Common use of CHIP Expense Clause in Contracts

CHIP Expense. CHIP Expense shall be equal to the sum of the following: (i) Inpatient costs for Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers, valued at the actual costs incurred by PacifiCare; plus, (ii) Other Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers other than inpatient services, valued at actual costs incurred by PacifiCare; plus, (iii) The actual amount paid for Hospital Services which are rendered by non-Participating Providers; minus, (iv) Amounts paid by PacifiCare under the Reinsurance Program, if any; minus (v) Any and all amounts received from third parties for Hospital Services provided to Commercial Plan Members, excluding Commercial POS Plan Members, through coordination of benefits, work-related accidents or injuries, stop-loss and reinsurance payments and Member Copayments.

CHIP Expense. CHIP Expense shall be equal to the sum of the following: (i) Inpatient costs for Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers, valued at the actual costs incurred by PacifiCare; plus, (ii) Other Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers other than inpatient services, valued at actual costs incurred by PacifiCare; plus, (iii) The actual amount paid for Hospital Services which are rendered by non-non- Participating Providers; minus, (iv) Amounts paid by PacifiCare under the Reinsurance Program, if any; minus (v) Any and all amounts received from third parties for Hospital Services provided to Commercial Plan Members, excluding Commercial POS Plan Members, through coordination of benefits, work-related accidents or injuries, stop-loss and reinsurance payments and Member Copayments.

CHIP Expense. CHIP Expense shall be equal to the sum of the following: (i) Inpatient costs for Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers, valued at the actual costs incurred by PacifiCare; plusPlus, (ii) Other Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers other than inpatient services, valued at actual costs incurred by PacifiCare; plus,. (iii) The actual amount paid for Hospital Services which are rendered by non-Participating Providers; minus, (iv) Amounts paid by PacifiCare under the Reinsurance Program, if any; minus (v) Any and all amounts received from third parties for Hospital Services provided to Commercial Plan Members, excluding Commercial POS Plan Members, through coordination of benefits, work-related accidents or injuries, stop-loss and reinsurance payments and Member Copayments.

CHIP Expense. CHIP Expense shall be equal to the sum of the following: (i) Inpatient costs for Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers, valued at the actual costs incurred by PacifiCare; plus, (ii) Other Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers other than inpatient services, valued at actual costs incurred by PacifiCare; plus, (iii) The actual amount paid for Hospital Services which are rendered by non-Participating Providers; minus, (iv) Amounts paid by PacifiCare under the Reinsurance Program, if any; minus (v) Any and all amounts received from third parties panties for Hospital Services provided to Commercial Plan Members, excluding Commercial POS Plan Members, through coordination of benefits, work-related accidents or injuries, stop-loss and reinsurance payments and Member Copayments.

CHIP Expense. CHIP Expense shall be equal to the sum of the following: (i) Inpatient costs for Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers, valued at the actual costs incurred by PacifiCare; plus, (ii) Other Hospital Services rendered to Commercial Plan Members, excluding Commercial POS Plan Members, by Participating Providers other than inpatient services, valued at actual costs incurred by PacifiCare; plus, (iii) The actual amount paid for Hospital Services which are rendered by non-Participating Providers; minus, (iv) Amounts paid by PacifiCare under the Reinsurance Program, if any; minus, (v) Any and all amounts received from third parties for Hospital Services provided to Commercial Plan Members, excluding Commercial POS Plan Members, through coordination of benefits, work-related accidents or injuries, stop-loss and reinsurance payments and Member Copayments.