Premium Calculations Clause Samples
The Premium Calculations clause defines how insurance premiums are determined and calculated under the agreement. It typically outlines the basis for premium amounts, such as risk factors, coverage limits, or specific rating formulas, and may specify when and how adjustments to premiums can occur, for example, after an annual review or in response to changes in insured values. This clause ensures transparency and predictability in premium payments, helping both parties understand their financial obligations and reducing the risk of disputes over payment amounts.
Premium Calculations. 2 For Kaiser Plans, the premium charges shall be the amount charged by 3 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 4 using sound actuarial principles, and include projected claim costs based on plan 5 experience as required by state regulations, IBNR expenses, Oregon Medical 6 Insurance Pool assessments, pharmaceutical claim expenses, stop-loss premiums, 7 third-party benefit plan administration costs, and an appropriate trend factor selected 8 to limit County contributions and employee cost shares while providing adequate 9 funding for plan operations. 10 If a government agency or other taxing authority imposes or increases a tax or 11 other charge upon the County’s Medical and/or Dental benefit plan(s) or any activity 12 of the plan(s), the County may increase the appropriate premium(s) to include the 13 new or increased tax or charge.
Premium Calculations. Premiums for all plans shall be established using standard actuarial principles or actual rates being charged by the carrier or HMO. Covered employees for premium calculation purposes shall include all employees receiving the same benefits.
Premium Calculations. 6 For Kaiser Plans, the premium charges shall be the amount charged by Kaiser
Premium Calculations. 4 For Kaiser Plans, the premium charges shall be the amount charged by 5 Kaiser to the County. For the ODS plans, the premium charges shall be calculated, 6 using sound actuarial principles, and include projected claim costs based on plan 7 experience as required by state regulations, IBNR expenses, Oregon Medical 8 Insurance Pool assessments, pharmaceutical claim expenses, stop-loss premiums, 11 funding for plan operations. 12 If a government agency or other taxing authority imposes or increases a tax or 13 other charge upon the County’s Medical and/or Dental benefit plan(s) or any activity 14 of the plan(s), the County may increase the appropriate premium(s) to include the 15 new or increased tax or charge.
Premium Calculations. 19 For Kaiser Plans, the premium charges shall be the amount charged by 20 Kaiser to the County. For the MODA plan, the premium charges shall be calculated, 21 using sound actuarial principles, and include projected claim costs based on plan 22 experience as required by state regulations, IBNR expenses, federal or Oregon Pool 23 assessments, pharmaceutical claim expenses, stop-loss premiums, third-party benefit 24 plan administration costs, and an appropriate trend factor selected to limit County 25 contributions and employee cost shares while providing adequate funding for plan 26 operations.
Premium Calculations. 1 For Kaiser Plans, the premium charges shall be the amount 2 charged by Kaiser to the County. For the ODS plans, the premium charges shall 3 be calculated, using sound actuarial principles, and include projected claim costs 4 based on plan experience as required by state regulations, IBNR expenses, 5 Oregon Medical Insurance Pool assessments, pharmaceutical claim expenses, 6 stop-loss premiums, third-party benefit plan administration costs, and an 7 appropriate trend factor selected to limit County contributions and employee cost 8 shares while providing adequate funding for plan operations.
Premium Calculations. 6 For Kaiser Plans, the premium charges shall be the amount charged by 7 Kaiser to the County. For the Moda plans, the premium charges shall be calculated, 8 using sound actuarial principles, and include projected claim costs based on plan 11 premiums, third-party benefit plan administration costs, and an appropriate trend 12 factor selected to limit County contributions and employee cost shares while 13 providing adequate funding for plan operations. 14 If a government agency or other taxing authority imposes or increases a 15 tax or other charge upon the County’s Medical and/or Dental benefit plan(s) or any 16 activity of the plan(s), the County may increase the appropriate premium(s) to include 17 the new or increased tax or charge.
Premium Calculations. 13 For Kaiser Plans, the premium charges shall be the amount 14 charged by Kaiser to the County. For the ODS plans, the premium charges shall 15 be calculated, using sound actuarial principles, and include projected claim costs 16 based on plan experience as required by state regulations, IBNR expenses, 17 Oregon Medical Insurance Pool assessments, pharmaceutical claim expenses, 18 stop-loss premiums, third-party benefit plan administration costs, and an 19 appropriate trend factor selected to limit County contributions and employee cost 20 shares while providing adequate funding for plan operations. 21 Other than the High Cost Employer Sponsored Health Coverage 22 Excise Tax (“Excise Tax”), if a government agency or other taxing authority 23 imposes or increases a tax or other charge upon the County’s Medical and/or 24 Dental benefit plan(s) or any activity of the plan(s), the County may increase the 25 appropriate premium(s) to include the new or increased tax or charge.
Premium Calculations. Insurance premiums will be calculated monthly and deducted from the owner operator’s account. • Premiums will be reviewed annually.
Premium Calculations. 17 1. For ▇▇▇▇▇▇ Plans, the premium charges shall be the amount 18 charged by ▇▇▇▇▇▇ to the County. For the Moda plans, the premium charges shall be 19 calculated, using sound actuarial principles, and include projected claim costs based 20 on plan experience as required by state regulations, IBNR expenses, Federal or 21 Oregon Medical Insurance Poolstate assessments, pharmaceutical claim expenses, 22 stop-loss premiums, third-party benefit plan administration costs, and an appropriate 23 trend factor selected to limit County contributions and employee cost shares while 24 providing adequate funding for plan operations. The Association may challenge the 25 accuracy of the premium calculations through the grievance and arbitration procedure 26 and the arbitrator shall have the authority to award a refund of excess contributions for 27 the calendar year in which the miscalculation was determined to have occurred.
28 2. Such a challenge shall not be limited by the time lines set forth in 29 Article 20; but only one challenge may be filed for any calendar year, and any award 30 of excess contributions shall be limited to that year.