Shared Risk Program Clause Samples
Shared Risk Program. PPG shall participate in an incentive program for Shared Risk Services which shall reward PPG for effectively coordinating such care. Under this Program, a budget shall be established for Shared Risk Services, and the actual cost of such services shall be compared to the budget.
Shared Risk Program. HMO shall be solely responsible for all Shared Risk services and for pharmacy benefit costs of Medicare Supplement Members.
Shared Risk Program. Subsection 3.1 Shared Risk Budget, shall be deleted and replaced with the following:
Shared Risk Program. For each Reconciliation Period, HEALTH NET will calculate Shared Risk Claims and compare them to the corresponding Shared Risk Budget for the purpose of determining whether PPG is entitled to a bonus payment. In the event that Shared Risk Claims are less than the Shared Risk Budget, HEALTH NET shall pay PPG the lesser of: (a) *** of the differential between the Shared Risk Budget and the total Shared Risk Claims; or (b) *** of the aggregate Capitation. HEALTH NET will calculate the shared risk amount payable to PPG ninety (90) days after the exhaustion of each Reconciliation Period. Any amounts payable will be sent to PPG within forty-five (45) days after said ninety (90) day claims runout period. Any Shared Risk Claims not paid during the Reconciliation Period will be applied toward the next reconciliation.
Shared Risk Program