Medical Trust Actuarial Report
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5706254v1/00914.015 Rachel Calisi Senior Health Consultant T 602.381.4027 rcalisi@segalco.com 1501 West Fountainhead Parkway, Suite 370 Tempe, AZ 85282 segalco.com November 8, 2021 Ms. Rae Lynn Nielsen Human Resources Director City of Chandler PO Box 4008 Chandler, AZ 85244-4008 Re: City of Chandler Medical and Prescription Drug Plan Monthly Reporting January 1, 2021 through December 31, 2021 – Data through Sept. 30, 2021 Dear Rae Lynn: Enclosed is the monthly experience reporting for the City’s medical and prescription drug plans. The report contains medical claims, prescription drug claims, enrollment, and expense information as furnished by Blue Cross Blue Shield of Arizona (Whyzen Analytics reporting tool) through September 30, 2021. For the month of September, Medical paid claims were approximately $1,332,000 while net Rx claims were about $379,000. For the 2021 plan year-to-date, claims and expenses (after stop- loss reimbursements and pharmacy rebates) exceeded contributions by approximately $2,391,000 or 14.5% of contributions. Based on paid claims and expenses, all Retiree and Active Plans, except for the Active white plan, have experienced an operating deficit, as displayed on Page 8. There have been twenty-one claimants (one new claimant since last month) with paid claims in excess of $100,000 during the reporting period that accounts for 28.2% of total medical and prescription drug paid claims. Expenses included in this report are medical plan administration, stop-loss premium, capitation for behavioral health & chiropractic services, value based services, HSA administration, and fees associated with the Affordable Care Act. Also included is the amount of $114,555 per month from the 2021 Operating Budget. These expenses exclude those funded by Blue Cross Blue Shield of Arizona. These expenses include categories such as personnel support, audit & financial services, promotional, operating supplies & equipment, bank charges, contractual services, and health savings and flex account contributions. In September 2021, approximately 39% of all active employees and retirees were enrolled in the Red plan, with 5% enrolled in the Blue plan, and 56% enrolled in the White plan. At the end of 2020, approximately 38% of enrollment was in the Red plan, 5% in the Blue plan and 57% in the 5706254v1/00914.015 Ms. Rae Lynn Nielsen November 8, 2021 Page 2 White plan. The current average enrollment in 2021 is approximately 0.5% higher than the 2020 average enrollment. The Coronavirus (COVID-19) pandemic has impacted the 2020 and 2021 US economy and health plan claim’s history and projections for most Health Plan Sponsors. Realized trends in the 2020 plan year could be significantly different in 2021 as the population is vaccinated and changes in the spread of the COVID-19 virus is altered. I look forward to discussing this report with you. Sincerely yours, Rachel Calisi Senior Health Consultant /as City of Chandler Medical/Rx Monthly Reporting: January 2021 - December 2021 (Data Through September 2021) 11/8/2021 Presented by: Rachel Calisi © 2021 by The Segal Group Inc. Sep'21 Oct'20-Sep'21 Oct'19-Sep'20 Sep'21 Oct'20-Sep'21 Oct'19-Sep'20 Contributions $1,841,570 $21,962,355 $21,921,626 Avg. # of Employees 1,717 1,699 1,695 Net Paid Medical Claims $1,200,352 $17,603,327 $14,237,536 Avg. # of Members 4,551 4,540 4,574 Net Paid Rx Claims $378,985 $4,594,938 $4,392,443 Ratio Members to EEs 2.65 2.67 2.70 Total Claims $1,579,337 $22,198,264 $18,629,979 Age/Gender Index 1 - 0.979 0.964 Stop Loss & Adm Expenses $279,041 $3,210,574 $2,763,884 Total Claims & Expenses $1,858,377 $25,408,838 $21,393,863 Surplus/Deficit -$16,807 -$3,446,483 $527,763 Loss Ratio 101% 116% 98% PEPM Cost $1,082.34 $1,246.02 $1,051.81 Oct'20-Sep'21 Oct'19-Sep'20 % Change PEPM % Change -13.1% 18.5% # of Claimants 34 23 47.8% $ of Medical/Rx Paid Claims $8,223,305 $5,160,443 59.4% % of Medical/Rx Paid Claims 33.0% 24.2% 36.3% Oct'20-Sep'21 Oct'19-Sep'20 % Change Oct'20-Sep'21 Oct'19-Sep'20 % Change Bed Days/1,000 314.5 285.6 10.1% Generic $289,734 $388,618 -25.4% Avg Length of Stay 6.5 6.3 2.4% Brand Preferred $1,875,372 $1,284,410 46.0% Brand Non-Preferred $115,504 $683,440 -83.1% Specialty $1,295,697 $1,020,374 27.0% Total $3,576,307 $3,376,843 5.9% Oct'20-Sep'21 Oct'19-Sep'20 % Change Oct'20-Sep'21 Oct'19-Sep'20 % Change In-Network Allowed % 97.0% 97.1% -0.1% Retail Scripts PMPY 13.76 14.02 -1.8% Discount from Billed 67.3% 70.4% -4.5% Mail Order Scripts PMPY 0.16 0.30 -47.0% % Mail Order 1.1% 2.1% -45.5% Oct'20-Sep'21 Oct'19-Sep'20 % Change Generic Dispensing Rate 80.8% 80.4% 0.5% Oct'20-Sep'21 Oct'19-Sep'20 % Change Generic Plan Paid/Script $10.61 $13.31 -20.3% Member Cost Share % 13.4% 15.2% -11.7% Brand Plan Paid/Script $321.68 $289.60 11.1% Plan Paid % 86.6% 84.8% 2.1% Specialty Plan Paid/Script $4,206.81 $3,082.70 36.5% Total Plan Paid/Script $105.76 $92.97 13.8% 1 Pharmacy Spend 2 Medical In-Network Usage & Discounts Pharmacy Retail vs Mail Order Pharmacy Per Script Metrics2 Medical/Rx Plan - Member Cost Sharing 3 (1) BCBS factor for measuring the cost deviation of a population from that of a benchmark population based on age and gender attributes. (2) The amount that plan participants enrolled in the White plan pay for their prescription drugs is not included in the Pharmacy Spend and Pharmacy Per Script Metric sections of the Dashboard because the information is not available broken down by pharmacy category in the BCBSAZ Whyzen system. Differences in pharmacy spend may also be due to the reporting data source. (3) Cost share means the member's out-of-pocket expense compared to the sum of plan paid claims plus member out-of-pocket. Percentages do not reflect employee contributions. (4) Percentages are rounded to the first decimal. Inpatient Hospital City of Chandler HealthPlan Dashboard - Data thru September 2021 Income vs Paid Medical/Rx Claims + Expenses Demographics Large Claimants (> $100,000) 5705171v1 Financial Prescription Drugs (Rx) Enrollment Medical Utilization Medical Network Medical/Rx Plan Design Month Enrollment Contributions1 Medical Paid2,3 Stop Loss Refunds Rx Paid Net Claims Expenses4 Total Paid Claims and Expenses Surplus/ (Deficit) Total Loss Ratio Jan-20 1,692 $1,820,331 $1,017,630 ($98,075) $451,761 $1,371,316 $225,066 $1,596,382 $223,949 87.7% Feb-20 1,696 $1,825,192 $1,170,609 ($17,635) $277,563 $1,430,536 $228,621 $1,659,158 $166,035 90.9% Mar-20 1,703 $1,830,865 $1,344,793 ($21,030) $393,606 $1,717,369 $228,972 $1,946,340 ($115,476) 106.3% Apr-20 1,701 $1,828,635 $1,052,366 ($228,666) $338,407 $1,162,107 $228,806 $1,390,914 $437,721 76.1% May-20 1,705 $1,833,086 $1,073,564 ($74,375) $255,628 $1,254,817 $229,050 $1,483,867 $349,219 80.9% Jun-20 1,707 $1,835,410 $1,044,771 ($49,557) $339,982 $1,335,196 $229,234 $1,564,430 $270,980 85.2% Jul-20 1,708 $1,836,171 $1,208,441 ($107,215) $379,367 $1,480,592 $229,387 $1,709,979 $126,192 93.1% Aug-20 1,708 $1,837,644 $1,580,514 ($67,580) $432,267 $1,945,201 $229,343 $2,174,544 ($336,900) 118.3% Sep-20 1,701 $1,826,449 $1,531,706 ($122,766) $370,090 $1,779,029 $228,823 $2,007,852 ($181,403) 109.9% Oct-20 1,690 $1,814,532 $1,507,055 ($68,205) $386,117 $1,824,968 $227,948 $2,052,916 ($238,384) 113.1% Nov-20 1,691 $1,817,174 $1,520,779 ($136,289) $403,105 $1,787,595 $228,001 $2,015,596 ($198,421) 110.9% Dec-20 1,703 $1,826,453 $1,869,092 ($96,244) $443,178 $2,216,027 $228,937 $2,444,964 ($618,511) 133.9% 2020 Total 20,405 $21,931,941 $15,921,319 ($1,087,637) $4,471,071 $19,304,753 $2,742,188 $22,046,940 ($114,999) 100.5% 2020 Avg. 1,700 $1,827,662 $1,326,777 ($90,636) $372,589 $1,608,729 $228,516 $1,837,245 ($9,583) 100.5% Jan-21 1,708 $1,829,009 $1,661,205 ($71,830) $389,983 $1,979,358 $278,182 $2,257,540 ($428,532) 123.4% Feb-21 1,698 $1,819,359 $1,384,946 ($11,968) $375,656 $1,748,635 $280,266 $2,028,901 ($209,542) 111.5% Mar-21 1,704 $1,828,100 $1,739,289 ($20,983) $321,008 $2,039,314 $280,796 $2,320,110 ($492,010) 126.9% Apr-21 1,703 $1,828,978 $1,524,544 ($1,603) $388,568 $1,911,509 $280,675 $2,192,184 ($363,206) 119.9% May-21 1,703 $1,830,244 $1,714,029 ($83,558) $394,335 $2,024,807 $280,636 $2,305,443 ($475,200) 126.0% Jun-21 1,722 $1,847,707 $1,640,304 ($134,389) $374,365 $1,880,279 $282,462 $2,162,742 ($315,035) 117.1% Jul-21 1,717 $1,839,218 $1,349,631 ($104,469) $360,363 $1,605,525 $281,979 $1,887,503 ($48,286) 102.6% Aug-21 1,714 $1,840,013 $1,352,027 ($130,390) $379,275 $1,600,912 $281,650 $1,882,563 ($42,550) 102.3% Sep-21 1,717 $1,841,570 $1,332,072 ($131,720) $378,985 $1,579,337 $279,041 $1,858,377 ($16,807) 100.9% Oct-21 Nov-21 Dec-21 2021 Total 15,386 $16,504,196 $13,698,046 ($690,909) $3,362,538 $16,369,675 $2,525,688 $18,895,363 ($2,391,167) 114.5% 2021 Avg. 1,710 $1,833,800 $1,522,005 ($76,768) $373,615 $1,818,853 $280,632 $2,099,485 ($265,685) 114.5% 2 City of Chandler 2020-2021 Medical/Rx Contributions and Expenses Year-to-date through September 2021 (1) Contributions for COBRA are assumed to be the same as the Actives. (2) Medical Paid claims include BCBSAZ AEA amounts, access fees, and capitation. (3) Medical Paid claims includes retroactive adjustments which causes discrepancies when comparing to BCBSAZ invoices. (4) Expenses include prorated monthly PCORI fees. $2,257,540 $4,286,441 $6,606,551 $8,798,735 $11,104,179 $13,266,920 $15,154,423 $17,036,986 $18,895,363 $1,596,382 $3,255,540 $5,201,880 $6,592,794 $8,076,661 $9,641,091 $11,351,070 $13,525,614 $15,533,466 $17,586,381 $19,601,977 $22,046,940 $- $5,000,000 $10,000,000 $15,000,000 $20,000,000 $25,000,000 Jan. Feb. Mar. Apr. May Jun. Jul. Aug. Sept. Oct. Nov. Dec. 2021 vs 2020 Cumulative Paid Claims & Expenses 2021 Cumulative Claims & Expenses 2020 Cumulative Claims & Expenses 5705171v1 Red Blue White Total Red Blue White Total Red Blue White Total Jan-21 602 45 879 1,526 63 28 91 182 665 73 970 1,708 Feb-21 595 44 871 1,510 64 29 95 188 659 73 966 1,698 Mar-21 597 48 871 1,516 64 29 95 188 661 77 966 1,704 Apr-21 597 48 871 1,516 64 29 94 187 661 77 965 1,703 May-21 596 47 869 1,512 67 29 95 191 663 76 964 1,703 Jun-21 603 47 880 1,530 67 29 96 192 670 76 976 1,722 Jul-21 599 50 873 1,522 68 27 100 195 667 77 973 1,717 Aug-21 600 51 866 1,517 68 27 102 197 668 78 968 1,714 Sep-21 598 54 870 1,522 68 26 101 195 666 80 971 1,717 Oct-21 Nov-21 Dec-21 2021 Avg. 599 48 872 1,519 66 28 97 191 664 76 969 1,710 % of Total 35% 3% 51% 89% 4% 2% 6% 11% 39% 4% 57% 100% 2020 Avg. 594 49 885 1,528 59 28 86 173 652 78 971 1,700 % Change 1% -2% -1% -1% 12% -1% 12% 10% 2% -2% 0% 0.5% 3 City of Chandler 2021 Enrollment by Status and Plan Year-to-date through September 2021 TOTAL ACTIVE RETIREE 0 500 1,000 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 Oct-21 Nov-21 Dec-21 Active Enrollment by Plan ACTIVE Red ACTIVE Blue ACTIVE White 0 20 40 60 80 100 120 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 Oct-21 Nov-21 Dec-21 Retiree Enrollment by Plan RETIREE Red RETIREE Blue RETIREE White 5705171v1 Notes: Paid claims illustrated include capitation but are not reduced for stop loss reimbursements and prescription drug rebates. The claims information by Active and Retiree status is approximate based on the status information reported to Blue Cross Blue Shield as of the date the claim was adjudicated. 4 City of Chandler 2021 Medical/Rx Paid Claims by Plan and Status Year-to-date through September 2021 $1,433 $1,801 $712 $1,031 $3,361 $1,169 $782 $1,731 $1,625 $1,568 $719 $1,109 $0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 Red Blue White All Plans Claims per Employee per Month Medical/Rx YTD Claims Paid by Plan and Status -- 2021 Plan Year Actives '21 Retirees '21 All '21 $1,326 $745 $653 $917 $3,292 $944 $911 $1,724 $1,502 $818 $676 $999 $0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 Red Blue White All Plans Claims per Employee per Month Medical/Rx YTD Claims Paid by Plan and Status -- 2020 Plan Year Actives '20 Retirees '20 All '20 5705171v1 Enrollment Contributions Claims & Expenses Active Loss Ratio Enrollment Contributions Claims & Expenses Retiree Loss Ratio Enrollment Contributions Total Claims & Expenses Total Loss Ratio All Plans 13,671 $15,016,762 $16,336,812 109% 1,715 $1,487,434 $3,249,459 218% 15,386 $16,504,196 $19,586,272 119% % of Total 89% 91% 83% 11% 9% 17% 100% 100% 100% Red Plan 5,387 $7,286,177 $8,606,250 118% 593 $636,230 $2,090,252 329% 5,980 $7,922,406 $10,696,502 135% % of Total 90% 92% 80% 10% 8% 20% 39% 48% 55% Blue Plan 434 $477,293 $852,951 179% 253 $212,394 $337,216 159% 687 $689,687 $1,190,166 173% % of Total 63% 69% 72% 37% 31% 28% 4% 4% 6% White Plan 7,850 $7,253,292 $6,877,612 95% 869 $638,810 $821,991 129% 8,719 $7,892,103 $7,699,603 98% % of Total 90% 92% 89% 10% 8% 11% 57% 48% 39% 4/10/2015 * 5 The claims information by Active and Retiree is approximate based on the status information reported to Blue Cross Blue Shield as of the date the claim was adjudicated. Notes: Paid claims include capitation but are unadjusted for stop loss reimbursements. City of Chandler 2021 Contributions and Paid Claims by Status and Plan Year-to-date through September 2021 ACTIVE RETIREE TOTAL Percent of Total rows sum Active and Retiree columns by plan and show each plan's percentage of the total in the Total columns. $- $2,000,000 $4,000,000 $6,000,000 $8,000,000 $10,000,000 $12,000,000 $14,000,000 $16,000,000 $18,000,000 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 Oct-21 Nov-21 Dec-21 $ Year-to-Date Active Contributions vs Claims and Expenses $- $500,000 $1,000,000 $1,500,000 $2,000,000 $2,500,000 $3,000,000 $3,500,000 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 Oct-21 Nov-21 Dec-21 $ Year-to-Date Retiree Contributions vs Claims and Expenses Contributions Claims & Expenses 5705171v1 Month EE EE+SP EE+Ch(rn) EE+Fam EE EE+SP EE+Ch(rn) EE+Fam EE EE+SP EE+Ch(rn) EE+Fam Jan-21 153 138 87 224 18 3 7 17 261 122 100 396 Feb-21 147 136 89 223 18 2 7 17 256 119 101 395 Mar-21 146 136 89 226 20 3 7 18 257 119 100 395 Apr-21 145 136 90 226 19 3 7 19 255 120 100 396 May-21 143 135 91 227 18 3 7 19 257 117 99 396 Jun-21 146 135 91 231 18 3 7 19 260 122 103 395 Jul-21 147 133 90 229 19 4 8 19 260 119 99 395 Aug-21 145 134 90 231 20 4 8 19 259 116 95 396 Sep-21 146 133 89 230 22 5 8 19 260 116 96 398 Oct-21 Nov-21 Dec-21 2021 Total 1,318 1,216 806 2,047 172 30 66 166 2,325 1,070 893 3,562 2021 Avg. 146 135 90 227 19 3 7 18 258 119 99 396 Month Retiree Ret+SP Ret+Ch(rn) Ret+Fam Retiree Ret+SP Ret+Ch(rn) Ret+Fam Retiree Ret+SP Ret+Ch(rn) Ret+Fam Jan-21 28 30 2 3 14 14 0 0 40 39 2 10 Feb-21 29 30 2 3 15 14 0 0 43 40 2 10 Mar-21 29 30 2 3 15 14 0 0 42 40 3 10 Apr-21 29 29 2 4 16 13 0 0 42 41 3 8 May-21 30 30 3 4 16 13 0 0 42 42 3 8 Jun-21 30 30 3 4 17 12 0 0 43 42 3 8 Jul-21 30 31 4 3 15 12 0 0 47 43 3 7 Aug-21 30 30 5 3 15 12 0 0 47 45 3 7 Sep-21 29 31 5 3 15 11 0 0 46 45 3 7 Oct-21 Nov-21 Dec-21 2021 Total 264 271 28 30 138 115 0 0 392 377 25 75 2021 Avg. 29 30 3 3 15 13 0 0 44 42 3 8 6 City of Chandler Enrollment by Tier Year-to-date through September 2021 Red Blue White Actives Retirees Red Blue White 5705171v1 Month EE EE+SP EE+Ch(rn) EE+Fam EE EE+SP EE+Ch(rn) EE+Fam EE EE+SP EE+Ch(rn) EE+Fam Jan-20 146 132 85 231 15 4 8 16 263 122 98 403 Feb-20 146 132 85 231 16 3 9 17 263 122 98 405 Mar-20 149 133 85 229 18 3 10 17 258 126 102 405 Apr-20 146 135 85 229 18 3 10 17 257 128 103 403 May-20 146 135 85 229 19 3 11 18 256 128 103 403 Jun-20 145 135 85 230 20 3 10 19 258 125 101 403 Jul-20 146 133 85 231 20 3 9 18 259 125 101 403 Aug-20 147 134 83 232 21 3 9 18 258 125 100 403 Sep-20 148 134 83 228 21 3 9 18 258 123 100 399 Oct-20 147 133 84 225 20 3 9 18 256 124 100 397 Nov-20 146 135 81 227 22 3 9 18 256 123 98 396 Dec-20 147 135 82 228 22 3 8 18 262 124 97 397 2020 Total 1,759 1,606 1,008 2,750 232 37 111 212 3,104 1,495 1,201 4,817 2020 Avg. 147 134 84 229 19 3 9 18 259 125 100 401 Month Retiree Ret+SP Ret+Ch(rn) Ret+Fam Retiree Ret+SP Ret+Ch(rn) Ret+Fam Retiree Ret+SP Ret+Ch(rn) Ret+Fam Jan-20 26 25 2 4 15 14 0 0 42 30 2 9 Feb-20 25 25 2 4 15 14 0 0 42 31 2 9 Mar-20 25 25 2 4 15 14 0 0 41 31 2 9 Apr-20 26 25 2 3 15 14 0 0 41 30 2 9 May-20 27 25 2 3 15 14 0 0 41 31 2 9 Jun-20 28 27 2 2 15 14 0 0 42 31 2 10 Jul-20 28 28 2 2 15 14 0 0 41 32 2 11 Aug-20 29 28 2 2 14 14 0 0 40 33 2 11 Sep-20 28 28 2 2 14 14 0 0 40 35 2 12 Oct-20 27 28 2 2 14 13 0 0 38 35 3 12 Nov-20 28 28 2 2 14 13 0 0 38 36 3 13 Dec-20 29 29 2 2 14 13 0 0 40 35 3 13 2020 Total 326 321 24 32 175 165 0 0 486 390 27 127 2020 Avg. 27 27 2 3 15 14 0 0 41 33 2 11 7 Actives Retirees Red Blue White City of Chandler Enrollment by Tier Plan Year 2020 Red Blue White 5705171v1 4/10/2015 * 8 City of Chandler 2021 Contributions and Expenses by Status and Plan Year-to-date through September 2021 Claims include capitation (allocated by claims paid year-to-date), but are unreduced for stop loss reimbursements. Expenses on these graphs are limited to self-insurance administrative fees, PCORI fees, and paid claims. The claims information by Active and Retiree status is approximate based on the status information reported to Blue Cross as of the date the claim was adjudicated. $1,353 $1,100 $924 $1,098 $1,598 $1,965 $876 $1,195 ($245) ($866) $48 ($97) -$1,500 -$1,000 -$500 $0 $500 $1,000 $1,500 $2,000 $2,500 Red Blue White All Plans $ per Employee per Month Active Surplus/(Deficit) by Plan Contributions Claims+Expenses Surplus/(Deficit) $1,073 $840 $735 $867 $3,525 $1,333 $946 $1,895 ($2,452) ($493) ($211) ($1,027) -$3,000 -$2,000 -$1,000 $0 $1,000 $2,000 $3,000 $4,000 Red Blue White All Plans $ per Employee per Month Retiree Surplus/(Deficit) by Plan Contributions Claims+Expenses Surplus/(Deficit) 89% 11% Enrollment Active % Retiree % 91% 9% Contributions Active Retiree 83% 17% Claims and Expenses Active Retiree 5705171v1 Rank Plan Medical/Rx Paid YTD Medical/Rx Paid in Excess of $350K Stop Loss Deductible 1 Red Plan $856,084 $506,084 2 Red Plan $427,272 $77,272 3 Blue Plan $282,437 $0 4 Red Plan $264,966 $0 5 White Plan $263,608 $0 6 Red Plan $260,463 $0 7 Red Plan $236,215 $0 8 White Plan $227,386 $0 9 White Plan $209,936 $0 10 White Plan $197,546 $0 11 Red Plan $179,499 $0 12 Red Plan $174,753 $0 13 Blue Plan $171,464 $0 14 Red Plan $150,075 $0 15 White Plan $141,551 $0 16 Red Plan $141,343 $0 17 Red Plan $140,579 $0 18 Red Plan $132,774 $0 19 Red Plan $128,554 $0 20 Red Plan $112,066 $0 21 Red Plan $107,090 $0 $4,805,659 $583,356 28.2% City of Chandler 2021 Incurred Medical Claims Paid in Excess of $100,000 Year-to-date through September 2021 9 Total of twenty-one claimants Percentage of Total Medical/Rx Paid: 28.2% 71.8% Large Claims All Other Medical/Rx Claims 5705171v1 Twelve Month Period Ending (a) Enrollment (b) Medical Claims Paid (c) Stop Loss Reimbursements (d)=(b)+(c) Net Medical Claims (e) Rx Paid (f)=(d)+(e) Net Claims (d)/(a) Net Medical Claims PEPM (e)/(a) Rx Claims PEPM Sep-20 20,367 $15,402,712 ($1,165,176) $14,237,536 $4,392,443 $18,629,979 $699.05 $215.66 Oct-20 20,388 $15,354,916 ($1,095,764) $14,259,152 $4,394,218 $18,653,370 $699.39 $215.53 Nov-20 20,392 $15,632,471 ($1,148,971) $14,483,499 $4,423,412 $18,906,911 $710.25 $216.92 Dec-20 20,405 $15,921,319 ($1,087,637) $14,833,682 $4,471,071 $19,304,753 $726.96 $219.12 Jan-21 20,421 $16,564,893 ($1,061,392) $15,503,501 $4,409,293 $19,912,794 $759.19 $215.92 Feb-21 20,423 $16,779,231 ($1,055,724) $15,723,506 $4,507,386 $20,230,893 $769.89 $220.70 Mar-21 20,424 $17,173,727 ($1,055,678) $16,118,049 $4,434,789 $20,552,838 $789.17 $217.14 Apr-21 20,426 $17,645,904 ($828,614) $16,817,290 $4,484,949 $21,302,239 $823.33 $219.57 May-21 20,424 $18,286,370 ($837,797) $17,448,573 $4,623,656 $22,072,229 $854.32 $226.38 Jun-21 20,439 $18,881,903 ($922,629) $17,959,274 $4,658,039 $22,617,313 $878.68 $227.90 Jul-21 20,448 $19,023,093 ($919,883) $18,103,210 $4,639,035 $22,742,245 $885.33 $226.87 Aug-21 20,454 $18,794,607 ($982,693) $17,811,914 $4,586,043 $22,397,956 $870.83 $224.21 Sep-21 20,470 $18,594,973 ($991,646) $17,603,327 $4,594,938 $22,198,264 $859.96 $224.47 Notes: Medical Claims Paid includes capitation. 10 City of Chandler Thirteen Month Snapshot - Medical and Rx Plan Paid Claims Through September 2021 $699 $699 $710 $727 $759 $770 $789 $823 $854 $879 $885 $871 $860 $0 $100 $200 $300 $400 $500 $600 $700 $800 $900 $1,000 Claims per Employee per Month 12-Month Period Ending Rolling Twelve Month Net Medical Claims PEPM Net Medical Trend 23.0% $216 $216 $217 $219 $216 $221 $217 $220 $226 $228 $227 $224 $224 $160 $170 $180 $190 $200 $210 $220 $230 $240 $250 $260 Claims per Employee per Month 12-Month Period Ending Rolling Twelve Month Rx Claims PEPM Rx Trend 4.1% 5705171v1