Common use of Capitation Rates Clause in Contracts

Capitation Rates. PPG Capitation for Small Group HMO Members shall be determined on a monthly basis by multiplying the following normalized PMPM rates by the age, sex and benefit plan factors set forth in Addendum B for each assigned Member. Normalized PMPM rates represent the PMPM prior to the adjustment for PPG’s assigned Members’ age, sex and benefit plan. Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. Period Small Group HMO January 1, 1998 to June 30, 1998 $ *** PMPM July 1, 1998 to August 31, 1998 $ *** PMPM September 1, 1998 $ PMPM (See Section A8 above)

Capitation Rates. PPG Capitation for Small Group Standard HMO Members shall be determined on a monthly basis by multiplying the following normalized PMPM rates by the age, sex and benefit plan factors set forth in Addendum B for each assigned Member. Normalized PMPM rates represent the PMPM prior to the adjustment for PPG’s assigned Members’ age, sex and benefit plan. Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. Period Small Group Standard HMO January 1, 1998 to June 30, 1998 $ *** PMPM July 1, 1998 to August 31, 1998 $ *** PMPM September 1, 1998 $ PMPM (See Section section A8 above)

Capitation Rates. PPG Capitation for Small Group Individual HMO Members shall be determined on a monthly basis by multiplying the following normalized PMPM rates by the age, sex and benefit plan factors set forth in Addendum B for each assigned Member. Normalized PMPM rates represent the PMPM prior to the adjustment for PPG’s assigned Members’ age, sex and benefit plan. Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. Period Small Group Individual HMO January 1, 1998 to June 30, 1998 $ *** PMPM July 1, 1998 to August 31, 1998 $ *** PMPM September 1, 1998 $ PMPM (See Section A8 above)

Capitation Rates. PPG Capitation for Small Group Individual HMO Members shall be determined on a monthly basis by multiplying the following normalized PMPM rates by the age, sex and benefit plan factors set forth in Addendum B for each assigned Member. Normalized PMPM rates represent the PMPM prior to the adjustment for PPG’s assigned Members’ age, sex and benefit plan. Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. Period Small Group Individual HMO January Capitation October 1, 1998 to June 302001, 1998 $ through December 31, 2001, *** PMPM July January 1, 1998 to August 2002, through December 31, 1998 $ 2002, *** PMPM September January 1, 1998 $ PMPM (See Section A8 above)2003, $*** PMPM

Capitation Rates. PPG Capitation for Small Group Standard HMO Members shall be determined on a monthly basis by multiplying the following normalized PMPM rates by the age, sex and benefit plan factors set forth in Addendum B for each assigned Member. , Normalized PMPM rates represent the PMPM prior to the adjustment for PPG’s assigned Members’ age, . sex and benefit plan. Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. Period Small Group Standard HMO January Capitation April 1, 1998 to June 30, 1998 $ 2003 *** PMPM July through December 31, 2003 January 1, 1998 to August 31, 1998 $ 2004 *** PMPM September 1, 1998 $ PMPM (See Section A8 above)PMPM

Capitation Rates. PPG Capitation for Small Group individual HMO Members shall be determined on a monthly basis by multiplying the following normalized PMPM rates by the age, sex and benefit plan factors set forth in Addendum B for each assigned Member. Normalized PMPM rates represent the PMPM prior to the adjustment for PPG’s assigned Members’ age, sex and benefit plan. Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuatesfluctuate. Period Small Group Individual HMO January 1, 1998 to June 30, 1998 $ $*** PMPM July 1, 1998 to August 31, 1998 $ $*** PMPM September 1, 1998 $ PMPM (See Section A8 aboveabove )

Capitation Rates. PPG Capitation for Small Group Standard HMO Members shall be determined on a monthly basis by multiplying the following normalized PMPM rates by the age, sex and benefit plan factors set forth in Addendum B for each assigned Member. Normalized PMPM rates represent the PMPM prior to the adjustment for PPG’s assigned Members’ age, sex and benefit plan. Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. Period Small Group Standard HMO Capitation October 1, 2001 Through December 31, 2001 $44.61 PMPM January 1, 1998 to June 302002 Through December 31, 1998 $ 2002 $47.29 PMPM January 1, 2003 *** PMPM July 1, 1998 to August 31, 1998 $ *** PMPM September 1, 1998 $ PMPM (See Section A8 above)PMPM

Capitation Rates. PPG Capitation for Small Group HMO Members shall be determined on a monthly basis by multiplying the following normalized PMPM rates by the age, sex and benefit plan factors set forth in Addendum B for each assigned Member. Normalized PMPM rates represent the PMPM prior to the adjustment for PPG’s assigned Members’ age, sex and benefit plan. Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. Period Small Group HMO January 1, 1998 to June 30, 1998 $ $*** PMPM July 1, 1998 to August 31, 1998 $ $*** PMPM September 1, 1998 $ $PMPM (See Section A8 aboveabove )

Capitation Rates. PPG Capitation for Small Group Standard HMO Members shall be determined on a monthly basis by multiplying the following normalized PMPM rates by the age, sex and benefit plan factors set forth in Addendum B for each assigned Member. Normalized PMPM rates represent the PMPM prior to the adjustment for PPG’s assigned Members’ age, sex and benefit plan. Actual PPG gross Capitation shall fluctuate from month to month to the extent that PPG’s age, sex and benefit plan mix fluctuates. Period Small Group Standard HMO January 1, 1998 to June 30, 1998 $ $*** PMPM July 1, 1998 to August 31, 1998 $ $*** PMPM September 1, 1998 $ PMPM (See Section section A8 aboveabove )