260125_10312025_2025-09_City_of_Tucson_Rolling_36_Claims_and_Enrollment.pdf
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- Solicitation number
- 260125
- Issued by
- Pima County, Tucson City, Arizona
About this file
This document is a medical and pharmacy claims report for the City of Tucson, covering a rolling 12-month period with Cigna as the self-funded insurance provider. The report provides a detailed monthly breakdown of subscriber and member counts, medical and pharmacy claims, and excess insurance (ISL) for three distinct time periods: prior 25-36 months, prior 13-24 months, and the most recent 12 months. The data tracks key metrics such as gross fee-for-service claims, net claims, capitation, and cost containment across multiple months from October through September.
The financial analysis reveals a consistent increase in total net claims per member per month (PMPM), with the most recent 12-month period showing a 9.7% increase over the previous period. Total net claims rose from $67,418,851 in the prior 13-24 months to $72,625,565 in the recent 12 months. The medical claims increased significantly from $42,042,862 to $47,421,273, while pharmacy claims also saw a slight uptick from $18,558,352 to $18,598,770. The report includes a detailed bar graph visualizing the year-to-date claims for medical and pharmacy expenses across the three time periods, providing a clear comparison of the city's healthcare expenditures.
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Text version
City of Tucson Medical & Pharmacy Historic - Rolling 12
Reporting Month: September 2025 Page 15
Prior 25-36 Months Prior 13-24 Months Recent 12 Months
Cigna Cigna Cigna
Self Funded Self Funded Self Funded
Subs Mbrs Medical Pharmacy ISL Excess Subs Mbrs Medical Pharmacy ISL Excess Subs Mbrs Medical Pharmacy ISL Excess
October 4,416 10,333 3,920,361$ 1,195,031$ 73,821$ 4,508 10,354 3,114,955$ 1,611,249$ -$ 4,521 10,271 3,635,761$ 1,661,127$ 7,621$
November 4,434 10,356 3,452,373 1,295,285 135,107 4,516 10,377 3,530,722 1,636,393 3,019 4,516 10,293 3,026,858 1,397,748 (501)
December 4,447 10,399 3,527,313 1,350,496 15,090 4,501 10,347 3,257,710 1,627,101 2,327 4,486 10,225 3,303,056 1,801,104 398
January 4,452 10,409 3,149,760 1,248,177 92,103 4,509 10,319 3,028,597 1,579,312 995 4,485 10,242 3,665,478 1,605,419 77
February 4,431 10,340 3,430,235 1,442,189 38,001 4,525 10,367 3,380,268 1,117,384 32,843 4,464 10,178 3,764,936 1,472,803 67
March 4,447 10,350 3,846,573 1,361,117 192,685 4,561 10,391 3,184,970 1,645,672 13,027 4,466 10,193 3,988,366 1,499,703 13
April 4,459 10,353 3,200,327 1,372,206 63,807 4,553 10,375 3,668,570 1,681,685 240,498 4,507 10,255 4,174,856 1,601,089 221
May 4,460 10,352 4,208,211 1,389,367 1,062,118 4,566 10,378 3,536,748 1,601,202 73,060 4,535 10,292 5,682,775 1,629,653 503,441
June 4,463 10,346 3,698,161 1,303,288 141,023 4,555 10,352 4,497,114 1,571,143 163,910 4,532 10,257 4,845,453 1,554,048 698,254
July 4,498 10,352 3,378,649 1,566,288 464,451 4,565 10,399 4,280,619 1,392,192 124,760 4,530 10,250 3,497,507 1,383,368 (74,501)
August 4,491 10,334 3,069,333 1,547,736 (5,349) 4,542 10,353 3,336,119 1,456,488 6,289 4,509 10,195 4,170,468 1,410,181 832
September 4,508 10,357 3,141,725 1,466,810 9,963 4,540 10,338 3,226,472 1,638,532 7,126 4,505 10,178 3,665,758 1,582,525 (76,339)
Total 53506 124,281 42,023,019$ 16,537,989$ 2,282,820$ 54441 124,350 42,042,862$ 18,558,352$ 667,854$ 54056 122,829 47,421,273$ 18,598,770$ 1,059,582$
Gross FFS Claims $58,561,008 $60,601,215 $66,020,043
ISL Excess $2,282,820 $667,854 $1,059,582
Net FFS Claims $56,278,187 $59,933,361 $64,960,462
Capitation $4,727,523 $4,856,264 $5,060,378
Cost Containment $1,360,470 $2,629,226 $2,604,726
Net Total $62,366,180 $67,418,851 $72,625,565
Avg Subs per Month 4459 4537 4505
Total Net Claims PEPM $1,165.59 $1,238.38 $1,343.52
Percent Over Prior N/A 6.2%▲• 8.5%▲•
Average Mbrs Per Month 10357 10363 10236
Total Net Claims PMPM $452.83 $481.97 $528.87
Percent Over Prior N/A 6.4%▲• 9.7%▲•
$42,023,019.03 $42,042,862.28
$47,421,273.07
$16,537,988.56 $18,558,352.26 $18,598,770.18
$0
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Prior 25-36 Months Prior 13-24 Months Recent 12 Months
YTD Claims
Medical
Pharmacy
McGriff | Employee Benefits Proprietary/Confidential - For McGriff and McGriff Client Use Only
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