex Factors for PPG Capitation and Hospital Capitation Capitation/Shared Risk Budgets Effective January 1, 1998 through August 31,1998 2000 Sex Age Prof Factor Inst Factor Child 0 2.008 5.228 1 1.075 0.644 2 – 4 0.598 0.406 5 – 9 0.439 0.296 10 – 14 0.418 0.338 15 – 19 0.590 0.607 Female 0 1.774 3.843 1 0.664 0.463 2 - 4 0.493 0.370 5 - 9 0.436 0.382 10 - 14 0.399 0.390 15 - 19 0.421 0.418 20 – 24 1.195 1.066 25 – 29 1.653 1.431 30 – 34 1.509 1.315 35 – 39 1.378 1.143 40 – 44 1.322 1.031 45 – 49 1.386 1.102 50 – 54 1.551 1.338 55 – 59 1.794 1.741 60 – 64 2.090 2.313 65 + 2.414 2.907 Medicare Eligible 1.000 1.000 Male 20 - 24 0.902 0.999 0.398 0.477 25 - 29 1.525 1.664 0.477 0.486 30 - 34 1.543 1.478 0.546 0.506 35 - 39 1.547 1.281 0.626 0.589 40 - 44 1.567 1.272 0.734 0.768 45 - 49 1.630 1.293 0.890 1.087 50 - 54 1.712 1.448 1.139 1.580 00 - 00 0.000 0.000 00 - 00 2.161 2.260 2.009 2.880 65 + 2.251 2.025 Medicare Eligible 1.000 1.000 Male 0 1.774 3.843 1 0.664 0.463 2 - 4 0.493 0.370 5 - 9 0.436 0.382 10 - 14 0.399 0.390 15 - 19 0.421 0.418 20 - 24 0.432 0.447 25 - 29 0.492 0.486 30 - 34 0.569 0.536 35 - 39 0.667 0.673 40 - 44 0.780 0.800 45 - 49 0.933 0.975 50 - 54 1.251 1.415 00 - 00 0.000 0.000 00 - 00 2.177 2.928 65 + 2.276 2.658 2.561 3.586 Medicare Eligible 1.000 1.000

Age, Sex and Benefit Plan Factors for PPG Capitation and Shared Risk Budgets. A.1 Age, Sex Factors for PPG Capitation and Hospital Capitation Shared Risk Budgets Effective January June 1, 1998 through August 31,1998 31, 1998 Sex Age Prof Pro Factor Inst Factor Female 0 1.774 3.843 1 0.664 0.463 2 - 2-4 0.493 0.370 5 - 5-9 0.436 0.382 10 - 10-14 0.399 0.390 15 - 15-19 0.421 0.418 20 - 20-24 0.902 0.999 25 - 25-29 1.525 1.664 30 - 30-34 1.543 1.478 35 - 35-39 1.547 1.281 40 - 40-44 1.567 1.272 45 - 45-49 1.630 1.293 50 - 50-54 1.712 1.448 00 - 00 0.000 0.000 00 - 00 55-59 1.982 1.927 60-64 2.161 2.260 65 65+ 2.251 2.025 Medicare Eligible 1.000 1.000 Male 0 1.774 3.843 1 0.664 0.463 2 - 2-4 0.493 0.370 5 - 5-9 0.436 0.382 10 - 10-14 0.399 0.390 15 - 15-19 0.421 0.418 20 - 20-24 0.432 0.447 25 - 25-29 0.492 0.486 30 - 30-34 0.569 0.536 35 - 35-39 0.667 0.673 40 - 40-44 0.780 0.800 45 - 45-49 0.933 0.975 50 - 50-54 1.251 1.415 00 - 00 0.000 0.000 00 - 00 55-59 1.625 1.998 60-64 2.177 2.928 65 65+ 2.276 2.658 Medicare Eligible 1.000 1.000

Age, Sex and Benefit Plan Factors for PPG Capitation and Shared Risk Budgets. A.1 Age, Sex Factors for PPG Capitation and Hospital Capitation Capitation/Shared Risk Budgets Effective January 1, 1998 through August 31,1998 1999 Sex Age Prof Factor Inst Factor Child 0 2.008 5.228 1 1.075 0.644 2 – 4 0.598 0.406 5 – 9 0.439 0.296 10 – 14 0.418 0.338 15 – 19 0.590 0.607 Female 0 1.774 3.843 1 0.664 0.463 2 - 4 0.493 0.370 5 - 9 0.436 0.382 10 - 14 0.399 0.390 15 - 19 0.421 0.418 20 - – 24 0.902 0.999 1.195 1.066 25 - – 29 1.525 1.664 1.653 1.431 30 - – 34 1.543 1.478 1.509 1.315 35 - – 39 1.547 1.281 1.378 1.143 40 - – 44 1.567 1.272 1.322 1.031 45 - – 49 1.630 1.293 1.386 1.102 50 - – 54 1.712 1.448 00 - 00 0.000 0.000 00 - 00 2.161 2.260 1.551 1.338 55 – 59 1.794 1.741 60 – 64 2.090 2.313 65 + 2.251 2.025 2.414 2.907 Medicare Eligible 1.000 1.000 Male 0 1.774 3.843 1 0.664 0.463 2 - 4 0.493 0.370 5 - 9 0.436 0.382 10 - 14 0.399 0.390 15 - 19 0.421 0.418 20 - – 24 0.432 0.447 0.398 0.477 25 - – 29 0.492 0.477 0.486 30 - – 34 0.569 0.536 0.546 0.506 35 - – 39 0.667 0.673 0.626 0.589 40 - – 44 0.780 0.800 0.734 0.768 45 - – 49 0.933 0.975 0.890 1.087 50 - – 54 1.251 1.415 00 - 00 0.000 0.000 00 - 00 2.177 2.928 1.139 1.580 55 – 59 1.516 2.203 60 – 64 2.009 2.880 65 + 2.276 2.658 2.561 3.586 Medicare Eligible 1.000 1.000