Risk corridors Clause Samples
Risk corridors. New section 1860D-16 would require entities to notify the Administrator for each year (beginning in 2007) of the total actual costs the entity incurred in providing standard coverage in the preceding year. Total actual costs would reflect total payments made to pharmacies and other entities for coverage and the aggregate amount of discounts, direct or indirect subsidies, rebates, or other price concessions or direct or indirect remunerations made to the entity. The notification would not include spending for administrative costs, amounts spent for coverage in excess of standard coverage, or amounts for which the entity subsequently received reinsurance payments.
Risk corridors. New Section 1860D-15 of the conference agreement provides for the establishment of risk corridors, which are defined as specified percentages above and below a target amount. The target amount is defined as total payments paid to the plan, taking into Present Law House Bill Senate Bill
Risk corridors. The Contractor’s capitation rates for State Fiscal Year 2021 (consisting of April 1, 2020 through and including March 31, 2021) will include a risk corridor as a risk mitigation mechanism whereby SDOH retains gains and losses outside of defined levels, as described in Appendix N.1 of this Agreement, which is hereby made a part of this Agreement as if set forth fully herein. The risk corridor is added in recognition of claims cost uncertainty attributable to the COVID-19 pandemic. Risk corridors for future rating periods will be evaluated by SDOH.