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5764583v1/00914.015 Rachel Calisi Senior Health Consultant T 602.381.4027 rcalisi@segalco.com 1501 West Fountainhead Parkway, Suite 370 Tempe, AZ 85282 segalco.com May 24, 2023 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, 2023 through December 31, 2023 – Data through March 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 March 31, 2023. For the month of March, Medical paid claims were approximately $1,497,000 while net Rx claims were about $307,000. For the 2023 plan year-to-date, contributions exceeded claims and expenses (after stop-loss reimbursements and pharmacy rebates) by approximately $59,400 or 1.0% of contributions. Based on paid claims and expenses, all Actives and Retirees on the Red Plan, as well as Actives on the Blue Plan, and Retirees on the White Plan experienced an operating deficit, as displayed on Page 8. There are three claimants with paid claims in excess of $100,000 during the reporting period. There are no individuals in the current plan year who have exceeded the stop loss deductible of $350,000. Expenses included in this report are medical plan administration, stop-loss premium, capitation for behavioral health & chiropractic services, value based services, out-of-network shared savings costs, HSA administration, and fees associated with the Affordable Care Act. Also included is the amount of $99,454 per month from the 2023 Operating Budget. These expenses exclude those funded by Blue Cross Blue Shield of Arizona. These expenses include categories such as wellness incentives, wellness portal, personnel support, audit & financial services, promotional, operating supplies & equipment, bank charges, contractual services, IT reports, and health savings and flex account contributions. In March 2023, approximately 39.7% of all active employees and retirees were enrolled in the Red plan, with 4.6% enrolled in the Blue plan, and 55.7% enrolled in the White plan. At the end 5764583v1/00914.015 Ms. Rae Lynn Nielsen May 24, 2023 Page 2 of 2022, approximately 39.4% of enrollment was in the Red plan, 5.2% in the Blue plan and 55.4% in the White plan. The current average total enrollment in 2023 is approximately 2.0% higher than the 2022 average enrollment. The Coronavirus (COVID-19) pandemic has impacted the US economy and health plan claim’s history and projections for most Health Plan Sponsors. Realized trends in the prior year could be significantly different in the current year 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 City of Chandler (Data Through March 2023) 5/24/2023 Presented by: Rachel Calisi © 2023 by The Segal Group Inc. Medical/Rx Monthly Reporting: January 2023 - December 2023 Mar'23 Jan'23-Mar'23 Jan'22-Dec'22 Mar'23 Jan'23-Mar'23 Jan'22-Dec'22 Contributions (PEPM) $1,143.18 $1,142.72 $1,063.64 Avg. # of Employees 1,810 1,808 1,773 Net Paid Medical Claims (PEPM) $748.47 $767.08 $847.10 Avg. # of Members 4,683 4,678 4,650 Net Paid Rx Claims (PEPM) $169.78 $189.08 $201.38 Ratio Members to EEs 2.59 2.59 2.62 Total Claims (PEPM) $918.25 $956.15 $1,048.48 Age/Gender Index 1 - 0.979 0.973 Stop Loss & Adm Expenses (PEPM) $177.82 $175.64 $161.99 Total Claims & Expenses (PEPM) $1,096.07 $1,131.79 $1,210.47 Surplus/Deficit (PEPM) $47.11 $10.93 -$146.83 Loss Ratio 96% 99% 114% PEPM % Change -3.2% -6.5% Jan'23-Mar'23 Jan'22-Mar'22 % Change # of Claimants 3 3 0.0% $ of Medical/Rx Paid Claims $389,155 $406,028 -4.2% % of Medical/Rx Paid Claims 5.9% 7.8% -24.1% Jan'23-Mar'23 Jan'22-Dec'22 % Change Jan'23-Mar'23 Jan'22-Dec'22 % Change Bed Days/1,000 481.4 350.7 37.2% Generic (PEPM) $32.60 $29.53 10.4% Avg Length of Stay 8.3 6.9 20.3% Brand Preferred (PEPM) $223.81 $227.47 -1.6% Brand Non-Preferred (PEPM) $12.38 $13.40 -7.6% Specialty (PEPM) $102.40 $106.53 -3.9% Total (PEPM) $371.19 $376.94 -1.5% Jan'23-Mar'23 Jan'22-Dec'22 % Change Jan'23-Mar'23 Jan'22-Dec'22 % Change In-Network Allowed % 98.4% 97.3% 1.2% Retail Scripts PMPY 3.63 14.19 -74.4% Discount from Billed5 71.2% 66.4% 7.3% Mail Order Scripts PMPY 0.08 0.26 -69.8% % Mail Order 2.1% 1.8% 17.7% Jan'23-Mar'23 Jan'22-Dec'22 % Change Generic Dispensing Rate 81.4% 82.2% -0.9% Jan'23-Mar'23 Jan'22-Dec'22 % Change Generic Plan Paid/Script $10.19 $9.41 8.3% Member Cost Share % 17.6% 13.4% 31.3% Brand Plan Paid/Script $337.65 $368.71 -8.4% Plan Paid % 82.4% 86.6% -4.9% Specialty Plan Paid/Script $3,407.66 $3,940.46 -13.5% Total Plan Paid/Script $94.47 $98.71 -4.3% 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. (5) Dashboard Large Claims data is taken from the BCBSAZ Whyzen reporting tool, which is a utilization "snapshot in time" possibly resulting in a difference between the dashboard and the monthly report. Inpatient Hospital City of Chandler HealthPlan Dashboard - Data thru March 2023 Income vs Paid Medical/Rx Claims + Expenses Demographics Large Claimants (> $100,000) 5764574 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-22 1,760 $1,871,210 $1,507,401 ($191,783) $326,101 $1,641,719 $281,799 $1,923,518 ($52,308) 102.8% Feb-22 1,756 $1,865,487 $1,231,204 ($21,351) $235,866 $1,445,719 $284,154 $1,729,873 $135,614 92.7% Mar-22 1,747 $1,857,678 $1,649,945 ($117,877) $288,374 $1,820,442 $283,206 $2,103,648 ($245,971) 113.2% Apr-22 1,748 $1,858,559 $818,074 $123,627 $318,247 $1,259,948 $283,190 $1,543,138 $315,421 83.0% May-22 1,751 $1,861,273 $1,078,484 ($78,321) $317,526 $1,317,688 $280,830 $1,598,519 $262,755 85.9% Jun-22 1,760 $1,873,065 $1,879,251 ($100,053) $415,766 $2,194,964 $287,330 $2,482,294 ($609,229) 132.5% Jul-22 1,751 $1,866,769 $2,082,781 ($74,800) $336,149 $2,344,130 $283,699 $2,627,829 ($761,060) 140.8% Aug-22 1,786 $1,900,415 $1,848,497 ($226,992) $427,426 $2,048,932 $287,501 $2,336,433 ($436,018) 122.9% Sep-22 1,808 $1,923,563 $1,923,765 ($138,353) $358,691 $2,144,102 $289,810 $2,433,912 ($510,349) 126.5% Oct-22 1,809 $1,924,393 $1,704,342 ($119,102) $466,946 $2,052,187 $308,866 $2,361,053 ($436,660) 122.7% Nov-22 1,815 $1,930,281 $1,721,274 ($226,115) $416,835 $1,911,995 $290,621 $2,202,616 ($272,336) 114.1% Dec-22 1,821 $1,935,584 $1,927,357 ($147,886) $383,966 $2,163,436 $291,273 $2,454,710 ($519,126) 126.8% 2022 Total 21,312 $22,668,277 $19,372,376 ($1,319,006) $4,291,893 $22,345,263 $3,452,281 $25,797,543 ($3,129,267) 113.8% 2022 Avg. 1,776 $1,889,023 $1,614,365 ($109,917) $357,658 $1,862,105 $287,690 $2,149,795 ($260,772) 113.8% Jan-23 1,813 $2,072,635 $1,757,955 ($529,140) $346,274 $1,575,089 $310,806 $1,885,895 $186,740 91.0% Feb-23 1,809 $2,065,461 $2,234,521 ($651,299) $373,487 $1,956,708 $321,404 $2,278,112 ($212,651) 110.3% Mar-23 1,810 $2,069,164 $1,496,646 ($141,915) $307,300 $1,662,031 $321,862 $1,983,893 $85,271 95.9% Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 2023 Total 5,432 $6,207,260 $5,489,121 ($1,322,354) $1,027,061 $5,193,828 $954,071 $6,147,900 $59,361 99.0% 2023 Avg. 1,811 $2,069,087 $1,829,707 ($440,785) $342,354 $1,731,276 $318,024 $2,049,300 $19,787 99.0% 2 City of Chandler 2022-2023 Medical/Rx Contributions and Expenses Year-to-date through March 2023 (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. (5) Enrollment may change retrospectively based on updated BCBSAZ reporting. $1,885,895 $4,164,007 $6,147,900 $1,923,518 $3,653,391 $5,757,039 $7,300,177 $8,898,696 $11,380,990 $14,008,819 $16,345,252 $18,779,164 $21,140,217 $23,342,834 $25,797,543 $- $5,000,000 $10,000,000 $15,000,000 $20,000,000 $25,000,000 $30,000,000 Jan. Feb. Mar. Apr. May Jun. Jul. Aug. Sept. Oct. Nov. Dec. 2023 vs 2022 Cumulative Paid Claims & Expenses 2023 Cumulative Claims & Expenses 2022 Cumulative Claims & Expenses 5764574 Red Blue White Total Red Blue White Total Red Blue White Total Jan-23 639 63 895 1,597 73 22 121 216 712 85 1,016 1,813 Feb-23 637 63 891 1,591 75 22 121 218 712 85 1,012 1,809 Mar-23 644 62 885 1,591 74 22 123 219 718 84 1,008 1,810 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 2023 Avg. 640 63 890 1,593 74 22 122 218 714 85 1,012 1,811 % of Total 35% 3% 49% 88% 4% 1% 7% 12% 39% 5% 56% 100% 2022 Avg. 604 64 892 1,559 77 26 114 217 681 90 1,005 1,776 % Change 6% -2% 0% 2% -4% -15% 7% 1% 5% -6% 1% 2% 3 City of Chandler 2023 Enrollment by Status and Plan Year-to-date through March 2023 TOTAL ACTIVE RETIREE 0 500 1,000 Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Active Enrollment by Plan ACTIVE Red ACTIVE Blue ACTIVE White 0 20 40 60 80 100 120 140 Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Retiree Enrollment by Plan RETIREE Red RETIREE Blue RETIREE White 5764574 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 2023 Medical/Rx Paid Claims by Plan and Status Year-to-date through March 2023 $1,806 $1,216 $673 $1,150 $2,874 $488 $965 $1,566 $1,916 $1,027 $708 $1,200 $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 -- 2023 Plan Year Actives '23 Retirees '23 All '23 $1,494 $1,158 $727 $1,041 $2,343 $1,523 $1,127 $1,608 $1,590 $1,263 $772 $1,110 $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 Claims Paid by Plan and Status -- 2022 Plan Year Actives '22 Retirees '22 All '22 5764574 Enrollment Contributions Claims & Expenses Active Loss Ratio Enrollment Contributions Claims & Expenses Retiree Loss Ratio Enrollment Contributions Total Claims & Expenses Total Loss Ratio All Plans 4,779 $5,605,027 $6,333,252 113% 653 $602,233 $1,137,002 189% 5,432 $6,207,260 $7,470,254 120% % of Total 88% 90% 85% 12% 10% 15% 100% 100% 100% Red Plan 1,920 $2,771,264 $3,804,344 137% 222 $243,012 $676,874 279% 2,142 $3,014,276 $4,481,218 149% % of Total 90% 92% 85% 10% 8% 15% 39% 49% 60% Blue Plan 188 $195,783 $261,604 134% 66 $61,424 $43,802 71% 254 $257,207 $305,406 119% % of Total 74% 76% 86% 26% 24% 14% 5% 4% 4% White Plan 2,671 $2,637,980 $2,267,303 86% 365 $297,797 $416,326 140% 3,036 $2,935,777 $2,683,629 91% % of Total 88% 90% 84% 12% 10% 16% 56% 47% 36% 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 2023 Contributions and Paid Claims by Status and Plan Year-to-date through March 2023 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. $- $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 $6,000,000 Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 $ Year-to-Date Active Contributions vs Claims and Expenses $- $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 $ Year-to-Date Retiree Contributions vs Claims and Expenses Contributions Claims & Expenses 5764574 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-23 171 137 91 240 31 7 13 12 293 105 93 404 Feb-23 173 133 92 239 32 7 12 12 294 100 91 406 Mar-23 176 136 93 239 31 7 12 12 291 99 89 406 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 2023 Total 520 406 276 718 94 21 37 36 878 304 273 1,216 2023 Avg. 173 135 92 239 31 7 12 12 293 101 91 405 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-23 39 29 3 2 12 9 0 1 52 49 4 16 Feb-23 40 30 3 2 12 9 0 1 54 48 4 15 Mar-23 40 29 3 2 12 9 0 1 54 48 5 16 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 2023 Total 119 88 9 6 36 27 0 3 160 145 13 47 2023 Avg. 40 29 3 2 12 9 0 1 53 48 4 16 6 City of Chandler Enrollment by Tier Year-to-date through March 2023 Red Blue White Actives Retirees Red Blue White 5764574 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-22 148 136 81 226 26 6 10 14 277 117 100 415 Feb-22 145 136 81 223 26 7 10 14 278 115 99 413 Mar-22 141 136 81 222 25 8 10 14 278 111 99 410 Apr-22 144 135 82 223 25 8 10 14 278 110 97 407 May-22 146 132 83 225 28 9 11 14 276 110 96 405 Jun-22 151 134 85 225 28 9 12 15 271 110 96 405 Jul-22 149 133 87 225 29 9 12 15 268 107 94 403 Aug-22 154 137 89 229 33 8 13 16 277 109 93 407 Sep-22 158 140 91 232 32 8 14 16 284 110 91 409 Oct-22 163 132 90 240 29 8 15 16 292 107 89 406 Nov-22 168 133 91 243 31 8 15 16 292 105 89 405 Dec-22 173 133 91 242 32 7 15 17 291 105 90 406 2022 Total 1,840 1,617 1,032 2,755 344 95 147 181 3,362 1,316 1,133 4,891 2022 Avg. 153 135 86 230 29 8 12 15 280 110 94 408 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-22 33 32 5 3 14 13 0 0 47 44 4 9 Feb-22 34 33 5 3 14 12 0 1 48 44 4 11 Mar-22 33 34 5 3 14 12 0 1 48 45 4 13 Apr-22 36 33 5 3 14 12 0 1 47 45 4 15 May-22 37 34 4 3 14 12 0 1 49 44 3 15 Jun-22 37 34 4 3 14 12 0 1 50 44 3 17 Jul-22 37 35 4 3 14 11 0 1 48 47 3 17 Aug-22 37 35 4 3 14 10 0 1 49 47 4 17 Sep-22 36 35 4 4 14 10 0 1 50 48 4 17 Oct-22 37 35 4 3 13 10 0 1 51 48 3 17 Nov-22 37 33 4 3 13 10 0 1 52 46 4 16 Dec-22 38 32 4 4 12 10 0 1 52 46 4 16 2022 Total 432 405 52 38 164 134 0 11 591 548 44 180 2022 Avg. 36 34 4 3 14 11 0 1 49 46 4 15 7 Actives Retirees Red Blue White City of Chandler Enrollment by Tier Plan Year 2022 Red Blue White 5764574 4/10/2015 * 8 City of Chandler 2023 Contributions and Expenses by Status and Plan Year-to-date through March 2023 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. $1,443 $1,041 $988 $1,173 $1,981 $1,392 $849 $1,325 ($538) ($350) $139 ($152) -$3,000 -$2,000 -$1,000 $0 $1,000 $2,000 $3,000 $4,000 Red Blue White All Plans $ per Employee per Month Active Surplus/(Deficit) by Plan Contributions Claims+Expenses Surplus/(Deficit) $1,095 $931 $816 $922 $3,049 $664 $1,141 $1,741 ($1,954) $267 ($325) ($819) -$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) 88% 12% Enrollment Active % Retiree % 90% 10% Contributions Active Retiree 85% 15% Claims and Expenses Active Retiree 5764574 Rank Plan Medical/Rx Paid YTD Medical/Rx Paid in Excess of $350K Stop Loss Deductible 1 Red Medical Plan $145,081 $0 2 Red Medical Plan $125,041 $0 3 Red Medical Plan $119,033 $0 $389,155 $0 6.0% City of Chandler 2023 Incurred Medical Claims Paid in Excess of $100,000 Year-to-date through March 2023 9 Total of three claimants Percentage of Total Medical/Rx Paid: 6.0% 94.0% Large Claims All Other Medical/Rx Claims 5764574 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 Mar-22 20,759 $18,599,010 ($1,467,858) $17,131,152 $4,318,659 $21,449,811 $825.24 $208.04 Apr-22 20,804 $17,892,540 ($1,342,629) $16,549,911 $4,248,338 $20,798,250 $795.52 $204.21 May-22 20,852 $17,256,995 ($1,337,393) $15,919,602 $4,171,528 $20,091,131 $763.46 $200.05 Jun-22 20,890 $17,495,942 ($1,303,057) $16,192,886 $4,212,930 $20,405,815 $775.15 $201.67 Jul-22 20,924 $18,229,093 ($1,273,388) $16,955,705 $4,188,716 $21,144,421 $810.35 $200.19 Aug-22 20,996 $18,725,563 ($1,369,990) $17,355,574 $4,236,868 $21,592,441 $826.61 $201.79 Sep-22 21,087 $19,317,256 ($1,376,623) $17,940,633 $4,216,574 $22,157,206 $850.79 $199.96 Oct-22 21,163 $19,420,783 ($1,375,851) $18,044,932 $4,260,514 $22,305,446 $852.66 $201.32 Nov-22 21,243 $19,475,389 ($1,417,669) $18,057,719 $4,332,196 $22,389,915 $850.06 $203.94 Dec-22 21,312 $19,372,376 ($1,319,006) $18,053,370 $4,291,893 $22,345,263 $847.10 $201.38 Jan-23 21,365 $19,622,929 ($1,656,363) $17,966,567 $4,312,066 $22,278,633 $840.93 $201.83 Feb-23 21,418 $20,626,247 ($2,286,311) $18,339,935 $4,449,687 $22,789,622 $856.29 $207.75 Mar-23 21,481 $20,472,947 ($2,310,350) $18,162,598 $4,468,614 $22,631,211 $845.52 $208.03 Notes: Medical Claims Paid includes capitation. 10 City of Chandler Thirteen Month Snapshot - Medical and Rx Plan Paid Claims Through March 2023 $825 $796 $763 $775 $810 $827 $851 $853 $850 $847 $841 $856 $846 $700 $720 $740 $760 $780 $800 $820 $840 $860 $880 Claims per Employee per Month 12-Month Period Ending Rolling Twelve Month Net Medical Claims PEPM Net Medical Trend 2.5% $208 $204 $200 $202 $200 $202 $200 $201 $204 $201 $202 $208 $208 $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 0.0% 5764574