Document ID: chunk:federal_register_of_legislation:F2016C00820:body:0:p7
Version: federal_register_of_legislation:F2016C00820
Segment Type: other
Provision Reference: 
Character Range: 15948–18661

amount notionally allocated to the HCCP in the preceding 3 quarters is zero.
                 Example 2:  Assuming that, in the next quarter, Mr X has another gross benefit of $100,000 and is still 63, the amount to be notionally allocated to the ABP will be the same as in the previous example.  That is, the amount allocated to the ABP will be $42,500.  The calculation of the total amount not notionally allocated to the ABP will need to account for the previous claim amount in Example 1 for the purposes of calculating whether the total amount not allocated to the ABP exceeds the designated threshold.  In this case, the total residual amount will be $115,000 ($57,500 (amount not allocated in the ABP in the previous quarter) + $57,500 (amount not allocated in the ABP in the current quarter).  The result is that the total amount not allocated to the ABP in the current quarter and in the preceding 3 quarters of $115,000 exceeds the designated threshold of $50,000.  Subject to the limit in subrule (9), the amount to be notionally allocated to the HCCP in this case will be $47,150, which represents 82% of the difference between the sum of the total amount not allocated to the ABP in the current and in the preceding 3 quarters ($57,500 + $57,500) and the threshold ($50,000), minus the sum of the amount notionally allocated to the HCCP in the preceding 3 quarters (in this case, as there was only one amount in the previous quarter, the sum is $6,150).
(9)        Where the amount notionally allocated to the HCCP under subrule (7) exceeds (m-p)C where:
(a)                    m is 82%;
(b)                    p is the percentage of the eligible benefit paid having regard to the age cohort set out in the table in subrule (5) into which the insured person falls on the day or days on which the insured person receives the treatment to which the eligible benefit relates;
(c)                    C is the gross benefit in the current quarter,
then the amount notionally allocated to the HCCP will be the amount calculated using the formula (m-p)C.
           Note In the case of example 2 under subrule (7) above, the amount allocated to the HCCP is $47,150.  The maximum under subrule (9) that can be notionally allocated is $39,500 ($100,000 (the gross benefit) multiplied by 0.82 (the HCCP percentage) minus 0.425 (the ABP cohort percentage)).  As the maximum calculated using (m-p)C of $39,500 is less than $47,150, the amount to be notionally allocated to the HCCP will be $39,500.
(10)    For the purposes of these Rules, the designated threshold for an insured person is $50,000.

8.                      Payments by former insurer
Where:
(a)                    an insurer (former insurer) has