Document ID: chunk:federal_register_of_legislation:F2016C00820:body:0:p6
Version: federal_register_of_legislation:F2016C00820
Segment Type: other
Provision Reference: 
Character Range: 13532–16190

X is discharged from the hospital on 29 January.  Mr X's gross benefit is $10,000.  In this case, as half the time in which Mr X was receiving treatment was spent while he was 59 years old and the other half while he was 60 years old, the amount to be notionally allocated to the ABP will use the rates in both the 55-59 and the 60-64 age cohorts.  Therefore, the amount notionally allocated to the ABP will be:  0.5*$10,000*15%+0.5*$10,000*42.5% which equals $2,875.
(7)        An amount is to be notionally allocated to the HCCP for a current quarter in respect of an insured person if:
(a)                    an amount has been notionally allocated to the ABP pursuant to subrule (4); and
(b)                    the total gross benefit for the current and the immediately preceding 3 quarters less the amount notionally allocated to the ABP under subrule (4), or subrule 7(4) of the old rules, as appropriate, in the current and preceding 3 quarters exceeds the designated threshold.
(8)        The amount to be notionally allocated to the HCCP is to be calculated in accordance with the formula m(R-T) - H, where:
(a)                    m is 82%;
(b)                    R is the total gross benefit for the current and the preceding 3 quarters less the amount notionally allocated to the ABP under subrule (4), or subrule 7(4) of the old rules, as appropriate, in the current and preceding 3 quarters;
(c)                    T is the designated threshold;
(d)                    H is the sum of the amounts notionally allocated to the HCCP under this rule, or rule 7 of the old rules, as appropriate, in the preceding 3 quarters.
                Note: Example 1:  Mr X is 63 and has a gross benefit of $100,000.  In this case, the amount that will be notionally allocated to the ABP is $42,500 (42.5% * $100,000).  Assuming that Mr X has not made a previous claim in the preceding 3 quarters, Mr X will be above the $50,000 threshold.  That is, $57,500 (the amount not notionally allocated to ABP in the current quarter with no other claims in the preceding 3 quarters) exceeds the designated threshold of $50,000.  Here, the amount that will be notionally allocated to the HCCP is $6,150 (82% * ($57,500 - $50,000) - 0).  As there are no gross benefits in the preceding 3 quarters, the only amount that was not allocated to the ABP is the amount in the current quarter (ie, $100,000 - 42,500 = $57,500) and the 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