2024 Segal Monthly Reporting Medical
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Rachel Calisi, GBDS, CEBS Senior Health Consultant T 602.381.4027 M 480.490.7306 rcalisi@segalco.com 1501 West Fountainhead Parkway Suite 370 Tempe, AZ 85282-1936 segalco.com 5920055v1/00914.015 November 1, 2024 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, 2024 through December 31, 2024 – Data through September 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, 2024. For the month of September, Medical paid claims were approximately $1,649,500 while net Rx claims were about $516,000. For the 2024 plan year-to-date, claims and expenses (after stop- loss reimbursements and pharmacy rebates) exceeded contributions by approximately $2,812,400 or 13.7% of contributions. Based on paid claims and expenses, Actives and Retirees on the Red Plan and Blue Plan, as well as Retirees on the White 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 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 $125,689 per month from the estimated 2024 Operating Budget. These expenses exclude those funded by Blue Cross Blue Shield of Arizona. These expenses include categories such as wellness incentives, personnel support, audit & financial services, promotional, operating supplies & equipment, bank charges, contractual services, and health savings and flex account contributions. In September 2024, approximately 39.0% of all active employees and retirees were enrolled in the Red plan, with 5.0% enrolled in the Blue plan, and 56.0% enrolled in the White plan. The current average total enrollment in 2024 is approximately 2.4% higher than the 2023 average enrollment. Rae Lynn Nielsen November 1, 2024 Page 2 5920055v1/00914.015 This document has been prepared for the exclusive use and benefit of the City of Chandler, based upon information provided by you and your other service providers or otherwise made available to Segal at the time this document was created. Segal makes no representation or warranty as to the accuracy of any forward-looking statements and does not guarantee any particular outcome or result. Except as may be required by law, this document should not be shared, copied or quoted, in whole or in part, without the consent of Segal. This document does not constitute legal, tax or investment advice or create or imply a fiduciary relationship. You are encouraged to discuss any issues raised with your legal, tax and other advisors before taking, or refraining from taking, any action. I look forward to discussing this report with you. Sincerely yours, Rachel Calisi, GBDS, CEBS Senior Health Consultant City of Chandler (Data Through September 2024) 11/01/2024 Presented by: Rachel Calisi © 2024 by The Segal Group Inc. Medical/Rx Monthly Reporting: January 2024 - December 2024 Sep'24 Jan'24-Sep'24 Jan'23-Dec'23 Sep'24 Jan'24-Sep'24 Jan'23-Dec'23 Contributions (PEPM) $1,218.45 $1,218.57 $1,141.17 Avg. # of Employees 1,873 1,864 1,818 Net Paid Medical Claims (PEPM) $880.40 $908.05 $832.44 Avg. # of Members 4,740 4,726 4,678 Net Paid Rx Claims (PEPM) $275.48 $265.82 $248.75 Ratio Members to EEs 2.53 2.54 2.57 Total Claims (PEPM) $1,155.87 $1,173.87 $1,081.19 Age/Gender Index 1 - 0.944 0.980 Stop Loss & Adm Expenses (PEPM) $219.73 $212.11 $181.52 Total Claims & Expenses (PEPM) $1,375.60 $1,385.98 $1,262.71 Surplus/Deficit (PEPM) -$157.16 -$167.41 -$121.53 Loss Ratio 113% 114% 111% PEPM % Change -0.7% 9.8% Jan'24-Sep'24 Jan'23-Sep'23 % Change # of Claimants 26 21 23.8% $ of Medical/Rx Paid Claims $4,186,858 $5,610,319 -25.4% % of Medical/Rx Paid Claims 21.1% 29.8% -29.2% Jan'24-Sep'24 Jan'23-Dec'23 % Change Jan'24-Sep'24 Jan'23-Dec'23 % Change Bed Days/1,000 263.8 258.4 2.1% Generic (PEPM) $20.16 $32.38 -37.8% Avg Length of Stay 5.5 5.9 -7.2% Brand Preferred (PEPM) $169.60 $222.34 -23.7% Brand Non-Preferred (PEPM) $18.87 $11.86 59.0% Specialty (PEPM) $256.32 $171.40 49.5% Total (PEPM) $464.95 $437.98 6.2% Jan'24-Sep'24 Jan'23-Dec'23 % Change Jan'24-Sep'24 Jan'23-Dec'23 % Change In-Network Allowed % 96.8% 97.8% -1.0% Retail Scripts PMPY 7.46 10.92 -31.7% Discount from Billed5 67.7% 68.1% -0.6% Mail Order Scripts PMPY 0.27 0.39 -31.8% % Mail Order 3.5% 3.5% -0.2% Jan'24-Sep'24 Jan'23-Dec'23 % Change Generic Dispensing Rate 83.3% 82.6% 0.9% Jan'24-Sep'24 Jan'23-Dec'23 % Change Generic Plan Paid/Script $9.19 $13.35 -31.2% Member Cost Share % 16.3% 13.4% 21.9% Brand Plan Paid/Script $466.22 $483.48 -3.6% Plan Paid % 83.7% 86.6% -3.4% Specialty Plan Paid/Script $7,354.15 $6,098.62 20.6% Total Plan Paid/Script $176.58 $149.04 18.5% Inpatient Hospital City of Chandler HealthPlan Dashboard - Data thru September 2024 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. (6) In the April 2024 reporting, 2023 and YTD2024 data was updated to reflect more accurate experience pulled from the BCBS Whyzen system. 5913302 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-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% Jan-24 1,837 $2,255,077 $2,391,086 ($121,423) $410,269 $2,679,932 $327,895 $3,007,827 ($752,750) 133.4% Feb-24 1,871 $2,282,167 $1,181,504 ($92,637) $432,642 $1,521,510 $386,675 $1,908,185 $373,982 83.6% Mar-24 1,866 $2,276,847 $1,419,172 ($20,165) $414,950 $1,813,957 $395,792 $2,209,748 $67,098 97.1% Apr-24 1,861 $2,267,739 $1,725,393 ($8,572) $409,060 $2,125,881 $428,808 $2,554,689 ($286,950) 112.7% May-24 1,867 $2,269,373 $1,793,138 $0 $565,709 $2,358,847 $393,110 $2,751,957 ($482,584) 121.3% Jun-24 1,866 $2,268,861 $1,764,187 ($1,853) $591,275 $2,353,608 $390,143 $2,743,751 ($474,890) 120.9% Jul-24 1,879 $2,282,875 $1,783,173 ($67,503) $560,440 $2,276,109 $428,029 $2,704,139 ($421,264) 118.5% Aug-24 1,879 $2,285,642 $1,861,896 ($2,003) $565,136 $2,425,029 $401,274 $2,826,303 ($540,662) 123.7% Sep-24 1,873 $2,282,149 $1,649,463 ($477) $515,968 $2,164,953 $411,554 $2,576,508 ($294,358) 112.9% Oct-24 Nov-24 Dec-24 2024 Total 16,799 $20,470,729 $15,569,010 ($314,632) $4,465,449 $19,719,827 $3,563,280 $23,283,106 ($2,812,377) 113.7% 2024 Avg. 1,867 $2,274,525 $1,729,890 ($34,959) $496,161 $2,191,092 $395,920 $2,587,012 ($312,486) 113.7% 2 City of Chandler 2023-2024 Medical/Rx Contributions and Expenses Year-to-date through September 2024 (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. $3,007,827 $4,916,012 $7,125,760 $9,680,449 $12,432,405 $15,176,157 $17,880,295 $20,706,599 $23,283,106 $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 $- $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. 2024 vs 2023 Cumulative Paid Claims & Expenses 2024 Cumulative Claims & Expenses 2023 Cumulative Claims & Expenses 5913302 Red Blue White Total Red Blue White Total Red Blue White Total Jan-24 657 74 881 1,612 71 22 132 225 728 96 1,013 1,837 Feb-24 661 76 907 1,644 71 21 135 227 732 97 1,042 1,871 Mar-24 664 75 903 1,642 69 21 134 224 733 96 1,037 1,866 Apr-24 663 75 900 1,638 70 21 132 223 733 96 1,032 1,861 May-24 659 75 911 1,645 70 20 132 222 729 95 1,043 1,867 Jun-24 654 75 917 1,646 71 20 129 220 725 95 1,046 1,866 Jul-24 662 74 925 1,661 71 21 126 218 733 95 1,051 1,879 Aug-24 656 73 930 1,659 73 22 125 220 729 95 1,055 1,879 Sep-24 660 72 923 1,655 71 21 126 218 731 93 1,049 1,873 Oct-24 Nov-24 Dec-24 2024 Avg. 660 74 911 1,645 71 21 130 222 730 95 1,041 1,867 % of Total 35% 4% 49% 88% 4% 1% 7% 12% 39% 5% 56% 100% 2023 Avg. 650 69 881 1,600 75 22 126 223 725 91 1,007 1,822 % Change 1.4% 8.4% 3.4% 2.8% -5.0% -4.2% 3.0% -0.4% 0.7% 5.3% 3.4% 2.4% 3 City of Chandler 2024 Enrollment by Status and Plan Year-to-date through September 2024 TOTAL ACTIVE RETIREE 0 200 400 600 800 1,000 Jan-24 Feb-24 Mar-24 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Active Enrollment by Plan ACTIVE Red ACTIVE Blue ACTIVE White 0 50 100 150 Jan-24 Feb-24 Mar-24 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Retiree Enrollment by Plan RETIREE Red RETIREE Blue RETIREE White 5913302 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 2024 Medical/Rx Paid Claims by Plan and Status Year-to-date through September 2024 $1,669 $1,464 $716 $1,132 $2,026 $1,856 $1,398 $1,642 $1,703 $1,550 $801 $1,193 $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 -- 2024 Plan Year Actives '24 Retirees '24 All '24 $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 Claims Paid by Plan and Status -- 2023 Plan Year Actives '23 Retirees '23 All '23 5913302 Enrollment Contributions Claims & Expenses Active Loss Ratio Enrollment Contributions Claims & Expenses Retiree Loss Ratio Enrollment Contributions Total Claims & Expenses Total Loss Ratio All Plans 14,802 $18,491,736 $19,896,061 108% 1,997 $1,978,994 $3,701,677 187% 16,799 $20,470,729 $23,597,738 115% % of Total 88% 90% 84% 12% 10% 16% 100% 100% 100% Red Plan 5,936 $9,081,165 $11,164,633 123% 637 $781,862 $1,425,518 182% 6,573 $9,863,026 $12,590,151 128% % of Total 90% 92% 89% 10% 8% 11% 39% 48% 53% Blue Plan 669 $782,096 $1,120,862 143% 189 $187,943 $390,853 208% 858 $970,038 $1,511,715 156% % of Total 78% 81% 74% 22% 19% 26% 5% 5% 6% White Plan 8,197 $8,628,475 $7,610,566 88% 1,171 $1,009,189 $1,885,306 187% 9,368 $9,637,665 $9,495,872 99% % of Total 88% 90% 80% 13% 10% 20% 56% 47% 40% 04/10/2015 * 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 2024 Contributions and Paid Claims by Status and Plan Year-to-date through September 2024 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-24 Feb-24 Mar-24 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 $ 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 $4,000,000 Jan-24 Feb-24 Mar-24 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 $ Year-to-Date Retiree Contributions vs Claims and Expenses Contributions Claims & Expenses 5913302 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-24 181 148 95 233 37 4 16 17 292 101 93 395 Feb-24 185 147 100 229 37 4 17 18 310 104 94 399 Mar-24 188 149 99 228 36 4 17 18 309 102 93 399 Apr-24 190 146 101 226 34 5 18 18 310 100 93 397 May-24 190 144 100 225 34 5 19 17 315 106 94 396 Jun-24 184 142 100 228 34 5 19 17 321 104 95 397 Jul-24 191 144 100 227 34 5 18 17 321 105 99 400 Aug-24 190 141 98 227 33 5 18 17 321 105 99 405 Sep-24 193 142 98 227 32 5 18 17 317 105 97 404 Oct-24 Nov-24 Dec-24 2024 Total 1,692 1,303 891 2,050 311 42 160 156 2,816 932 857 3,592 2024 Avg. 188 145 99 228 35 5 18 17 313 104 95 399 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-24 35 30 4 2 13 8 0 1 65 42 7 18 Feb-24 35 29 4 3 12 8 0 1 65 44 7 19 Mar-24 33 29 4 3 12 8 0 1 65 44 7 18 Apr-24 33 30 4 3 13 7 0 1 65 43 7 17 May-24 33 30 4 3 12 7 0 1 65 41 7 19 Jun-24 34 30 4 3 12 7 0 1 64 41 7 17 Jul-24 33 30 5 3 12 7 1 1 62 40 7 17 Aug-24 32 32 6 3 12 7 1 2 62 39 7 17 Sep-24 31 31 6 3 11 7 1 2 61 40 7 18 Oct-24 Nov-24 Dec-24 2024 Total 299 271 41 26 109 66 3 11 574 374 63 160 2024 Avg. 33 30 5 3 12 7 0 1 64 42 7 18 6 City of Chandler Enrollment by Tier Year-to-date through September 2024 Red Blue White Actives Retirees Red Blue White 5913302 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 City of Chandler Enrollment by Tier Plan Year 2023 Red Blue White 7 Actives Retirees Red Blue White 5913302 04/10/2015 * 8 City of Chandler 2024 Contributions and Expenses by Status and Plan Year-to-date through September 2024 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. $1,530 $1,169 $1,053 $1,249 $1,881 $1,675 $928 $1,344 ($351) ($506) $124 ($95) -$2,000 -$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) $1,227 $994 $862 $991 $2,238 $2,068 $1,610 $1,854 ($1,010) ($1,074) ($748) ($863) -$2,000 -$1,500 -$1,000 -$500 $0 $500 $1,000 $1,500 $2,000 $2,500 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 84% 16% Claims and Expenses Active Retiree 5913302 Rank Plan Medical/Rx Paid YTD Medical/Rx Paid in Excess of $350K Stop Loss Deductible 1 Red Plan $323,707 $0 2 Red Plan $307,502 $0 3 White Plan $296,193 $0 4 White Plan $202,474 $0 5 Blue Plan $196,854 $0 6 Blue Plan $177,903 $0 7 Red Plan $169,015 $0 8 Red Plan $165,402 $0 9 Red Plan $158,942 $0 10 Red Plan $152,561 $0 11 Red Plan $152,332 $0 12 White Plan $150,835 $0 13 Blue Plan $145,952 $0 14 White Plan $141,843 $0 15 Red Plan $141,052 $0 16 Red Plan $139,349 $0 17 White Plan $138,410 $0 18 Red Plan $136,586 $0 19 Red Plan $130,369 $0 20 Blue Plan $116,494 $0 21 Red Plan $115,909 $0 22 Red Plan $114,722 $0 23 Red Plan $114,106 $0 24 White Plan $108,928 $0 25 White Plan $106,627 $0 26 Red Plan $105,506 $0 27 Red Plan $103,316 $0 $4,312,890 $0 21.5% City of Chandler 2024 Incurred Medical Claims Paid in Excess of $100,000 Year-to-date through September 2024 9 Total of twenty-seven claimants Percentage of Total Medical/Rx Paid: 21.5% 78.5% Large Claims All Other Medical/Rx Claims 5913302 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-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 Jan-24 21,892 $21,202,529 ($1,957,882) $19,244,647 $5,503,561 $24,748,208 $879.07 $251.40 Feb-24 21,954 $20,149,512 ($1,399,219) $18,750,293 $5,562,716 $24,313,009 $854.07 $253.38 Mar-24 22,010 $20,072,038 ($1,277,469) $18,794,569 $5,670,366 $24,464,935 $853.91 $257.63 Apr-24 22,068 $20,408,381 ($1,256,148) $19,152,232 $5,607,109 $24,759,341 $867.87 $254.08 May-24 22,120 $20,681,578 ($1,228,147) $19,453,431 $5,674,403 $25,127,835 $879.45 $256.53 Jun-24 22,161 $20,849,263 ($1,232,865) $19,616,398 $5,814,207 $25,430,605 $885.18 $262.36 Jul-24 22,213 $21,074,591 ($1,227,870) $19,846,720 $5,910,029 $25,756,750 $893.47 $266.06 Aug-24 22,272 $21,165,027 ($986,152) $20,178,875 $5,964,326 $26,143,201 $906.02 $267.79 Sep-24 22,310 $21,130,907 ($800,784) $20,330,123 $5,989,654 $26,319,777 $911.26 $268.47 Notes: Medical Claims Paid includes capitation. 10 City of Chandler Thirteen Month Snapshot - Medical and Rx Plan Paid Claims Through September 2024 $825 $833 $847 $832 $879 $854 $854 $868 $879 $885 $893 $906 $911 $780 $800 $820 $840 $860 $880 $900 $920 Claims per Employee per Month 12-Month Period Ending Rolling Twelve Month Net Medical Claims PEPM Net Medical Trend 10.4% $238 $239 $244 $249 $251 $253 $258 $254 $257 $262 $266 $268 $268 $160 $170 $180 $190 $200 $210 $220 $230 $240 $250 $260 $270 $280 Claims per Employee per Month 12-Month Period Ending Rolling Twelve Month Rx Claims PEPM Rx Trend 12.9% 5913302