Stop Loss Program Charges to Group Sample Clauses

Stop Loss Program Charges to Group. As reimbursement to Blue Shield for the Stop Loss Program coverage provided pursuant to this Exhibit, Blue Shield shall deduct from Capitation payable to Group pursuant to the Agreement, the following per Member per Month (PMPM) amounts: Commercial *** PMPM Point of Service (POS) *** PMPM Blue Shield 65 Plus *** of Group’s Capitation Amount
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Stop Loss Program Charges to Group. As reimbursement to Blue Shield for the Stop Loss Program coverage provided pursuant to this Exhibit, Blue Shield shall deduct from Capitation payable to Group pursuant to the Agreement, the following per Member per Month (PMPM) amounts: Commercial *** pmpm Point of Service (POS) *** pmpm Blue Shield 65 Plus *** of Group’s Capitation Amount Exhibit H-2, Schedule I HMO IPA/Medical Group Agreement POS Funds Allocations Gateway Medical Group, Inc. Effective Date: January 1, 2002-December 3l, 2002 As of 01/01/2002, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are *** for the POS In-network Shared Saving, *** for POS Out-of-network Professional, and *** for the POS Out-of-network Institutional, based on the 08/01/2001 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations Category POS Fund Allocation (PMPM) Sex Age IN-NETWORK SHARED SAVINGS OUT-OF-NETWORK PROFESSIONAL OUT-OF-NETWORK INSTITUTIONAL F 0 - 1 *** *** *** F 2 - 6 *** *** *** F 7 - 18 *** *** *** F 19 - 21 *** *** *** F 22 - 24 *** *** *** F 25 - 29 *** *** *** F 30 - 34 *** *** *** F 35 - 39 *** *** *** F 40 - 44 *** *** *** F 45 - 49 *** *** *** F 50 - 54 *** *** *** F 55 - 59 *** *** *** F 60 - 64 *** *** *** F 65 + (NM) *** *** *** F 65 + (M) * *** *** *** *** *** *** M 0 - 1 *** *** *** M 2 - 6 *** *** *** M 7 - 18 *** *** *** M 19 - 21 *** *** *** M 22 - 24 *** *** *** M 25 - 29 *** *** *** M 30 - 34 *** *** *** M 35 - 39 *** *** *** M 40 - 44 *** *** *** M 45 - 49 *** *** *** M 50 - 54 *** *** *** M 55 - 59 *** *** *** M 60 - 64 *** *** *** M 65 + (NM) *** *** *** M 65 + (M) * *** *** *** * = Medicare Primary *** Confidential Treatment Requested Effective Date: January 1, 2003-December 31, 2003 & thereafter until amended As of 01/01/2003, the effective net yield (which includes the deduction for Stop Loss, if applicable) for the following PMPMs are *** for the POS In-network Shared Saving, *** for POS Out-of-network Professional, and *** for the POS Out-of-network Institutional, based on the 08/01/2001 membership. The actual allocation to POS Fund for each month will be calculated based on the actual member mix for each age/sex category. Members Other Than Blue Shield 65 Plus Members Age & Sex Categories and POS Fund Allocations Category POS Fund Allocation (P...

Related to Stop Loss Program Charges to Group

  • Monthly Data Download Not later than fifteen (15) days after the end of each month, beginning with the month in which the Commencement Date occurs and ending with the Final Shared-Loss Month, Assuming Institution shall provide Receiver:

  • Reimbursement from Third Party Payors The accounts receivable of Holdings, the Borrower and the Restricted Subsidiaries have been and will continue to be adjusted to reflect the reimbursement policies required by all applicable Requirements of Law and other Third Party Payor Arrangements to which Holdings, the Borrower or such Restricted Subsidiary is subject, and do not exceed in any material respect amounts the Borrower or such Restricted Subsidiary is entitled to receive under any capitation arrangement, fee schedule, discount formula, cost-based reimbursement or other adjustment or limitation to usual charges. All xxxxxxxx by Holdings, the Borrower and each Restricted Subsidiary pursuant to any Third Party Payor Arrangements have been made in compliance with all applicable Requirements of Law, except where failure to comply would not, individually or in the aggregate, be reasonably likely to have a Material Adverse Effect. There has been no intentional or material over-billing or over-collection by the Borrower or any Restricted Subsidiary pursuant to any Third Party Payor Arrangements, other than as created by routine adjustments and disallowances made in the ordinary course of business by the Third Party Payors with respect to such xxxxxxxx.

  • Service Charges No service charge shall be made for any exchange or registration of transfer of Warrants.

  • Administrative Support Services Fees Within forty-five (45) days of the end of each calendar quarter or at such other period as deemed appropriate by the Distributor, the Fund will make payments in the aggregate amount of up to 0.25% on an annual basis of the average during the period of the aggregate net asset value of the Shares computed as of the close of each business day (the “Service Fee”). Such Service Fee payments received from the Fund will compensate the Distributor for providing administrative support services with respect to Accounts. The administrative support services in connection with Accounts may include, but shall not be limited to, the administrative support services that a Recipient may render as described in Section 3(b)(i) below.

  • Remittance Processing Services In order to provide a means of collection of the Receivables which will allow the Trustee to receive the proceeds of the Receivables and related security without AmeriCredit or its Affiliates having access to the funds, the parties hereto agree for the benefit of the Trustee that the processing services (the “Service(s)”) of Processor will be used for the collection and the deposit of remittances related to the Receivables and related security.

  • Reimbursable Expenses In addition to the compensation paid to the Advisor pursuant to Section 8 hereof, the Company or the Partnership shall pay directly or reimburse the Advisor for all of the expenses paid or incurred by the Advisor (to the extent not reimbursable by another party, such as the dealer manager) in connection with the services it provides to the Company and the Partnership pursuant to this Agreement, including, but not limited to:

  • Administrative Support Service Fees Within forty-five (45) days of the end of each calendar quarter, the Fund will make payments in the aggregate amount of 0.0625% (0.25% on an annual basis) of the average during that calendar quarter of the aggregate net asset value of the Shares computed as of the close of each business day (the "Service Fee"). Such Service Fee payments received from the Fund will compensate the Distributor for providing administrative support services with respect to Accounts. The administrative support services in connection with Accounts may include, but shall not be limited to, the administrative support services that a Recipient may render as described in Section 3(b)(i) below.

  • Networked Account Servicing Fees to Third Parties Subject to the limitation set forth in paragraph (d) below, the Investment Company will reimburse FTIS for servicing fee payments ("Networked Account Servicing Fees") made by FTIS on the Investment Company's behalf to an institution for each Fund account (a "Networked Account"), other than accounts holding R6 shares, maintained by FTIS in which servicing is shared with that institution by the exchange of account data through the National Securities Clearing Corporation (NSCC) networking system.

  • Payments for Distribution Assistance and Administrative Support Services (a) Payments to the Distributor. In consideration of the payments made by the Fund to the Distributor under this Plan, the Distributor shall provide administrative support services and distribution services to the Fund. Such services include distribution assistance and administrative support services rendered in connection with Shares (1) sold in purchase transactions, (2) issued in exchange for shares of another investment company for which the Distributor serves as distributor or sub-distributor, or (3) issued pursuant to a plan of reorganization to which the Fund is a party. If the Board believes that the Distributor may not be rendering appropriate distribution assistance or administrative support services in connection with the sale of Shares, then the Distributor, at the request of the Board, shall provide the Board with a written report or other information to verify that the Distributor is providing appropriate services in this regard. For such services, the Fund will make the following payments to the Distributor:

  • Distribution Assistance Fees (Asset-Based Sales Charge) Within ten (10) days of the end of each month or at such other period as deemed appropriate by the Distributor, the Fund will make payments in the aggregate amount of up to 0.75% on an annual basis of the average during the month of the aggregate net asset value of Shares computed as of the close of each business day (the “Asset-Based Sales Charge”) outstanding until such Shares are redeemed or converted to another class of shares of the Fund, provided, however, that a majority of the Independent Trustees may, but are not obligated to, set a time period (the “Fund Maximum Holding Period”) from time to time for such payments. Such Asset-Based Sales Charge payments received from the Fund will compensate the Distributor for providing distribution assistance in connection with the sale of Shares. The distribution assistance to be rendered by the Distributor in connection with the Shares may include, but shall not be limited to, the following: (i) paying sales commissions to any broker, dealer, bank or other person or entity that sells Shares, and/or paying such persons “Advance Service Fee Payments” (as defined below) in advance of, and/or in amounts greater than, the amount provided for in Section 3(b) of this Agreement; (ii) paying compensation to and expenses of personnel of the Distributor who support distribution of Shares by Recipients; (iii) obtaining financing or providing such financing from its own resources, or from an affiliate, for the interest and other borrowing costs of the Distributor's unreimbursed expenses incurred in rendering distribution assistance and administrative support services to the Fund; and (iv) paying other direct distribution costs, including without limitation the costs of sales literature, advertising and prospectuses (other than those prospectuses furnished to current holders of the Fund's shares ("Shareholders")) and state "blue sky" registration expenses.

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