Common use of Incentive Program Withhold Clause in Contracts

Incentive Program Withhold. PacifiCare may establish and/or adjust a withhold from Medical Group’s monthly Capitation Payment for purposes of offsetting potential incentive program deficits. PacifiCare shall provide full and complete data, of which shall be in mutually agreeable data format and which calculations, including IBNR, shall consistent with industry standards and accounting principles, which demonstrates the basis of the withhold modification to the group prior to any withhold modification. The group will have thirty (30) days to review and respond to the data. At no time will the Incentive Program Withhold exceed the downside risk limit proposed, or any mutually agreed upon limit. The Incentive Program Withhold shall be refunded to the Medical Group at the time of the incentive program settlements, except that Medical Group’s share of any incentive program deficits shall be deducted from such refund. As of the date of this Agreement, it is understood that the withhold for Secure Horizons is set at *** PMPM; and the withhold for PacifiCare Commercial and Commercial POS is ***. Effective January 1, 2002, the withhold for PacifiCare Commercial and Commercial POS is set at ***.

Incentive Program Withhold. PacifiCare may establish and/or adjust a withhold from Medical Group’s monthly Capitation Payment for purposes of offsetting potential incentive program deficits. PacifiCare shall provide full and complete data, of which shall be in mutually agreeable data format and which calculations, including IBNR, shall consistent with industry standards and accounting principles, which demonstrates the basis of the withhold modification to the group prior to any withhold modification. The group will have thirty (30) days to review and respond to the data. At no time will the Incentive Program Withhold exceed the downside risk limit proposed, or any mutually agreed upon limit. The Incentive Program Withhold shall be refunded to the Medical Group at the time of the incentive program settlements, except that Medical Group’s share of any incentive program deficits shall be deducted from such refund. As of the date of this Agreement, it is understood that the withhold for Secure Horizons is set at *** PMPM; and the withhold for PacifiCare Commercial and Commercial POS is ***. Effective January 1, 2002, the withhold for PacifiCare Commercial and Commercial POS is set at ***.