Medical Loss Ratios Sample Clauses

Medical Loss Ratios. At the end of each Contract Year, the Contractor shall provide to EOHHS an audited statement of its medical loss ratio for the past year. Beginning after the fourth full year of operation as a SCO, the Contractor shall conform on an annual basis to any minimum medical loss ratio as established by EOHHS. Beginning after the fourth full year of operation as a SCO, if the Contractor’s audited medical loss ratio is below a minimum level as established by EOHHS, the Contractor shall provide additional benefits or services to its Enrollees in the following Contract Year in an amount that would raise its medical loss ratio to the minimum level established by EOHHS, and shall submit a plan to EOHHS detailing how such benefits or services shall be provided to its Enrollees.
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Medical Loss Ratios. The Contractor shall submit a quarterly plan specific medical loss ratio to EOHHS in accordance with Appendix D. Beginning after the first full year of operation as a SCO, the Contractor must conform on an annual basis to a minimum medical loss ratio of 80 percent as established by EOHHS. After the first full year of operation as a SCO, if the Contractor’s annual reported SCO medical loss ratio is below the minimum level of 80 percent as established by EOHHS, the Contractor shall provide a corrective action plan in accordance with Section 5.5.

Related to Medical Loss Ratios

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  • Required Coverages For Generation Resources Of 20 Megawatts Or Less Each Constructing Entity shall maintain the types of insurance as described in section 11.1 paragraphs (a) through (e) above in an amount sufficient to insure against all reasonably foreseeable direct liabilities given the size and nature of the generating equipment being interconnected, the interconnection itself, and the characteristics of the system to which the interconnection is made. Additional insurance may be required by the Interconnection Customer, as a function of owning and operating a Generating Facility. All insurance shall be procured from insurance companies rated “A-,” VII or better by AM Best and authorized to do business in a state or states in which the Interconnection Facilities are located. Failure to maintain required insurance shall be a Breach of the Interconnection Construction Service Agreement.

  • Commercial General Liability and Business Auto Liability will be endorsed to provide primary and non-contributory coverage The Commercial General Liability Additional Insured endorsement will include on-going and completed operations and will be submitted with the

  • Product Coverage This Agreement shall apply to all manufactured products, - including capital goods, processed agricultural products, and those products failing outside the definition of agricultural products as set out in this Agreement. Agricultural products shall be excluded from the CEPT Scheme.

  • Loss of Shared-Loss Coverage on Shared-Loss Loans The Receiver shall be relieved of its obligations with respect to a Shared-Loss Loan upon payment of a Foreclosure Loss amount, or a Short Sale Loss amount with respect to such Single Family Shared-Loss Loan, or upon the sale without FDIC consent of a Single Family Shared-Loss Loan by Assuming Institution to a person or entity that is not an Affiliate. The Assuming Institution shall provide the Receiver with timely notice of any such sale. Failure to administer any Shared-Loss Loan or Loans in accordance with Article III shall at the discretion of the Receiver constitute grounds for the loss of shared loss coverage with respect to such Shared-Loss Loan or Loans. Notwithstanding the foregoing, a sale of the Single Family Shared-Loss Loan, for purposes of this Section 2.7, shall not be deemed to have occurred as the result of (i) any change in the ownership or control of Assuming Institution or the transfer of any or all of the Single Family Shared-Loss Loan(s) to any Affiliate of Assuming Institution, (ii) a merger by Assuming Institution with or into any other entity, or (iii) a sale by Assuming Institution of all or substantially all of its assets.

  • Rate Redetermination after Catastro- phic Damage In event of Catastrophic Damage and ad- justment, if any, of Included Timber, Contracting Officer shall make an appraisal to determine for each species the catastrophe-caused difference between the appraised unit value of Included Timber remaining immediately prior to the catastrophe and the appraised unit value of existing and potential Included Timber immediately after the ca- tastrophe. Included Timber is any that would not be elimi- nated under B8.32. Potential Included Timber is any that would be added under B8.32. Tentative Rates and Flat Rates in effect at the time of catastrophe shall be adjusted by said differences to be- come the redetermined rates for the purpose of a contract modification under B8.32. Accordingly, Base Rates shall be adjusted to correspond to the redetermined rates if redetermined rates are less than the original Base Rates, subject to new Base Rate limitations of 25 cents per hun- dred cubic feet or equivalent. However, existing Base In- dices shall not be changed under this Subsection. Upon agreement under B8.32, redetermined rates and Required Deposits shall be considered established under B3.1 for timber Scaled subsequent to Catastrophic Damage. At time of such appraisal, Specified Road construc- tion cost shall include the estimated cost of any construc- tion work listed in the Schedule of Items performed and abandoned.

  • Insurance Availability The teacher will be given an opportunity to continue insurance coverage in the school insurance program during the leave of absence, but will be required to pay all premiums connected with this coverage. All premiums must be paid in advance of the month due. Such premiums shall be prorated on an annual basis from August to August. Teachers initiating leaves of absence shall be charged the prorated amounts during the school year in which their leave begins. As leaves of absence extend into the next school year, the teacher will be expected to pay full premiums.

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