Common use of Risk Corridor Clause in Contracts

Risk Corridor. 1. The Parties agree that the ETCOC serves as the benchmark upon which the Risk Corridor is based. 2. Additionally, the Parties agree to a Risk Corridor arrangement as follows: A. The Risk Corridor for the Traditional Attribution Cohort and Expanded Attribution Cohort will be 3% in aggregate. B. The aggregate Risk Corridor for the Traditional Attribution Cohort and Expanded Attribution Cohort shall be applied as follows: i. If, at the time of Year-End Reconciliation, the ATCOC is between 100% and 103% of the ETCOC amount for the two cohorts in aggregate, Contractor agrees it is liable for the costs between 100% and 103%. To the extent those costs are borne by DVHA during the year, Contractor shall be liable to DVHA. If the ATCOC is greater than 103% of the ETCOC amount for the two cohorts in aggregate, Contractor is liable for costs between 100% and 103%, and DVHA is liable for any costs exceeding 103%. ii. Conversely, if the ATCOC is between 97% and 100% of the ETCOC amount for the two cohorts in aggregate, Contractor will be entitled to receive from DVHA payment of the full amount of the ETCOC. If the ATCOC is lower than 97% of the ETCOC amount for the two cohorts in aggregate, Contractor will be entitled to receive payment of the full value of the ETCOC less the difference between the ATCOC and 97% of the ETCOC. 3. If during the Contract, DVHA or Contractor determines that the Fee-for-Service Payments are 10% or more above the expected allocation of Fee-for-Service Payments multiplied by the number of member months or if the ATCOC is projecting to exceed the upper bound of the risk corridor, then the parties shall meet to discuss utilization or costs and potential remedies. Evaluations will occur no less frequently than quarterly within 60 days of the end of the quarter.