HBR definition
Examples of HBR in a sentence
In such event, HBR shall have the option to terminate this Agreement upon written notice to IWRA given not later than thirty (30) days after HBR's receipt of such notice from IWRA.
The Baseline HBR for each applicable Contract Year shall be set at eighty five percent (85%) of the total Applicable Premium.
HBR totals contained on such baseline and monthly cumulative reports shall be deemed final unless Health Plan receives an objection from Provider within fifteen (15) days of Provider’s receipt of the applicable report.
All HBR amounts shall be calculated using Applicable Premium, Expenses, and “Applicable Claims Data,” which is defined as data from claims for Covered Services: (i) in which the dates of service took place during the applicable Contract Year, and (ii) in which the claims were received during the periods specified below.
In the event of such termination, or any termination of the Agreement, Provider shall not be eligible for payment of any HBR Incentive Payment corresponding to the Contract Year in which such termination is effective, and this Exhibit and the HBR Incentive Program will be of no further force and effect.
In the event Provider’s Cumulative HBR is at or above the Baseline HBR, Provider shall not be eligible for any HBR Incentive.
The cumulative HBR for any Contract Year, as of a specified date within such Contract Year (“Cumulative HBR”), shall be calculated using Applicable Claims Data for the period commencing as of the first day of the applicable Contract Year and continuing through the end of the month immediately preceding the specific date of determination.
Provider acknowledges and agrees that, except as otherwise provided below, once the accumulated annual claims expense for a Designated Covered Person exceeds the reinsurance threshold amount, payments for Covered Services provided to any individual Designated Covered Person in excess of the reinsurance threshold amount will not be considered when calculating Provider’s HBR as set forth in this Exhibit.
The remaining one-half (1/2) of the HBR Shared Savings will be retained by Health Plan to be used as described in Section 6(d) below.
If, following the Year-End Reconciliation, Health Plan should determine either the Provider has not attained a HBR below the Baseline HBR or that Provider has not met all the eligibility requirements specified in Section 2, Provider shall repay Health Plan any monthly HBR Incentive payments made during the Contract Year within thirty (30) days of Health Plan’s written request.