Common use of Rate Certification Clause in Contracts

Rate Certification. In preparing the capitation rates for the CY 2014 managed care members, Mercer has used and relied upon enrollment, eligibility, encounter, and other information supplied by the State and its vendors. The State and its vendors are responsible for the validity and completeness of this supplied data and information. We have reviewed the data and information for internal consistency and reasonableness, but we did not audit it. If the data and information is incomplete or inaccurate, the values shown in this letter may need to be revised accordingly. Mercer certifies that the rates were developed in accordance with generally accepted actuarial practices and principles and are appropriate for the Medicaid covered populations and services under the managed care contract. The undersigned actuaries are members of the American Academy of Actuaries and meet its qualification standards to certify the actuarial soundness2 of Medicaid managed-care capitation rates. Capitation rates developed by Mercer are actuarial projections of future contingent events. Actual costs will differ from these projections. Mercer has developed these rates on behalf of the State to demonstrate compliance with the Centers for Medicare & Medicaid Services (CMS) requirements under 42 CFR 438.6(c) and in accordance with applicable laws and regulations. Use of these rates for any purpose beyond that stated may not be appropriate. MCPs are advised that the use of these rates may not be appropriate for their particular circumstance and Mercer disclaims any responsibility for the use of these rates by MCPs for any purpose. Mercer recommends that any MCP considering contracting with the State should analyze its own projected medical expense, administrative expense, and any other premium needs for comparison to these rates before deciding whether to contract with the State.

Rate Certification. In preparing the capitation rates for the CY 2014 managed care members, Mercer ▇▇▇▇▇▇ has used and relied upon enrollment, eligibility, encounter, and other information supplied by the State and its vendors. The State and its vendors are responsible for the validity and completeness of this supplied data and information. We have reviewed the data and information for internal consistency and reasonableness, but we did not audit it. If the data and information is incomplete or inaccurate, the values shown in this letter may need to be revised accordingly. Mercer ▇▇▇▇▇▇ certifies that the rates were developed in accordance with generally accepted actuarial practices and principles and are appropriate for the Medicaid covered populations and services under the managed care contract. The undersigned actuaries are members of the American Academy of Actuaries and meet its qualification standards to certify the actuarial soundness2 of Medicaid managed-care capitation rates. Capitation rates developed by Mercer ▇▇▇▇▇▇ are actuarial projections of future contingent events. Actual costs will differ from these projections. Mercer ▇▇▇▇▇▇ has developed these rates on behalf of the State to demonstrate compliance with the Centers for Medicare & Medicaid Services (CMS) requirements under 42 CFR 438.6(c) and in accordance with applicable laws and regulations. Use of these rates for any purpose beyond that stated may not be appropriate. MCPs are advised that the use of these rates may not be appropriate for their particular circumstance and Mercer ▇▇▇▇▇▇ disclaims any responsibility for the use of these rates by MCPs for any purpose. Mercer ▇▇▇▇▇▇ recommends that any MCP considering contracting with the State should analyze its own projected medical expense, administrative expense, and any other premium needs for comparison to these rates before deciding whether to contract with the State.