Common use of Incentive Program Withhold Clause in Contracts

Incentive Program Withhold. PacifiCare shall establish a single withhold from Medical Group’s monthly Capitation Payment for purposes of offsetting potential deficits for the combined incentive programs. The monthly incentive withhold shall initially be *** per Member per month for the PacifiCare Commercial Health Plan and *** per Member per month for the Secure Horizons Health Plan. The Incentive Program Withhold shall not exceed *** per Member per month for the PacifiCare Commercial Health Plan and *** per Member per month for the Secure Horizons Health Plan. Should the Incentive Program Withhold exceed the Incentive Program Deficits, PacifiCare shall prospectively adjust the withhold on a quarterly basis, based on Medical Group’s experience under the combined incentive programs at the time of the program settlements described below. Medical Group’s Incentive Program Withhold limits, as referenced above, are based upon a calendar year. To the extent that Incentive Program Withhold amounts are decreased through the quarterly settlement process, these amounts may be subsequently increased above the stated withhold limits, provided that the average per member per month Incentive Program Withhold for the calendar year does not exceed the stated withhold limits.

Incentive Program Withhold. PacifiCare shall establish a single withhold from Medical Group’s monthly Capitation Payment for purposes of offsetting potential deficits for the combined incentive programs. The monthly incentive withhold shall initially be *** per Member per month for the PacifiCare Commercial Health Plan and *** Twenty Five Dollars ($25.00) per Member per month for the Secure Horizons Health Plan. The Incentive Program Withhold shall not exceed *** per Member per month for the PacifiCare Commercial Health Plan and *** per Member per month for the Secure Horizons Health Plan. Should the Incentive Program Withhold exceed the Incentive Program Deficits, PacifiCare shall prospectively adjust the withhold on a quarterly basis, based on Medical Group’s experience under the combined incentive programs at the time of the program settlements described below. Medical Group’s Incentive Program Withhold limits, as referenced above, are based upon a calendar year. To the extent that Incentive Program Withhold amounts are decreased through the quarterly settlement process, these amounts may be subsequently increased above the stated withhold limits, provided that the average per member per month Incentive Program Withhold for the calendar year does not exceed the stated withhold limits.