Common use of E of the Contract Clause in Contracts

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 – December 31, 2021 RC I Adult Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $472.01 Greater Boston $474.83 Southern $523.12 Central $452.00 Western $433.59 RC I Child Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $206.64 Greater Boston $204.19 Southern $205.52 Central $194.65 Western $197.41 XX XX Adult Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,738.30 Greater Boston $1,866.79 Southern $1,885.45 Central $1,690.87 Western $1,547.68 XX XX Child Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $922.70 Greater Boston $943.37 Southern $903.64 Central $897.01 Western $661.42 RC IX Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $615.19 Greater Boston $583.80 Southern $673.57 Central $599.18 Western $561.00 RC X Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,722.52 Greater Boston $1,634.04 Southern $1,815.20 Central $1,763.25 Western $1,528.56 Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 – December 31, 2021 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 $10.71 $26.31 $24.68 $12.74 $23.34 Greater Boston $10.55 $10.42 $26.10 $27.59 $12.31 $22.48 Southern $11.48 $10.41 $25.73 $24.39 $13.11 $24.04 Central $10.77 $10.44 $24.96 $25.02 $13.00 $25.09 Western $10.28 $10.32 $21.99 $19.08 $12.18 $20.83 EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in

Appears in 1 contract

Samples: www.mass.gov

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E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 2023 December March 31, 2021 2023 RC I Adult Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $472.01 450.95 Greater Boston $474.83 473.01 Southern $523.12 510.46 Central $452.00 428.16 Western $433.59 424.14 RC I Child Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $206.64 201.08 Greater Boston $204.19 208.78 Southern $205.52 203.57 Central $194.65 195.89 Western $197.41 200.05 Xxxxxxx Medicaid Care Network, Inc. XX XX Adult Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $1,738.30 1,740.88 Greater Boston $1,866.79 1,874.08 Southern $1,885.45 1,916.89 Central $1,690.87 1,708.52 Western $1,547.68 1,528.45 XX XX Child Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $922.70 939.45 Greater Boston $943.37 945.58 Southern $903.64 876.30 Central $897.01 920.12 Western $661.42 689.77 RC IX Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $615.19 563.31 Greater Boston $583.80 546.22 Southern $673.57 645.49 Central $599.18 558.83 Western $561.00 532.16 Xxxxxxx Medicaid Care Network, Inc. RC X Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $1,722.52 1,787.00 Greater Boston $1,634.04 1,735.12 Southern $1,815.20 1,819.90 Central $1,763.25 1,744.64 Western $1,528.56 1,610.51 Xxxxxxx Medicaid Care Network, Inc. Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 2023 December March 31, 2021 2023 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 11.75 $10.71 10.53 $26.31 29.54 $24.68 26.73 $12.74 12.17 $23.34 25.31 Greater Boston $10.55 11.45 $10.42 10.09 $26.10 29.15 $27.59 28.80 $12.31 11.79 $22.48 24.40 Southern $11.48 12.57 $10.41 10.45 $25.73 29.45 $24.39 25.20 $13.11 12.98 $24.04 24.87 Central $10.77 11.45 $10.44 10.62 $24.96 28.33 $25.02 27.21 $13.00 12.68 $25.09 25.99 Western $10.28 11.27 $10.32 10.57 $21.99 24.47 $19.08 21.21 $12.18 11.98 $20.83 22.84 Xxxxxxx Medicaid Care Network, Inc. EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 6 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E 4.3.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in$150,000 Xxxxxxx Medicaid Care Network, Inc. EXHIBIT 3

Appears in 1 contract

Samples: www.mass.gov

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 – December 31, 2021 RC I Adult Effective January 1, 2021 – December 31June 30, 2021 REGION TCOC BENCHMARK Northern $472.01 475.74 Greater Boston $474.83 478.58 Southern $523.12 527.25 Central $452.00 455.57 Western $433.59 437.01 RC I Child Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $202.15 Greater Boston $199.76 Southern $201.07 Central $190.42 Western $193.13 Community Care Cooperative XX XX Adult Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $1,652.73 Greater Boston $1,774.89 Southern $1,792.63 Central $1,607.64 Western $1,471.49 XX XX Child Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $849.86 Greater Boston $868.90 Southern $832.30 Central $826.19 Western $609.20 RC IX Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $585.27 Greater Boston $555.41 Southern $640.81 Central $570.04 Western $533.71 Community Care Cooperative RC X Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $1,637.73 Greater Boston $1,553.60 Southern $1,725.84 Central $1,676.45 Western $1,453.31 RC I Adult Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $206.64 481.04 Greater Boston $204.19 482.88 Southern $205.52 533.53 Central $194.65 460.68 Western $197.41 XX XX Adult 442.39 RC I Child Effective January July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,738.30 206.34 Greater Boston $1,866.79 202.83 Southern $1,885.45 205.01 Central $1,690.87 193.87 Western $1,547.68 197.16 XX XX Child Adult Effective January July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $922.70 1,677.99 Greater Boston $943.37 1,797.19 Southern $903.64 1,817.67 Central $897.01 1,629.67 Western $661.42 RC IX 1,492.90 Community Care Cooperative XX XX Child Effective January July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $615.19 865.08 Greater Boston $583.80 881.47 Southern $673.57 846.54 Central $599.18 839.84 Western $561.00 620.81 RC X IX Effective January July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,722.52 593.34 Greater Boston $1,634.04 563.01 Southern $1,815.20 650.22 Central $1,763.25 577.93 Western $1,528.56 542.78 RC X Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,666.43 Greater Boston $1,581.83 Southern $1,759.08 Central $1,704.41 Western $1,481.54 Community Care Cooperative Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 – December 31, 2021 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 $10.71 $26.31 $24.68 $12.74 $23.34 Greater Boston $10.55 $10.42 $26.10 $27.59 $12.31 $22.48 Southern $11.48 $10.41 $25.73 $24.39 $13.11 $24.04 Central $10.77 $10.44 $24.96 $25.02 $13.00 $25.09 Western $10.28 $10.32 $21.99 $19.08 $12.18 $20.83 EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in25.09

Appears in 1 contract

Samples: www.mass.gov

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 – December 31, 2021 RC I Adult Effective January 1, 2021 – December 31June 30, 2021 REGION TCOC BENCHMARK Northern $472.01 Greater Boston $474.83 Southern $523.12 Central $452.00 Western $433.59 RC I Child Effective January 1, 2021 – December 31June 30, 2021 REGION TCOC BENCHMARK Northern $206.64 Greater Boston $204.19 Southern $205.52 Central $194.65 Western $197.41 Mass General Xxxxxxx ACO, LLC XX XX Adult Effective January 1, 2021 – December 31June 30, 2021 REGION TCOC BENCHMARK Northern $1,738.30 Greater Boston $1,866.79 Southern $1,885.45 Central $1,690.87 Western $1,547.68 XX XX Child Effective January 1, 2021 – December 31June 30, 2021 REGION TCOC BENCHMARK Northern $922.70 Greater Boston $943.37 Southern $903.64 Central $897.01 Western $661.42 RC IX Effective January 1, 2021 – December 31June 30, 2021 REGION TCOC BENCHMARK Northern $615.19 Greater Boston $583.80 Southern $673.57 Central $599.18 Western $561.00 Mass General Xxxxxxx ACO, LLC RC X Effective January 1, 2021 – December 31June 30, 2021 REGION TCOC BENCHMARK Northern $1,722.52 Greater Boston $1,634.04 Southern $1,815.20 Central $1,763.25 Western $1,528.56 RC I Adult Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $477.27 Greater Boston $479.10 Southern $529.35 Central $457.07 Western $438.93 RC I Child Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $210.92 Greater Boston $207.33 Southern $209.55 Central $198.18 Western $201.53 XX XX Adult Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,764.86 Greater Boston $1,890.24 Southern $1,911.79 Central $1,714.04 Western $1,570.20 Mass General Xxxxxxx ACO, LLC XX XX Child Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $939.22 Greater Boston $957.02 Southern $919.10 Central $911.83 Western $674.03 RC IX Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $623.68 Greater Boston $591.79 Southern $683.46 Central $607.48 Western $570.54 RC X Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,752.70 Greater Boston $1,663.74 Southern $1,850.17 Central $1,792.65 Western $1,558.25 Mass General Xxxxxxx ACO, LLC Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 – December 31, 2021 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 $10.71 $26.31 $24.68 $12.74 $23.34 Greater Boston $10.55 $10.42 $26.10 $27.59 $12.31 $22.48 Southern $11.48 $10.41 $25.73 $24.39 $13.11 $24.04 Central $10.77 $10.44 $24.96 $25.02 $13.00 $25.09 Western $10.28 $10.32 $21.99 $19.08 $12.18 $20.83 EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in25.09

Appears in 1 contract

Samples: www.mass.gov

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 – December 31, 2021 RC I Adult Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $472.01 453.86 Greater Boston $474.83 456.57 Southern $523.12 503.00 Central $452.00 434.62 Western $433.59 416.91 RC I Child Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $206.64 202.36 Greater Boston $204.19 199.96 Southern $205.52 201.27 Central $194.65 190.62 Western $197.41 193.32 XX XX Adult Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,738.30 1,652.73 Greater Boston $1,866.79 1,774.89 Southern $1,885.45 1,792.63 Central $1,690.87 1,607.64 Western $1,547.68 1,471.49 XX XX Child Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $922.70 874.14 Greater Boston $943.37 893.72 Southern $903.64 856.08 Central $897.01 849.80 Western $661.42 626.61 RC IX Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $615.19 587.06 Greater Boston $583.80 557.11 Southern $673.57 642.78 Central $599.18 571.79 Western $561.00 535.35 RC X Effective January 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,722.52 1,637.73 Greater Boston $1,634.04 1,553.60 Southern $1,815.20 1,725.84 Central $1,763.25 1,676.45 Western $1,528.56 1,453.31 Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 – December 31, 2021 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 $10.71 $26.31 $24.68 $12.74 $23.34 Greater Boston $10.55 $10.42 $26.10 $27.59 $12.31 $22.48 Southern $11.48 $10.41 $25.73 $24.39 $13.11 $24.04 Central $10.77 $10.44 $24.96 $25.02 $13.00 $25.09 Western $10.28 $10.32 $21.99 $19.08 $12.18 $20.83 EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in

Appears in 1 contract

Samples: www.mass.gov

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 2023 December March 31, 2021 2023 RC I Adult Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $472.01 489.22 Greater Boston $474.83 492.02 Southern $523.12 566.49 Central $452.00 464.15 Western $433.59 459.04 RC I Child Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $206.64 219.55 Greater Boston $204.19 200.24 Southern $205.52 215.91 Central $194.65 207.55 Western $197.41 211.53 Community Care Cooperative XX XX Adult Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $1,738.30 1,807.31 Greater Boston $1,866.79 1,898.03 Southern $1,885.45 1,980.38 Central $1,690.87 1,757.12 Western $1,547.68 1,573.73 XX XX Child Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $922.70 979.60 Greater Boston $943.37 929.53 Southern $903.64 885.06 Central $897.01 926.70 Western $661.42 701.70 RC IX Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $615.19 582.86 Greater Boston $583.80 549.24 Southern $673.57 668.45 Central $599.18 573.18 Western $561.00 540.88 Community Care Cooperative RC X Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $1,722.52 1,878.64 Greater Boston $1,634.04 1,757.37 Southern $1,815.20 1,897.66 Central $1,763.25 1,846.98 Western $1,528.56 1,672.77 Community Care Cooperative Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 2023 December March 31, 2021 2023 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 11.75 $10.71 10.53 $26.31 29.54 $24.68 26.73 $12.74 12.17 $23.34 25.31 Greater Boston $10.55 11.45 $10.42 10.09 $26.10 29.15 $27.59 28.80 $12.31 11.79 $22.48 24.40 Southern $11.48 12.57 $10.41 10.45 $25.73 29.45 $24.39 25.20 $13.11 12.98 $24.04 24.87 Central $10.77 11.45 $10.44 10.62 $24.96 28.33 $25.02 27.21 $13.00 12.68 $25.09 25.99 Western $10.28 11.27 $10.32 10.57 $21.99 24.47 $19.08 21.21 $12.18 11.98 $20.83 22.84 Community Care Cooperative EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 6 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E 4.3.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in$150,000 Community Care Cooperative EXHIBIT 3

Appears in 1 contract

Samples: www.mass.gov

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 2022 – December 31, 2021 2022 RC I Adult Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $472.01 517.29 Greater Boston $474.83 522.70 Southern $523.12 569.66 Central $452.00 475.28 Western $433.59 461.05 RC I Child Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $206.64 225.32 Greater Boston $204.19 210.23 Southern $205.52 213.92 Central $194.65 207.77 Western $197.41 206.58 Community Care Cooperative XX XX Adult Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $1,738.30 1,864.77 Greater Boston $1,866.79 1,972.48 Southern $1,885.45 2,026.28 Central $1,690.87 1,804.62 Western $1,547.68 1,582.58 XX XX Child Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $922.70 948.11 Greater Boston $943.37 935.87 Southern $903.64 850.70 Central $897.01 893.44 Western $661.42 652.63 RC IX Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $615.19 599.10 Greater Boston $583.80 572.28 Southern $673.57 658.29 Central $599.18 591.24 Western $561.00 531.53 RC X Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $1,722.52 1,903.40 Greater Boston $1,634.04 1,813.99 Southern $1,815.20 1,915.54 Central $1,763.25 1,864.48 Western $1,528.56 Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments 1,615.14 Community Care Cooperative RC I Adult Effective January July 1, 2021 2022 – December 31, 2021 2022 REGION RC I Adult TCOC BENCHMARK Northern $511.41 Greater Boston $517.99 Southern $562.82 Central $469.97 Western $455.28 RC I Child Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $220.92 Greater Boston $207.15 Southern $209.89 Central $204.12 Western $202.46 XX XX Adult Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $1,836.17 Greater Boston $1,948.21 Southern $1,999.30 Central $1,780.15 Western $1,560.40 XX XX Child RC IX RC X Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $10.96 $10.71 $26.31 $24.68 $12.74 $23.34 931.75 Greater Boston $10.55 $10.42 $26.10 $27.59 $12.31 $22.48 922.74 Southern $11.48 $10.41 $25.73 $24.39 $13.11 $24.04 836.31 Central $10.77 $10.44 $24.96 $25.02 $13.00 $25.09 879.50 Western $10.28 640.71 Community Care Cooperative RC IX Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $10.32 590.50 Greater Boston $21.99 563.65 Southern $19.08 648.07 Central $12.18 582.29 Western $20.83 EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E for the Contract Year. 521.97 RC X Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $150,000 Admission Level Stop-Loss Attachment Point MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in1,872.78 Greater Boston $1,781.88 Southern $1,877.93 Central $1,832.34

Appears in 1 contract

Samples: www.mass.gov

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 2023 December March 31, 2021 2023 RC I Adult Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $472.01 460.42 Greater Boston $474.83 467.62 Southern $523.12 581.46 Central $452.00 437.79 Western $433.59 433.23 RC I Child Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $206.64 203.38 Greater Boston $204.19 196.92 Southern $205.52 219.48 Central $194.65 198.82 Western $197.41 201.50 Mass General Xxxxxxx ACO, LLC XX XX Adult Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $1,738.30 1,818.04 Greater Boston $1,866.79 1,934.00 Southern $1,885.45 2,034.04 Central $1,690.87 1,785.34 Western $1,547.68 1,594.45 XX XX Child Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $922.70 997.72 Greater Boston $943.37 981.02 Southern $903.64 938.59 Central $897.01 974.87 Western $661.42 732.35 RC IX Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $615.19 579.36 Greater Boston $583.80 551.92 Southern $673.57 731.56 Central $599.18 575.57 Western $561.00 545.84 Mass General Xxxxxxx ACO, LLC RC X Effective January 1, 2021 2023 December March 31, 2021 2023 REGION TCOC BENCHMARK Northern $1,722.52 1,864.46 Greater Boston $1,634.04 1,778.09 Southern $1,815.20 1,939.65 Central $1,763.25 1,821.06 Western $1,528.56 1,676.95 Mass General Xxxxxxx ACO, LLC Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 2023 December March 31, 2021 2023 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 11.75 $10.71 10.53 $26.31 29.54 $24.68 26.73 $12.74 12.17 $23.34 25.31 Greater Boston $10.55 11.45 $10.42 10.09 $26.10 29.15 $27.59 28.80 $12.31 11.79 $22.48 24.40 Southern $11.48 12.57 $10.41 10.45 $25.73 29.45 $24.39 25.20 $13.11 12.98 $24.04 24.87 Central $10.77 11.45 $10.44 10.62 $24.96 28.33 $25.02 27.21 $13.00 12.68 $25.09 25.99 Western $10.28 11.27 $10.32 10.57 $21.99 24.47 $19.08 21.21 $12.18 11.98 $20.83 22.84 Mass General Xxxxxxx ACO, LLC EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 6 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E 4.3.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point $150,000 Mass General Xxxxxxx ACO, LLC EXHIBIT 3 MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 6 The table below indicates the Contractor’s selected minimum savings and losses threshold as described inin Section

Appears in 1 contract

Samples: www.mass.gov

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E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 2022 – December 31, 2021 2022 RC I Adult Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $472.01 525.36 Greater Boston $474.83 530.85 Southern $523.12 578.53 Central $452.00 482.70 Western $433.59 468.24 RC I Child Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $206.64 228.92 Greater Boston $204.19 213.59 Southern $205.52 217.34 Central $194.65 211.10 Western $197.41 209.88 XX XX Adult Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $1,738.30 1,893.63 Greater Boston $1,866.79 2,002.98 Southern $1,885.45 2,057.60 Central $1,690.87 1,832.55 Western $1,547.68 1,607.06 XX XX Child Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $922.70 962.94 Greater Boston $943.37 950.56 Southern $903.64 864.02 Central $897.01 907.45 Western $661.42 662.87 RC IX Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $615.19 608.41 Greater Boston $583.80 581.18 Southern $673.57 668.51 Central $599.18 600.44 Western $561.00 539.80 RC X Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $1,722.52 1,932.78 Greater Boston $1,634.04 1,842.00 Southern $1,815.20 1,945.09 Central $1,763.25 1,893.27 Western $1,528.56 1,640.07 RC I Adult Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $519.39 Greater Boston $526.07 Southern $571.59 Central $477.31 Western $462.39 RC I Child Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $224.45 Greater Boston $210.47 Southern $213.24 Central $207.39 Western $205.70 XX XX Adult Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $1,864.60 Greater Boston $1,978.34 Southern $2,030.21 Central $1,807.70 Western $1,584.54 XX XX Child Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $946.33 Greater Boston $937.23 Southern $849.41 Central $893.29 Western $650.77 RC IX Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $599.68 Greater Boston $572.42 Southern $658.14 Central $591.36 Western $530.10 RC X Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $1,901.69 Greater Boston $1,809.40 Southern $1,906.91 Central $1,860.64 Western $1,606.18 Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 2022 – December 31, 2021 2022 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 12.54 $10.71 10.80 $26.31 30.62 $24.68 25.81 $12.74 12.59 $23.34 25.70 Greater Boston $10.55 $10.42 $26.10 $27.59 $12.31 $22.48 10.63 $30.52 $29.07 $12.36 $25.23 Southern $11.48 12.82 $10.41 10.33 $25.73 30.36 $24.39 24.18 $13.11 12.90 $24.04 25.17 Central $10.77 11.82 $10.44 10.62 $24.96 29.25 $25.02 26.23 $13.00 13.14 $25.09 26.30 Western $11.41 $10.28 $10.32 24.77 $21.99 19.66 $19.08 11.86 $12.18 $20.83 22.13 EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 5 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point $150,000 EXHIBIT 3 MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 5 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in

Appears in 1 contract

Samples: www.mass.gov

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 2022 – December 31, 2021 2022 RC I Adult Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $472.01 495.79 Greater Boston $474.83 505.66 Southern $523.12 575.83 Central $452.00 455.53 Western $433.59 442.25 RC I Child Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $206.64 212.51 Greater Boston $204.19 210.42 Southern $205.52 216.53 Central $194.65 202.10 Western $197.41 199.64 XX XX Adult Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $1,738.30 1,907.38 Greater Boston $1,866.79 2,043.03 Southern $1,885.45 2,107.73 Central $1,690.87 1,862.19 Western $1,547.68 1,629.00 XX XX Child Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $922.70 979.77 Greater Boston $943.37 1,003.69 Southern $903.64 913.05 Central $897.01 954.40 Western $661.42 691.09 RC IX Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $615.19 605.77 Greater Boston $583.80 585.00 Southern $673.57 711.09 Central $599.18 603.18 Western $561.00 544.73 RC X Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $1,722.52 1,920.41 Greater Boston $1,634.04 1,865.72 Southern $1,815.20 1,972.95 Central $1,763.25 1,869.81 Western $1,528.56 1,642.52 RC I Adult Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $490.15 Greater Boston $501.10 Southern $568.92 Central $450.44 Western $436.73 RC I Child Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $208.36 Greater Boston $207.35 Southern $212.45 Central $198.55 Western $195.67 XX XX Adult Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $1,878.13 Greater Boston $2,017.90 Southern $2,079.68 Central $1,836.94 Western $1,606.17 XX XX Child Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $962.87 Greater Boston $989.62 Southern $897.61 Central $939.51 Western $678.48 RC IX Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $597.07 Greater Boston $576.18 Southern $700.07 Central $594.05 Western $534.95 RC X Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $1,889.52 Greater Boston $1,832.69 Southern $1,934.22 Central $1,837.58 Western $1,608.57 Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 2022 – December 31, 2021 2022 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 12.54 $10.71 10.80 $26.31 30.62 $24.68 25.81 $12.74 12.59 $23.34 25.70 Greater Boston $10.55 $10.42 $26.10 $27.59 $12.31 $22.48 10.63 $30.52 $29.07 $12.36 $25.23 Southern $11.48 12.82 $10.41 10.33 $25.73 30.36 $24.39 24.18 $13.11 12.90 $24.04 25.17 Central $10.77 11.82 $10.44 10.62 $24.96 29.25 $25.02 26.23 $13.00 13.14 $25.09 26.30 Western $11.41 $10.28 $10.32 24.77 $21.99 19.66 $19.08 11.86 $12.18 $20.83 22.13 EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 5 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point $150,000 MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 5 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in

Appears in 1 contract

Samples: www.mass.gov

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 2022 – December 31, 2021 2022 RC I Adult Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $472.01 488.17 Greater Boston $474.83 497.89 Southern $523.12 567.00 Central $452.00 448.52 Western $433.59 435.45 RC I Child Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $206.64 209.16 Greater Boston $204.19 207.10 Southern $205.52 213.13 Central $194.65 198.91 Western $197.41 196.49 XX XX Adult Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $1,738.30 1,878.31 Greater Boston $1,866.79 2,011.93 Southern $1,885.45 2,075.66 Central $1,690.87 1,833.82 Western $1,547.68 1,604.19 XX XX Child Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $922.70 964.69 Greater Boston $943.37 988.20 Southern $903.64 898.99 Central $897.01 939.69 Western $661.42 680.43 RC IX Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $615.19 596.49 Greater Boston $583.80 576.04 Southern $673.57 700.23 Central $599.18 593.94 Western $561.00 536.38 RC X Effective January 1, 2021 2022 December 31June 30, 2021 2022 REGION TCOC BENCHMARK Northern $1,722.52 1,891.22 Greater Boston $1,634.04 1,837.36 Southern $1,815.20 1,942.98 Central $1,763.25 1,841.37 Western $1,528.56 Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments 1,617.55 RC I Adult Effective January July 1, 2021 2022 – December 31, 2021 2022 REGION RC I Adult TCOC BENCHMARK Northern $482.61 Greater Boston $493.40 Southern $560.19 Central $443.51 Western $430.01 RC I Child Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $205.07 Greater Boston $204.08 Southern $209.11 Central $195.41 Western $192.58 XX XX Adult Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $1,849.50 Greater Boston $1,987.17 Southern $2,048.03 Central $1,808.95 Western $1,581.71 XX XX Child RC IX RC X Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $10.96 $10.71 $26.31 $24.68 $12.74 $23.34 948.04 Greater Boston $10.55 $10.42 $26.10 $27.59 $12.31 $22.48 974.34 Southern $11.48 $10.41 $25.73 $24.39 $13.11 $24.04 883.78 Central $10.77 $10.44 $24.96 $25.02 $13.00 $25.09 925.02 Western $10.28 668.01 RC IX Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $10.32 587.93 Greater Boston $21.99 567.35 Southern $19.08 689.38 Central $12.18 584.94 Western $20.83 EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E for the Contract Year. 526.75 RC X Effective July 1, 2022 – December 31, 2022 REGION TCOC BENCHMARK Northern $150,000 Admission Level Stop-Loss Attachment Point MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in1,860.79 Greater Boston $1,804.82 Southern $1,904.83 Central $1,809.62

Appears in 1 contract

Samples: www.mass.gov

E of the Contract. Exhibit 1.1: ACO TCOC Benchmarks (per member per month) Effective January 1, 2021 – December 31, 2021 RC I Adult Effective January 1, 2021 – December 31June 30, 2021 REGION TCOC BENCHMARK Northern $472.01 453.86 Greater Boston $474.83 456.57 Southern $523.12 503.00 Central $452.00 434.62 Western $433.59 416.91 RC I Child Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $202.36 Greater Boston $199.96 Southern $201.27 Central $190.62 Western $193.32 Xxxxxxx Medicaid Care Network, Inc. XX XX Adult Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $1,652.73 Greater Boston $1,774.89 Southern $1,792.63 Central $1,607.64 Western $1,471.49 XX XX Child Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $874.14 Greater Boston $893.72 Southern $856.08 Central $849.80 Western $626.61 RC IX Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $587.06 Greater Boston $557.11 Southern $642.78 Central $571.79 Western $535.35 Xxxxxxx Medicaid Care Network, Inc. RC X Effective January 1, 2021 – June 30, 2021 REGION TCOC BENCHMARK Northern $1,637.73 Greater Boston $1,553.60 Southern $1,725.84 Central $1,676.45 Western $1,453.31 RC I Adult Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $206.64 458.92 Greater Boston $204.19 460.67 Southern $205.52 508.99 Central $194.65 439.49 Western $197.41 XX XX Adult 422.04 RC I Child Effective January July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,738.30 206.55 Greater Boston $1,866.79 203.03 Southern $1,885.45 205.22 Central $1,690.87 194.08 Western $1,547.68 197.35 XX XX Child Adult Effective January July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $922.70 1,677.99 Greater Boston $943.37 1,797.19 Southern $903.64 1,817.67 Central $897.01 1,629.67 Western $661.42 RC IX 1,492.90 Xxxxxxx Medicaid Care Network, Inc. XX XX Child Effective January July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $615.19 889.79 Greater Boston $583.80 906.65 Southern $673.57 870.73 Central $599.18 863.84 Western $561.00 638.56 RC X IX Effective January July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,722.52 595.16 Greater Boston $1,634.04 564.74 Southern $1,815.20 652.22 Central $1,763.25 579.71 Western $1,528.56 544.45 RC X Effective July 1, 2021 – December 31, 2021 REGION TCOC BENCHMARK Northern $1,666.43 Greater Boston $1,581.83 Southern $1,759.08 Central $1,704.41 Western $1,481.54 Xxxxxxx Medicaid Care Network, Inc. Exhibit 1.2: ACO Administrative Payments (per member per month) ACO Administrative Payments Effective January 1, 2021 – December 31, 2021 REGION RC I Adult RC I Child XX XX Adult XX XX Child RC IX RC X Northern $10.96 $10.71 $26.31 $24.68 $12.74 $23.34 Greater Boston $10.55 $10.42 $26.10 $27.59 $12.31 $22.48 Southern $11.48 $10.41 $25.73 $24.39 $13.11 $24.04 Central $10.77 $10.44 $24.96 $25.02 $13.00 $25.09 Western $10.28 $10.32 $21.99 $19.08 $12.18 $20.83 EXHIBIT 2 STOP-LOSS ATTACHMENT POINT Contract Year 4 The table below indicates the admission-level stop-loss attachment point as described in Section 4.5.E for the Contract Year. $150,000 Admission Level Stop-Loss Attachment Point MINIMUM SAVINGS AND LOSSES THRESHOLD SELECTION Contract Year 4 The table below indicates the Contractor’s selected minimum savings and losses threshold as described in25.09

Appears in 1 contract

Samples: www.mass.gov

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