Common use of Financial Benchmarks Clause in Contracts

Financial Benchmarks. The success of the Rhode Island Medicaid managed care program is contingent on the financial stability of participating Health Plans. As part of its oversight activities, the State has established financial viability criteria, or benchmarks, to be used in measuring and tracking the fiscal status of Health Plans. The areas in which financial benchmarks have been established include the following: • Current ratio • Plan equity per enrollee • Administrative expenses as a percent of capitation • Net medical costs as a percent of capitation • ▇▇▇▇ and RBUC levels, including days claims outstanding Contractor agrees to provide the information necessary for calculating benchmark levels (see the following section). Contractor also agrees to comply with corrective actions ordered by the State to address any identified deficiencies with respect to financial benchmarks.

Financial Benchmarks. The success of the Rhode Island Medicaid managed care program is contingent on the financial stability of participating Health PlansDental Plan(s). As part of its oversight activities, the State has established financial viability criteria, or benchmarks, to be used in measuring and tracking the fiscal status of Health PlansDental Plan(s). The areas in which financial benchmarks have been established include the following: • Current ratio • Plan equity per enrollee • Administrative expenses as a percent of capitation • Net medical costs as a percent of capitation • ▇▇▇▇ IBNR and RBUC levels, including days claims outstanding Contractor agrees to provide the information necessary for calculating benchmark levels (see the following section). Contractor also agrees to comply with corrective actions ordered by the State to address any identified deficiencies with respect to financial benchmarks.