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An ACO under a two-sided model that meets or exceeds its MLR shares in losses at a shared loss rate specified by the ACO's participation track (and level, if applicable), not to exceed a loss recoupment limit (a percentage of the ACO's updated historical benchmark)

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ACA/individual-market plans under Blue Shield of California apply the same BMI 40 restriction

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Caregiver support might require paid assistance or lost wages for a relative