Common use of Premium Calculations Clause in Contracts

Premium Calculations. 2 For Kaiser Plans, the premium charges shall be the amount charged by 3 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 4 using sound actuarial principles, and include projected claim costs based on plan 5 experience as required by state regulations, IBNR expenses, Oregon Medical 6 Insurance Pool assessments, pharmaceutical claim expenses, stop-loss premiums, 7 third-party benefit plan administration costs, and an appropriate trend factor selected 8 to limit County contributions and employee cost shares while providing adequate 9 funding for plan operations. 10 If a government agency or other taxing authority imposes or increases a tax or 11 other charge upon the County’s Medical and/or Dental benefit plan(s) or any activity 12 of the plan(s), the County may increase the appropriate premium(s) to include the 13 new or increased tax or charge.

Premium Calculations. 2 7 For Kaiser Plans, the premium charges shall be the amount charged by 3 8 Kaiser to the County. For the Moda ODS plans, the premium charges shall be calculated, 4 using 9 sound actuarial principles, and include projected claim costs based on plan 5 experience as 10 required by state regulations, IBNR expenses, Oregon Medical 6 Insurance Pool 11 assessments, pharmaceutical claim expenses, stop-loss premiums, 7 third-party benefit plan 12 administration costs, and an appropriate trend factor selected 8 to limit County contributions 13 and employee cost shares while providing adequate 9 funding for plan operations. 10 14 If a government agency or other taxing authority imposes or increases a 15 tax or 11 other charge upon the County’s Medical and/or Dental benefit plan(splans(s) or any 16 activity 12 of the plan(s), the County may increase the appropriate premium(s) to include the 13 17 new or increased tax or charge.

Premium Calculations. 2 5 For Kaiser Plans, the premium charges shall be the amount charged by 3 6 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 4 using 7 sound actuarial principles, and include projected claim costs based on plan 5 experience as 8 required by state regulations, IBNR expenses, Oregon Medical 6 federal and state Insurance Pool 9 assessments, pharmaceutical claim expenses, stop-loss premiums, 7 third-party benefit plan 10 administration costs, and an appropriate trend factor selected 8 to limit County contributions 11 and employee cost shares while providing adequate 9 funding for plan operations. 10 12 If a government agency or other taxing authority imposes or increases a 13 tax or 11 other charge upon the County’s Medical and/or Dental benefit plan(splans(s) or any 14 activity 12 of the plan(s), the County may increase the appropriate premium(s) to include the 13 15 new or increased tax or charge.

Premium Calculations. 2 24 1. For Kaiser Plans, the premium charges shall be the amount charged by 3 25 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 4 using 44 1 sound actuarial principles, and include projected claim costs based on plan 5 experience as 2 required by state regulations, IBNR expenses, Oregon Medical 6 federal and state Insurance Pool assessments, 3 pharmaceutical claim expenses, stop-loss premiums, 7 third-party benefit plan administration 4 costs, and an appropriate trend factor selected 8 to limit County contributions and employee cost 5 shares while providing adequate 9 funding for plan operations. 6 2. 10 If a government agency or other taxing authority imposes or increases a 7 tax or 11 other charge upon the County’s Medical and/or Dental benefit plan(splans(s) or any activity 12 of 8 the plan(s), the County may increase the appropriate premium(s) to include the 13 new or 9 increased tax or charge.

Premium Calculations. 2 30 For Kaiser Plans, the premium charges shall be the amount charged by 3 31 Kaiser to the County. For the ODS Moda plans, the premium charges shall be calculated, 4 32 using sound actuarial principles, and include projected claim costs based on plan 5 33 experience as required by state regulations, IBNR expenses, federal and state Oregon 34 Medical 6 Insurance Pool assessments, pharmaceutical claim expenses, stop-loss 35 premiums, 7 third-party benefit plan administration costs, and an appropriate trend factor 36 selected 8 to limit County contributions and employee cost shares while providing adequate 9 37 funding for plan operations. 10 38 If a government agency or other taxing authority imposes or increases a 39 tax or 11 other charge upon the County’s Medical and/or Dental benefit plan(splans(s) or any 40 activity 12 of the plan(s), the County may increase the appropriate premium(s) to include the 13 41 new or increased tax or charge.. 42 D. Employee Contribution

Premium Calculations. 2 1. For Kaiser Plans, the premium charges shall be the amount charged by 3 Kaiser to the County. For the Moda Preferred Provider Organizational Plans (PPO) plans, the premium charges shall be calculated, 4 using sound actuarial principles, and include projected claim costs based on plan 5 experience as required by state regulations, IBNR expenses, Oregon Medical 6 federal and state Insurance Pool assessments, pharmaceutical claim expenses, stop-loss premiums, 7 third-party benefit plan administration costs, and an appropriate trend factor selected 8 to limit County contributions and employee cost shares while providing adequate 9 funding for plan operations. 2. 10 If a government agency or other taxing authority imposes or increases a tax or 11 other charge upon the County’s Medical and/or Dental benefit plan(splans(s) or any activity 12 of the plan(s), the County may increase the appropriate premium(s) to include the 13 new or increased tax or charge.

Premium Calculations. 2 4 1. For Kaiser Plans, the premium charges shall be the amount charged by 3 5 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 4 using 6 sound actuarial principles, and include projected claim costs based on plan 5 experience as 7 required by state regulations, IBNR expenses, Oregon Medical 6 federal and state Insurance Pool assessments, 8 pharmaceutical claim expenses, stop-loss premiums, 7 third-party benefit plan administration 9 costs, and an appropriate trend factor selected 8 to limit County contributions and employee cost 10 shares while providing adequate 9 funding for plan operations. 11 2. 10 If a government agency or other taxing authority imposes or increases a 12 tax or 11 other charge upon the County’s Medical and/or Dental benefit plan(splans(s) or any activity 12 of 13 the plan(s), the County may increase the appropriate premium(s) to include the 13 new or 14 increased tax or charge.