Common use of Rate Adjustment Denials Clause in Contracts

Rate Adjustment Denials. In the event that HEALTH PLAN'S rate adjustment is denied by the Board of Directors of the FHKC, HEALTH PLAN may request that an independent actuary be retained to determine whether or not the proposed rate is excessive or inadequate. A. Any request for a review of a denied rate must be submitted by HEALTH PLAN to the FHKC in writing within fourteen (14) calendar days of the date of the board meeting in which the Board of Directors' denied the rate request. B. HEALTH PLAN must provide FHKC with a list of three qualified Independent actuaries and also provide the curriculum vitae for each proposed actuary within thirty (30) days from HEALTH PLAN'S notification of intention to seek a review of the denied rate. C. FHKC shall select an actuary from the list provided by HEALTH PLAN no later than fourteen (14) calendar days following receipt of the information from HEALTH PLAN. D. The actuary's findings must be in writing and communicated to both FHKC and HEALTH PLAN within thirty (30) days after execution of the Letter of the Engagement by all parties. E. The effective date of the actuary's determination shall be October 1st or the first of the month following the receipt of the actuary's findings, whichever occurs later. F. The cost for such review will be shared equally between FHKC and HEALTH PLAN. G. The decision of the independent actuary will be binding on FHKC and HEALTH PLAN.

Rate Adjustment Denials. AMERIGROUP Effective Date: October 1, 2003 - September 30, 2005 In the event that HEALTH PLANAMERIGROUP'S rate adjustment is denied by the Board of Directors of the FHKC, HEALTH PLAN AMERIGROUP may request that an independent actuary be retained to determine whether or not the proposed rate is excessive or inadequate. A. Any request for a review of a denied rate must be submitted by HEALTH PLAN AMERIGROUP to the FHKC in writing within fourteen (14) calendar days of the date of the board meeting in which the Board of Directors' denied the rate request. B. HEALTH PLAN AMERIGROUP must provide FHKC with a list of three qualified Independent independent actuaries and also provide the curriculum vitae for each proposed actuary within thirty (30) days from HEALTH PLANAMERIGROUP'S notification of intention to seek a review of the denied rate. C. FHKC shall select an actuary from the list provided by HEALTH PLAN AMERIGROUP no later than fourteen (14) calendar days following receipt of the information from HEALTH PLANAMERIGROUP. D. The actuary's findings must be in writing and communicated to both FHKC and HEALTH PLAN AMERIGROUP within thirty (30) days after execution of the Letter of the Engagement by all parties. E. The effective date of the actuary's determination shall be October 1st or the first of the month following the receipt of the actuary's findings, whichever occurs later. F. The cost for such review will be shared equally between FHKC and HEALTH PLANAMERIGROUP. G. The decision of the independent actuary will be binding on FHKC and HEALTH PLANAMERIGROUP.

Rate Adjustment Denials. In the event that HEALTH PLAN'S the INSURER's rate adjustment is denied by the Board of Directors of the FHKC, HEALTH PLAN the INSURER may request that an independent actuary be retained to determine whether or not the proposed rate is excessive or inadequate. A. Any request for a review of a denied rate must be submitted by HEALTH PLAN the INSURER to the FHKC in writing within fourteen (14) calendar days of the date of the board meeting in which the Board of Directors' Directors denied the rate request. B. HEALTH PLAN The INSURER must provide FHKC with a list of three (3) qualified Independent independent actuaries and also provide the curriculum vitae for each proposed actuary within thirty (30) days from HEALTH PLAN'S notification of intention to seek a review of the denied rate. C. actuary. FHKC shall select an actuary from the list provided by HEALTH PLAN the INSURER no later than fourteen (14) calendar days following receipt of the information from HEALTH PLANINSURER. D. C. The actuary's findings must be in writing and communicated to both FHKC and HEALTH PLAN the INSURER within thirty (30) days after execution of the Letter of the Engagement by all parties. E. D. The effective date of the actuary's determination shall be October 1st or the first of the month following the receipt of the actuary's findings, whichever occurs later. F. E. The cost for such review will be shared equally split between FHKC and HEALTH PLANINSURER. G. F. The decision of the independent actuary will be binding on FHKC and HEALTH PLAN.INSURER. AMERIGROUP FLORIDA, INC. Effective Date: October 1, 2005 Services shall be provided by INSURER under the following conditions: