PERIODIC CALCULATIONS. The Secure Horizons Point-Of-Service Plan Control Program shall be administered on an IPA-specific basis. For IPAs with multiple IPA Facilities, the program shall be calculated for each IPA Facility. However, Budget Savings and payment distributions shall be based on IPA's consolidated results. Cumulative calculations of the Secure Horizons Point-Of-Service Plan Control Program results will be based on calendar quarters and shall be calculated within one hundred and twenty (120) days of the end of each calendar quarter, except for the fourth quarter for which no calculation or payment will be made in anticipation of the year-end settlement. Interim distribution payments will be made within one hundred and twenty (120) days following the end of each quarter, except for the fourth quarter, and will be limited to [ ** ] of calculated Budget Savings to account for incurred but not received claims. Year-end calculations and payments of the Secure Horizons Point-of-Service Plan Control Program shall be made within one hundred eighty (180) days of the end of each calendar year.
PERIODIC CALCULATIONS. Section 2.1 [*]
PERIODIC CALCULATIONS. As necessary to reflect changes to Facilities Values or ATRRs, the Parties will update their respective Attachment O templates. MidAmerican will use that information to calculate the following:
PERIODIC CALCULATIONS. Sanofi shall be responsible for the calculation of Profit and Loss and the determination of the cash payment to or from the Licensors for each Calendar Quarter of the Term so that following such payment each Party has borne the Sharing Percentage of Profit or Loss.
PERIODIC CALCULATIONS. Section 2.1 Periodic Calculation of [*] and [*]. As of the close of business on each [*] from [*] through and including [*] or [*], the Parties shall determine the [*] the [*] and the [*]. For each [*], the Parties agree there shall also be [*] a [*] which shall be equal to [*] the [*] of the respective date’s [*].
PERIODIC CALCULATIONS. PAC shall be responsible for the calculation of Profit and Loss and the determination of the cash payment to or from the Licensors for each Calendar Quarter of the Term so that following such payment each Party has borne the Sharing Percentage of Profit or Loss.
PERIODIC CALCULATIONS. Cumulative calculations of the Utilization Control Program results will be based on calendar quarters. Interim calculations and payments will be made within sixty (60) days of the end of each calendar quarter except for the fourth quarter for which no calculation or payment will be made in anticipation of the final year end settlement. Calculations will be made in accordance with the contractual terms above and the amount of PacifiCare's quarterly payments to or from IPA will be sixty percent (60%) of the amount due in order to adjust for incurred Hospital Service claims not yet received by PacifiCare. A calendar year-end calculation of the Utilization Control Program shall be made by PacifiCare and payment, if required, shall be made within one hundred twenty (120) days of the end of the calendar year. If an additional amount is payable by IPA to PacifiCare, such payment is due within thirty (30) days of receipt of calculation.
PERIODIC CALCULATIONS. The PacifiCare Point of Service Control Program shall be administered on an IPA specific basis. For IPAs with multiple IPA Facilities, the program shall be calculated for each IPA Facility, however savings and payment distributions shall be based on IPA's consolidated results. Cumulative calculations of the PacifiCare Point of Service Control Program results will be based on calendar quarters in conjunction with Conventional Plan Hospital Control Program calculations, which are within sixty (60) days of the end of each calendar quarter except for the forth quarter for which no calculation or payment will be made in anticipation of the year end settlement. Interim distribution payments will be limited to sixty percent (60%) of calculated savings to account for incurred but not received claims. Year end calculations and payments of the PacifiCare Point of Service Control Program shall be made within one hundred twenty (120) days of the end of each calendar year. EXHIBIT 4 ATTACHMENT C CAPITATION PAYMENT RATES The monthly Capitation Payment which PacifiCare shall pay IPA shall equal IPA's cumulative shares of the Percent of Premium. The Percent of Premium designated by PacifiCare for payment for Medical Services shall equal [ ** ] of the Net Premiums per Subscriber per month, minus the applicable ISL premium as identified in Attachment A3. IPA's portion of the Percent of Net Premium shall equal IPA's cumulative share per employer group based upon the number of men, women and children Subscribers of such employer group designating IPA as their Participating Medical Group for the month of Capitation Payment." An Experience-Rated Plan is a non-federally qualified plan in which the employers' premium is partially deferred and/or adjusted to reflect the actual medical costs incurred by the employers' Subscribers. For Experience-Rated Plans, the percent of premium for Capitation Payment purposes shall be calculated as a percent of the Actuarial Experience Rate, rather than of gross premiums billed. The Actuarial Experience Rate is calculated by the same method used to determine the premium for federally qualified plans, except that trended claims/utilization data may be considered to determine expected medical costs, and PacifiCare's administrative retention may be adjusted to reflect actuarial risk taken by the employer instead of PacifiCare. The Actuarial Experience will also be higher than billed premiums where employer premiums are partially deferred. IPA ackno...
PERIODIC CALCULATIONS. Cumulative calculations of the Hospital Control Program results will be based on calendar quarters. Interim calculations and payments will be made within sixty (60) days of the end of each calendar quarter except for the fourth quarter for which no calculation or payment will be made in anticipation of the final year end settlement. Calculations will be made in accordance with the contractual terms above and the amount of PacifiCare's quarterly payments to IPA will be sixty percent (60%) of the amount due in order to adjust for incurred Hospital Service claims not yet received by PacifiCare. In the event that the interim calculation reflects a cumulative loss for the IPA, no interim payment will be due from IPA in the first quarter that a loss results. However, if a cumulative loss is reflected for two consecutive quarters, the IPA will make an interim payment of sixty percent (60%) of the cumulative amount due to PacifiCare. Such payment to PacifiCare shall be due within fifteen (15) days of the IPA's receipt of such notice from PacifiCare. A calendar year-end calculation of the Hospital Control Program shall be made by PacifiCare and payment to the appropriate party shall be made within one hundred twenty (120) days of the end of the calendar year.
PERIODIC CALCULATIONS. The PacifiCare Choice Control Program shall be administered on an IPA specific basis. For IPAs with multiple IPA Facilities, the program shall be calculated for each IPA Facility, however savings and payment distributions shall be based on IPA's consolidated results. Cumulative calculations of the PacifiCare Choice Control Program results will be based on calendar quarters in conjunction with Conventional Plan Hospital Control Program calculations, which are within sixty (60) days of the end of each calendar quarter except for the fourth quarter for which no calculation or payment will be made in anticipation of the year end settlement. Interim distribution payments will be limited to sixty percent (60%) of calculated savings to account for incurred but not received claims. Year end calculations and payments of the PacifiCare Choice Control Program shall be made within one hundred fifty (150) days of the end of each calendar year.
