Extracted text (via pymupdf)
22130 characters
5818577v1/00914.015
Rachel Calisi
Senior Health Consultant
T 602.381.4027
rcalisi@segalco.com
1501 West Fountainhead Parkway
Suite 370
Tempe, AZ 85282
segalco.com
February 8, 2024
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 December
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 December 31, 2023.
For the month of December, Medical paid claims were approximately $1,687,000 while net Rx
claims were about $485,000. For the 2023 plan year, claims and expenses (after stop-loss
reimbursements and pharmacy rebates) exceeded contributions by approximately $2,658,000
or 10.6% of contributions. Based on paid claims and expenses, Actives and Retirees on the Red
and White Plans, as well as Actives on the Blue Plan experienced an operating deficit, as
displayed on Page 8.
There are twenty-seven claimants with paid claims in excess of $100,000 during the reporting
period. There are six 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 December 2023, approximately 40.4% of all active employees and retirees were enrolled in
the Red plan, with 5.3% enrolled in the Blue plan, and 54.3% enrolled in the White plan. The
Ms. Rae Lynn Nielsen
February 8, 2024
Page 2
5818577v1/00914.015
current average total enrollment in 2023 is approximately 2.6% higher than the 2022 average
enrollment.
I look forward to discussing this report with you.
Sincerely yours,
Rachel Calisi
Senior Health Consultant
City of Chandler
(Data Through December 2023)
2/8/2024
Presented by: Rachel Calisi
© 2024 by The Segal Group Inc.
Medical/Rx Monthly Reporting:
January 2023 - December 2023
Dec'23
Jan'23-Dec'23
Jan'22-Dec'22
Dec'23
Jan'23-Dec'23
Jan'22-Dec'22
Contributions (PEPM)
$1,140.26
$1,141.17
$1,063.64
Avg. # of Employees
1,842
1,819
1,773
Net Paid Medical Claims (PEPM)
$797.90
$832.44
$847.10
Avg. # of Members
4,709
4,679
4,650
Net Paid Rx Claims (PEPM)
$263.09
$248.75
$201.38
Ratio Members to EEs
2.56
2.57
2.62
Total Claims (PEPM)
$1,060.99
$1,081.19
$1,048.48
Age/Gender Index 1
-
0.983
0.973
Stop Loss & Adm Expenses (PEPM)
$185.73
$181.52
$161.99
Total Claims & Expenses (PEPM)
$1,246.71
$1,262.71
$1,210.47
Surplus/Deficit (PEPM)
-$106.45
-$121.53
-$146.83
Loss Ratio
109%
111%
114%
PEPM % Change
-1.3%
4.3%
Jan'23-Dec'23
Jan'22-Dec'22
% Change
# of Claimants
27
38
-28.9%
$ of Medical/Rx Paid Claims
$6,513,266
$7,813,002
-16.6%
% of Medical/Rx Paid Claims
25.2%
33.3%
-24.4%
Jan'23-Dec'23
Jan'22-Dec'22
% Change
Jan'23-Dec'23
Jan'22-Dec'22
% Change
Bed Days/1,000
325.3
350.7
-7.3%
Generic (PEPM)
$32.50
$29.53
10.1%
Avg Length of Stay
6.7
6.9
-2.6%
Brand Preferred (PEPM)
$224.54
$227.47
-1.3%
Brand Non-Preferred (PEPM)
$11.98
$13.40
-10.7%
Specialty (PEPM)
$169.80
$106.53
59.4%
Total (PEPM)
$438.81
$376.94
16.4%
Jan'23-Dec'23
Jan'22-Dec'22
% Change
Jan'23-Dec'23
Jan'22-Dec'22
% Change
In-Network Allowed %
97.7%
97.3%
0.5%
Retail Scripts PMPY
14.40
14.19
1.5%
Discount from Billed5
69.0%
66.4%
4.1%
Mail Order Scripts PMPY
0.45
0.26
71.3%
% Mail Order
3.0%
1.8%
66.8%
Jan'23-Dec'23
Jan'22-Dec'22
% Change
Generic Dispensing Rate
81.4%
82.2%
-1.0%
Jan'23-Dec'23
Jan'22-Dec'22
% Change
Generic Plan Paid/Script
$10.56
$9.41
12.2%
Member Cost Share %
13.2%
13.4%
-1.7%
Brand Plan Paid/Script
$352.52
$368.71
-4.4%
Plan Paid %
86.8%
86.6%
0.3%
Specialty Plan Paid/Script
$5,004.49
$3,940.46
27.0%
Total Plan Paid/Script
$116.01
$98.71
17.5%
Inpatient Hospital
City of Chandler
HealthPlan Dashboard - Data thru December 2023
Income vs Paid Medical/Rx Claims + Expenses
Demographics
Large Claimants (> $100,000)
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.
5818498
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
1,803
$2,055,673
$1,389,050
($29,892)
$472,317
$1,831,474
$328,899
$2,160,373
($104,700)
105.1%
May-23
1,815
$2,067,151
$1,519,940
($28,001)
$498,414
$1,990,353
$347,770
$2,338,123
($270,973)
113.1%
Jun-23
1,825
$2,076,418
$1,596,502
$2,865
$451,471
$2,050,838
$340,928
$2,391,766
($315,348)
115.2%
Jul-23
1,827
$2,083,387
$1,557,845
($72,498)
$464,618
$1,949,965
$343,702
$2,293,667
($210,279)
110.1%
Aug-23
1,820
$2,082,858
$1,771,460
($243,721)
$510,839
$2,038,578
$334,372
$2,372,950
($290,092)
113.9%
Sep-23
1,835
$2,097,022
$1,683,582
($185,845)
$490,640
$1,988,377
$334,812
$2,323,189
($226,167)
110.8%
Oct-23
1,834
$2,092,480
$1,936,578
($162,907)
$502,805
$2,276,476
$343,721
$2,620,198
($527,718)
125.2%
Nov-23
1,835
$2,092,595
$1,937,863
($105,511)
$536,782
$2,369,134
$299,113
$2,668,247
($575,652)
127.5%
Dec-23
1,842
$2,100,360
$1,687,456
($217,733)
$484,618
$1,954,341
$342,106
$2,296,446
($196,086)
109.3%
2023 Total
21,868
$24,955,206
$20,569,398
($2,365,599)
$5,439,566
$23,643,364
$3,969,495
$27,612,859
($2,657,653)
110.6%
2023 Avg.
1,822
$2,079,601
$1,714,116
($197,133)
$453,297
$1,970,280
$330,791
$2,301,072
($221,471)
110.6%
2
City of Chandler
2022-2023 Medical/Rx Contributions and Expenses
Year-to-date through December 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
$8,308,272
$10,646,396
$13,038,162
$15,331,829
$17,704,779
$20,027,968
$22,648,166
$25,316,413
$27,612,859
$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
5818498
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
636
64
883
1,583
73
22
125
220
709
86
1,008
1,803
May-23
644
67
885
1,596
73
22
124
219
717
89
1,009
1,815
Jun-23
649
69
886
1,604
74
22
125
221
723
91
1,011
1,825
Jul-23
653
70
879
1,602
76
22
127
225
729
92
1,006
1,827
Aug-23
650
71
875
1,596
75
22
127
224
725
93
1,002
1,820
Sep-23
660
72
876
1,608
75
22
130
227
735
94
1,006
1,835
Oct-23
663
72
873
1,608
74
22
130
226
737
94
1,003
1,834
Nov-23
662
74
870
1,606
76
22
131
229
738
96
1,001
1,835
Dec-23
668
76
869
1,613
76
21
132
229
744
97
1,001
1,842
2023 Avg.
650
69
881
1,600
75
22
126
223
725
91
1,007
1,822
% of Total
36%
4%
48%
88%
4%
1%
7%
12%
40%
5%
55%
100%
2022 Avg.
604
64
892
1,559
77
26
114
217
681
90
1,005
1,776
% Change
8%
7%
-1%
3%
-4%
-15%
11%
3%
6%
1%
0%
3%
3
City of Chandler
2023 Enrollment by Status and Plan
Year-to-date through December 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
5818498
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 December 2023
$1,504
$1,223
$805
$1,107
$2,257
$598
$1,702
$1,779
$1,581
$1,072
$918
$1,189
$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
5818498
Enrollment
Contributions
Claims &
Expenses
Active
Loss Ratio Enrollment Contributions
Claims &
Expenses
Retiree
Loss Ratio Enrollment Contributions
Total Claims
& Expenses
Total Loss
Ratio
All Plans
19,195
$22,475,102
$24,738,506
110%
2,673
$2,480,104
$5,239,952
211%
21,868
$24,955,206
$29,978,458
120%
% of Total
88%
90%
83%
12%
10%
17%
100%
100%
100%
Red Plan
7,805
$11,175,487
$13,153,779
118%
894
$984,212
$2,180,051
222%
8,699
$12,159,700
$15,333,830
126%
% of Total
90%
92%
86%
10%
8%
14%
40%
49%
51%
Blue Plan
823
$878,786
$1,155,959
132%
263
$245,002
$204,873
84%
1,086
$1,123,787
$1,360,832
121%
% of Total
76%
78%
85%
24%
22%
15%
5%
5%
5%
White Plan
10,567
$10,420,829
$10,428,768
100%
1,516
$1,250,891
$2,855,028
228%
12,083
$11,671,719
$13,283,796
114%
% of Total
87%
89%
79%
13%
11%
21%
55%
47%
44%
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 December 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.
$-
$5,000,000
$10,000,000
$15,000,000
$20,000,000
$25,000,000
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
$-
$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
Retiree Contributions vs Claims and Expenses
Contributions
Claims & Expenses
5818498
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
174
137
95
230
31
7
12
14
291
98
88
406
May-23
177
140
95
232
33
7
13
14
297
96
88
404
Jun-23
183
143
95
228
33
8
13
15
297
94
88
407
Jul-23
183
141
96
233
34
8
12
16
295
93
88
403
Aug-23
178
140
95
237
34
8
13
16
292
93
88
402
Sep-23
184
143
95
238
33
8
13
18
295
94
87
400
Oct-23
187
143
97
236
35
6
12
19
294
94
88
397
Nov-23
187
142
98
235
35
6
13
20
297
93
85
395
Dec-23
189
148
96
235
36
6
14
20
298
93
86
392
2023 Total
2,162
1,683
1,138
2,822
398
85
152
188
3,534
1,152
1,059
4,822
2023 Avg.
180
140
95
235
33
7
13
16
295
96
88
402
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
40
28
3
2
12
9
0
1
54
48
6
17
May-23
40
28
3
2
12
9
0
1
53
48
6
17
Jun-23
40
29
3
2
12
9
0
1
53
47
6
19
Jul-23
39
32
3
2
12
9
0
1
55
45
7
20
Aug-23
38
32
3
2
12
9
0
1
54
45
7
21
Sep-23
38
32
3
2
12
9
0
1
58
44
7
21
Oct-23
37
32
3
2
12
9
0
1
59
43
7
21
Nov-23
39
32
3
2
12
9
0
1
58
43
7
23
Dec-23
39
32
3
2
11
9
0
1
57
44
7
24
2023 Total
469
365
36
24
143
108
0
12
661
552
73
230
2023 Avg.
39
30
3
2
12
9
0
1
55
46
6
19
6
City of Chandler
Enrollment by Tier
Year-to-date through December 2023
Red
Blue
White
Actives
Retirees
Red
Blue
White
5818498
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
City of Chandler
Enrollment by Tier
Plan Year 2022
Red
Blue
White
7
Actives
Retirees
Red
Blue
White
5818498
4/10/2015
*
8
City of Chandler
2023 Contributions and Expenses by Status and Plan
Year-to-date through December 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.
$1,432
$1,068
$986
$1,171
$1,685
$1,405
$987
$1,289
($253)
($337)
($1)
($118)
-$2,000
-$1,500
-$1,000
-$500
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
Red
Blue
White
All Plans
$ per Employee per Month
Active Surplus/(Deficit) by Plan
Contributions
Claims+Expenses
Surplus/(Deficit)
$1,101
$932
$825
$928
$2,439
$779
$1,883
$1,960
($1,338)
$153
($1,058)
($1,032)
-$2,000
-$1,500
-$1,000
-$500
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
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
83%
17%
Claims and Expenses
Active
Retiree
5818498
Rank
Plan
Medical/Rx Paid YTD
Medical/Rx Paid in Excess of
$350K Stop Loss Deductible
1
White Plan
$895,229
$545,229
2
Red Plan
$522,664
$172,664
3
White Plan
$513,772
$163,772
4
Red Plan
$422,278
$72,278
5
White Plan
$379,134
$29,134
6
White Plan
$370,150
$20,150
7
White Plan
$308,742
$0
8
Blue Plan
$304,277
$0
9
White Plan
$294,730
$0
10
Red Plan
$223,878
$0
11
Red Plan
$202,659
$0
12
White Plan
$178,499
$0
13
Red Plan
$166,610
$0
14
Red Plan
$155,423
$0
15
Red Plan
$140,650
$0
16
Red Plan
$138,048
$0
17
White Plan
$134,743
$0
18
White Plan
$129,158
$0
19
White Plan
$124,892
$0
20
Red Plan
$123,213
$0
21
Red Plan
$120,947
$0
22
Red Plan
$119,213
$0
23
Red Plan
$116,680
$0
24
Blue Plan
$112,406
$0
25
Red Plan
$109,210
$0
26
Red Plan
$104,778
$0
27
Red Plan
$101,281
$0
$6,513,266
$1,003,227
25.0%
City of Chandler
2023 Incurred Medical Claims Paid in Excess of $100,000
Year-to-date through December 2023
9
Total of twenty-seven claimants
Percentage of Total Medical/Rx Paid:
25.0%
75.0%
Large Claims
All Other Medical/Rx Claims
5818498
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
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
Apr-23
21,536
$21,043,923
($2,463,869)
$18,580,054
$4,622,683
$23,202,738
$862.74
$214.65
May-23
21,600
$21,485,380
($2,413,549)
$19,071,831
$4,803,572
$23,875,402
$882.96
$222.39
Jun-23
21,665
$21,202,631
($2,310,632)
$18,891,999
$4,839,277
$23,731,276
$872.01
$223.37
Jul-23
21,741
$20,677,694
($2,308,329)
$18,369,365
$4,967,746
$23,337,111
$844.92
$228.50
Aug-23
21,775
$20,600,656
($2,325,058)
$18,275,598
$5,051,159
$23,326,757
$839.29
$231.97
Sep-23
21,802
$20,360,474
($2,372,550)
$17,987,924
$5,183,108
$23,171,032
$825.06
$237.74
Oct-23
21,827
$20,592,710
($2,416,356)
$18,176,354
$5,218,967
$23,395,321
$832.75
$239.11
Nov-23
21,847
$20,809,299
($2,295,752)
$18,513,547
$5,338,914
$23,852,460
$847.42
$244.38
Dec-23
21,868
$20,569,398
($2,365,599)
$18,203,798
$5,439,566
$23,643,364
$832.44
$248.75
Notes:
Medical Claims Paid includes capitation.
10
City of Chandler
Thirteen Month Snapshot - Medical and Rx Plan Paid Claims Through December 2023
$847 $841
$856 $846
$863
$883
$872
$845
$839
$825
$833
$847
$832
$790
$800
$810
$820
$830
$840
$850
$860
$870
$880
$890
Claims per Employee per Month
12-Month Period Ending
Rolling Twelve Month Net Medical Claims PEPM
Net Medical Trend -1.7%
$201 $202
$208 $208
$215
$222 $223
$228 $232
$238 $239
$244 $249
$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 23.5%
5818498