471F0983-EB69-959C-3B62A289547CA11E.xlsx

This is a Paid & Incurred (P&I) Limited Liability Exhibit for Franklin County Cooperative Health Improvement Program (Plan ID: 157775), documenting long-term disability (LTD) claims experience and financial performance as of July 31, 2025. The exhibit covers a five-year experience period from January 1, 2020, through August 1, 2025, tracking claims activity for an average of 2,050 covered lives across the cooperative membership. The summary metrics reveal a total of 51 open and closed claims with 18 currently open claims, 34 denied claims, and 2 pending claims. Over the entire experience period, the program paid $1,516,944 in claims against $3,585,589 in paid premiums, with incurred claims totaling $2,693,725 when accounting for case reserves, incurred but not reported (IBNR) reserves, and investment credits. The incurred loss ratio (adjusted) across all periods averaged 0.788, indicating claims costs of approximately 79 cents per premium dollar received.

The detailed claim listing identifies 87 individual LTD claimants with specific disability dates, monthly gross benefits ranging from approximately $1,456 to $5,446, and various social security benefit coordination statuses. The majority of claimants have Social Security pending (SSP) status, with a significant portion already receiving Social Security benefits (SSA) or deemed ineligible for Social Security (NED). Claims span multiple years with active monthly indemnity payments totaling $42,702 during the current period, and substantial case reserves of $1,331,916 accumulated across open claims. Premium rates have remained consistent at 0.532 for most of the experience period, with adjusted annual premiums per employee averaging $334. The program demonstrates historical claims incidence of 5.13 per 1,000 covered lives with an average cost per claim of $50,989, reflecting the cooperative's disability risk profile and management of long-term disability benefits.