7-ATTACHMENT G - 2023 YTD Claim Analysis.pdf

December 2023

Presented by

This analysis is for illustrative purposes only, and is not a guarantee of future expenses, claims costs, managed care savings, etc. There are many variables that can affect future health care costs including utilization patterns, catastrophic claims, changes in plan design, health care trend increases, etc. This analysis does not amend, extend, or alter the coverage provided by the actual insurance policies and contracts. Please see your policy or contact us for specific information or further details in this regard.

January 01, 2023 - December 31, 2023

A Self-Insured Evaluation

YTD CLAIM ANALYSIS

PREPARED EXCLUSIVELY FOR:

Austin ISD

Financial Monitoring Report - Austin ISD Total Plan Summary

Reporting as of December 31, 2023

Carrier: Aetna/CVS Specific Deductible: $1,000,000 Contract Type: Paid Plan Year: 1/1/2023 - 12/31/2023

Paid Month Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Total PEPM

Enrollment

Subscribers1 9,032 9,066 9,048 9,046 9,028 8,987 8,949 8,819 9,254 9,366 9,384 9,402

Members1 12,452 12,494 12,480 12,491 12,473 12,419 12,371 12,229 12,770 12,903 12,926 12,951 Contract Size 1.38 1.38 1.38 1.38 1.38 1.38 1.38 1.39 1.38 1.38 1.38 1.38

Claim Payments Medical Claims $3,166,622 $2,578,027 $2,958,792 $2,737,113 $3,087,866 $3,527,781 $3,749,975 $3,421,579 $3,682,493 $4,477,933 $3,448,413 $4,084,093 $40,920,687 $374.11 Pharmacy Claims $1,449,351 $1,525,981 $1,364,514 $1,537,366 $1,650,286 $1,909,860 $1,686,058 $1,709,390 $1,927,149 $1,833,454 $2,118,650 $2,063,534 $20,775,593 $189.94 Pharmacy Rebates $0 $0 ($1,774,922) $0 $0 ($1,873,604) $0 $0 ($1,972,336) $0 $0 ($2,064,640) ($7,685,502) ($70.26) Claim Wire Billing $0 $0 ($9,748) $40,823 ($293,851) ($293,851) $334,582 $0 $0 $0 $40,658 $0 ($181,387) ($1.66) Claims Over Specific $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0.00 Total Net Claim Payments $4,615,974 $4,104,008 $2,538,636 $4,315,301 $4,444,301 $3,270,186 $5,770,615 $5,130,969 $3,637,305 $6,311,387 $5,607,721 $4,082,988 $53,829,391 $492.13

Fixed Costs Administrative Fees $334,365 $335,649 $334,931 $334,742 $334,100 $332,515 $331,004 $326,284 $342,521 $346,712 $347,392 $348,109 $4,048,325 $37.01 Stop Loss Premiums $64,730 $64,979 $64,840 $64,803 $64,679 $64,372 $64,079 $63,166 $66,309 $67,120 $67,252 $67,391 $783,720 $7.17 HSA Contribution $510,125 $513,000 $511,875 $512,000 $510,000 $507,000 $504,875 $495,375 $536,500 $547,125 $549,375 $550,250 $6,247,500 $57.12 Total Fixed Costs $909,220 $913,627 $911,646 $911,546 $908,779 $903,886 $899,959 $884,825 $945,330 $960,958 $964,019 $965,750 $11,079,545 $101.29

Total Plan Cost $5,525,193 $5,017,636 $3,450,282 $5,226,846 $5,353,080 $4,174,072 $6,670,573 $6,015,794 $4,582,635 $7,272,345 $6,571,740 $5,048,738 $64,908,936 $593.42

Employee Contributions2 $878,624 $882,407 $881,222 $882,716 $883,679 $880,585 $878,886 $869,977 $886,992 $891,466 $890,587 $894,954 $10,602,094 $96.93 Employer Cost $4,646,569 $4,135,229 $2,569,060 $4,344,130 $4,469,401 $3,293,487 $5,791,688 $5,145,817 $3,695,644 $6,380,879 $5,681,153 $4,153,784 $54,306,841 $496.49

Budget Comparison

Budgeted Cost2 $6,067,116 $6,094,121 $6,081,342 $6,081,058 $6,071,981 $6,045,649 $6,021,872 $5,936,736 $6,212,692 $6,286,926 $6,294,905 $6,311,266 $73,505,663 $672.01 Actual Cost $5,525,193 $5,017,636 $3,450,282 $5,226,846 $5,353,080 $4,174,072 $6,670,573 $6,015,794 $4,582,635 $7,272,345 $6,571,740 $5,048,738 $64,908,936 $593.42 Variance from Actual $541,923 $1,076,485 $2,631,060 $854,211 $718,901 $1,871,577 ($648,701) ($79,058) $1,630,057 ($985,419) ($276,835) $1,262,528 $8,596,728 $78.59

(1) Most recent month of enrollment based on prior month

(2) Estimated based on monthly enrollment and employer/employee contributions. Assumes all individuals fall under Salary Band 1.

Year-to-Date

109,381

150,959 1.38

($200)

($100)

$0

$100

$200

$300

$400

$500

$600

$700

$800

$900

Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Actual Cost $612 $553 $381 $578 $593 $464 $745 $682 $495 $776 $700 $537

Budgeted Cost $672 $672 $672 $672 $673 $673 $673 $673 $671 $671 $671 $671

Variance $60 $119 $291 $94 $80 $208 ($72) ($9) $176 ($105) ($30) $134

Budget Comparison PEPM

56%

28%

6%

1%

9%

Combined Plan Expenses

Medical Claims

Pharmacy Claims

Administrative Fees

Stop Loss Premiums

HSA Contribution

Seton Only

Reporting as of December 31, 2023

Carrier: Aetna/CVS Specific Deductible: $1,000,000 Contract Type: Paid Plan Year: 1/1/2023 - 12/31/2023

Paid Month Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Total PEPM

Enrollment

Subscribers1 3,668 3,677 3,664 3,656 3,653 3,635 3,616 3,573 3,636 3,652 3,646 3,654

Members1 4,924 4,932 4,920 4,923 4,919 4,884 4,866 4,813 4,921 4,938 4,926 4,935 Contract Size 1.34 1.34 1.34 1.35 1.35 1.34 1.35 1.35 1.35 1.35 1.35 1.35

Claim Payments Medical Claims $1,686,542 $1,381,186 $1,872,113 $1,450,641 $1,654,978 $1,311,086 $1,937,817 $1,660,374 $1,525,492 $2,313,853 $2,008,781 $1,979,150 $20,782,012 $475.23 Pharmacy Claims $846,565 $920,947 $855,661 $873,786 $986,311 $1,060,681 $897,551 $944,667 $1,107,423 $1,045,138 $1,151,012 $1,182,918 $11,872,661 $271.50 Claims Over Specific $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0.00 Total Net Claim Payments $2,533,107 $2,302,134 $2,727,774 $2,324,427 $2,641,289 $2,371,767 $2,835,368 $2,605,040 $2,632,915 $3,358,990 $3,159,793 $3,162,069 $32,654,673 $746.73

Fixed Costs Administrative Fees $138,504 $138,844 $138,353 $138,051 $137,937 $137,258 $136,540 $134,916 $137,295 $137,900 $137,673 $137,975 $1,651,245 $37.76 Stop Loss Premiums $26,813 $26,879 $26,784 $26,725 $26,703 $26,572 $26,433 $26,119 $26,579 $26,696 $26,652 $26,711 $319,666 $7.31 Total Fixed Costs $165,317 $165,722 $165,136 $164,776 $164,641 $163,829 $162,973 $161,035 $163,875 $164,596 $164,325 $164,686 $1,970,911 $45.07

Total Plan Cost $2,698,424 $2,467,856 $2,892,910 $2,489,203 $2,805,930 $2,535,597 $2,998,341 $2,766,075 $2,796,790 $3,523,586 $3,324,118 $3,326,755 $34,625,584 $791.80

Employee Contributions2 $515,396 $517,459 $516,061 $519,363 $519,198 $514,800 $515,030 $510,040 $522,015 $524,797 $523,343 $525,634 $6,223,136 $142.31 Employer Cost $2,183,028 $1,950,397 $2,376,849 $1,969,840 $2,286,732 $2,020,796 $2,483,311 $2,256,036 $2,274,775 $2,998,789 $2,800,775 $2,801,121 $28,402,447 $649.50

Budget Comparison

Budgeted Cost2 $2,437,008 $2,444,486 $2,435,631 $2,436,722 $2,435,057 $2,420,815 $2,411,485 $2,382,207 $2,424,381 $2,437,022 $2,430,677 $2,437,877 $29,133,367 $666.21 Actual Cost $2,698,424 $2,467,856 $2,892,910 $2,489,203 $2,805,930 $2,535,597 $2,998,341 $2,766,075 $2,796,790 $3,523,586 $3,324,118 $3,326,755 $34,625,584 $791.80 Variance from Actual ($261,416) ($23,371) ($457,279) ($52,481) ($370,873) ($114,782) ($586,856) ($383,868) ($372,409) ($1,086,564) ($893,441) ($888,878) ($5,492,217) ($125.59)

(1) Most recent month of enrollment based on prior month

(2) Estimated based on monthly enrollment and employer/employee contributions. Assumes all individuals fall under Salary Band 1.

1.35

Year-to-Date

43,730

58,901

($400)

($200)

$0

$200

$400

$600

$800

$1,000

$1,200

Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Actual Cost $736 $671 $790 $681 $768 $698 $829 $774 $769 $965 $912 $910

Budgeted Cost $664 $665 $665 $666 $667 $666 $667 $667 $667 $667 $667 $667

Variance ($71) ($6) ($125) ($14) ($102) ($32) ($162) ($107) ($102) ($298) ($245) ($243)

Budget Comparison PEPM

60%

34%

5%

1%

Combined Plan Expenses

Medical Claims

Pharmacy Claims

Administrative Fees

Stop Loss Premiums

Open Access

Reporting as of December 31, 2023

Carrier: Aetna/CVS Specific Deductible: $1,000,000 Contract Type: Paid Plan Year: 1/1/2023 - 12/31/2023

Paid Month Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Total PEPM

Enrollment

Subscribers1 0 0 0 0 0 0 0 0 0 0 0 0

Members1 0 0 0 0 0 0 0 0 0 0 0 0 Contract Size 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Claim Payments Medical Claims $208,147 $80,434 $151,650 $8,136 $4,144 $5,520 ($399) $7,307 $5,200 ($3,028) ($20,488) $2,097 $448,718 Pharmacy Claims $70,286 $23 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $70,309 Claims Over Specific $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Total Net Claim Payments $278,433 $80,456 $151,650 $8,136 $4,144 $5,520 ($399) $7,307 $5,200 ($3,028) ($20,488) $2,097 $519,027

Fixed Costs Administrative Fees $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Stop Loss Premiums $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Total Fixed Costs $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0

Total Plan Cost $278,433 $80,456 $151,650 $8,136 $4,144 $5,520 ($399) $7,307 $5,200 ($3,028) ($20,488) $2,097 $519,027

Employee Contributions2 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Employer Cost $278,433 $80,456 $151,650 $8,136 $4,144 $5,520 ($399) $7,307 $5,200 ($3,028) ($20,488) $2,097 $519,027

Budget Comparison

Budgeted Cost2 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Actual Cost $278,433 $80,456 $151,650 $8,136 $4,144 $5,520 ($399) $7,307 $5,200 ($3,028) ($20,488) $2,097 $519,027 Variance from Actual ($278,433) ($80,456) ($151,650) ($8,136) ($4,144) ($5,520) $399 ($7,307) ($5,200) $3,028 $20,488 ($2,097) ($519,027)

(1) Most recent month of enrollment based on prior month

(2) Estimated based on monthly enrollment and employer/employee contributions. Assumes all individuals fall under Salary Band 1.

Year-to-Date

$0

$0

$0

$0

$0

$1

$1

$1

$1

$1

$1

Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Actual Cost $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0

Budgeted Cost $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0

Variance

Budget Comparison PEPM

86%

14%

0% 0%

Combined Plan Expenses

Medical Claims

Pharmacy Claims

Administrative Fees

Stop Loss Premiums

Multi-Tier HDHP

Reporting as of December 31, 2023

Carrier: Aetna/CVS Specific Deductible: $1,000,000 Contract Type: Paid Plan Year: 1/1/2023 - 12/31/2023

Paid Month Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Total PEPM

Enrollment

Subscribers1 177 177 178 181 180 181 183 178 183 184 184 183

Members1 251 248 249 252 252 252 252 246 245 246 246 245 Contract Size 1.42 1.40 1.40 1.39 1.40 1.39 1.38 1.38 1.34 1.34 1.34 1.34

Claim Payments Medical Claims $20,664 $81,259 $45,931 $58,383 $170,654 $41,493 $200,437 $200,754 $129,632 $145,681 $106,791 $137,019 $1,338,698 $617.20 Pharmacy Claims $55,663 $53,380 $80,650 $83,305 $89,048 $109,884 $111,116 $98,388 $123,539 $107,655 $103,903 $113,646 $1,130,176 $521.06 Claims Over Specific $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0.00 Total Net Claim Payments $76,327 $134,639 $126,581 $141,688 $259,701 $151,377 $311,553 $299,142 $253,171 $253,336 $210,694 $250,665 $2,468,874 $1,138.25

Fixed Costs Administrative Fees $6,684 $6,684 $6,721 $6,835 $6,797 $6,835 $6,910 $6,721 $6,910 $6,948 $6,948 $6,910 $81,901 $37.76 Stop Loss Premiums $1,294 $1,294 $1,301 $1,323 $1,316 $1,323 $1,338 $1,301 $1,338 $1,345 $1,345 $1,338 $15,855 $7.31 HSA Contribution $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0.00 Total Fixed Costs $7,977 $7,977 $8,022 $8,158 $8,113 $8,158 $8,248 $8,022 $8,248 $8,293 $8,293 $8,248 $97,757 $45.07

Total Plan Cost $84,304 $142,616 $134,604 $149,845 $267,814 $159,534 $319,801 $307,165 $261,419 $261,629 $218,987 $258,913 $2,566,631 $1,183.32

Employee Contributions2 $83,505 $82,355 $82,640 $83,495 $83,785 $83,495 $83,491 $80,991 $79,086 $79,371 $79,371 $79,086 $980,673 $452.13 Employer Cost $799 $60,261 $51,963 $66,350 $184,029 $76,039 $236,310 $226,174 $182,332 $182,257 $139,615 $179,827 $1,585,958 $731.19

Budget Comparison

Budgeted Cost2 $156,359 $155,160 $155,870 $158,000 $157,889 $158,000 $158,820 $154,250 $155,151 $155,861 $155,861 $155,151 $1,876,370 $865.09 Actual Cost $84,304 $142,616 $134,604 $149,845 $267,814 $159,534 $319,801 $307,165 $261,419 $261,629 $218,987 $258,913 $2,566,631 $1,183.32 Variance from Actual $72,055 $12,543 $21,266 $8,154 ($109,925) ($1,535) ($160,981) ($152,915) ($106,268) ($105,768) ($63,126) ($103,762) ($690,261) ($318.24)

(1) Most recent month of enrollment based on prior month

(2) Estimated based on monthly enrollment and employer/employee contributions. Assumes all individuals fall under Salary Band 1.

1.38

Year-to-Date

2,169

2,984

($1,500)

($1,000)

($500)

$0

$500

$1,000

$1,500

$2,000

Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Actual Cost $476 $806 $756 $828 $1,488 $881 $1,748 $1,726 $1,429 $1,422 $1,190 $1,415

Budgeted Cost $883 $877 $876 $873 $877 $873 $868 $867 $848 $847 $847 $848

Variance $407 $71 $119 $45 ($611) ($8) ($880) ($859) ($581) ($575) ($343) ($567)

Budget Comparison PEPM

52%

44%

3%1%

0%

Combined Plan Expenses

Medical Claims

Pharmacy Claims

Administrative Fees

Stop Loss Premiums

HSA Seton

Reporting as of December 31, 2023

Carrier: Aetna/CVS Specific Deductible: $1,000,000 Contract Type: Paid Plan Year: 1/1/2023 - 12/31/2023

Paid Month Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Total PEPM

Enrollment

Subscribers1 5,187 5,212 5,206 5,209 5,195 5,171 5,150 5,068 5,435 5,530 5,554 5,565

Members1 7,277 7,314 7,311 7,316 7,302 7,283 7,253 7,170 7,604 7,719 7,754 7,771 Contract Size 1.40 1.40 1.40 1.40 1.41 1.41 1.41 1.41 1.40 1.40 1.40 1.40

Claim Payments Medical Claims $1,251,271 $1,035,148 $889,688 $1,219,686 $1,258,474 $2,169,597 $1,612,120 $1,552,676 $2,023,276 $2,021,344 $1,353,330 $1,965,826 $18,352,435 $289.10 Pharmacy Claims $476,837 $551,632 $428,203 $580,275 $574,927 $739,295 $677,391 $666,335 $696,187 $680,662 $863,735 $766,970 $7,702,448 $121.33 Claims Over Specific $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0.00 Total Net Claim Payments $1,728,107 $1,586,780 $1,317,891 $1,799,961 $1,833,401 $2,908,892 $2,289,510 $2,219,011 $2,719,463 $2,702,005 $2,217,064 $2,732,796 $26,054,883 $410.43

Fixed Costs Administrative Fees $195,861 $196,805 $196,579 $196,692 $196,163 $195,257 $194,464 $191,368 $205,226 $208,813 $209,719 $210,134 $2,397,080 $37.76 Stop Loss Premiums $37,917 $38,100 $38,056 $38,078 $37,975 $37,800 $37,647 $37,047 $39,730 $40,424 $40,600 $40,680 $464,053 $7.31 HSA Contribution $510,125 $513,000 $511,875 $512,000 $510,000 $507,000 $504,875 $495,375 $536,500 $547,125 $549,375 $550,250 $6,247,500 $98.41 Total Fixed Costs $743,903 $747,905 $746,509 $746,770 $744,139 $740,057 $736,986 $723,790 $781,455 $796,362 $799,694 $801,065 $9,108,634 $143.48

Total Plan Cost $2,472,011 $2,334,684 $2,064,400 $2,546,731 $2,577,540 $3,648,949 $3,026,496 $2,942,801 $3,500,919 $3,498,368 $3,016,758 $3,533,861 $35,163,517 $553.91

Employee Contributions2 $279,724 $282,592 $282,521 $279,858 $280,696 $282,290 $280,365 $278,946 $285,890 $287,297 $287,872 $290,234 $3,398,285 $53.53 Employer Cost $2,192,287 $2,052,092 $1,781,880 $2,266,872 $2,296,844 $3,366,660 $2,746,131 $2,663,855 $3,215,028 $3,211,071 $2,728,886 $3,243,627 $31,765,232 $500.38

Budget Comparison

Budgeted Cost2 $3,473,749 $3,494,476 $3,489,842 $3,486,336 $3,479,035 $3,466,835 $3,451,567 $3,400,278 $3,633,160 $3,694,043 $3,708,366 $3,718,238 $42,495,927 $669.42 Actual Cost $2,472,011 $2,334,684 $2,064,400 $2,546,731 $2,577,540 $3,648,949 $3,026,496 $2,942,801 $3,500,919 $3,498,368 $3,016,758 $3,533,861 $35,163,517 $553.91 Variance from Actual $1,001,739 $1,159,792 $1,425,442 $939,606 $901,496 ($182,115) $425,071 $457,477 $132,242 $195,675 $691,608 $184,378 $7,332,410 $115.50

(1) Most recent month of enrollment based on prior month

(2) Estimated based on monthly enrollment and employer/employee contributions. Assumes all individuals fall under Salary Band 1.

1.40

Year-to-Date

63,482

89,074

($100)

$0

$100

$200

$300

$400

$500

$600

$700

$800

Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Actual Cost $477 $448 $397 $489 $496 $706 $588 $581 $644 $633 $543 $635

Budgeted Cost $670 $670 $670 $669 $670 $670 $670 $671 $668 $668 $668 $668

Variance $193 $223 $274 $180 $174 ($35) $83 $90 $24 $35 $125 $33

Budget Comparison PEPM

52%

22%

7%

1%18%

Combined Plan Expenses

Medical Claims

Pharmacy Claims

Administrative Fees

Stop Loss Premiums

Large Claimants over $250,000

Reporting as of December 31, 2023

Carrier: Aetna/CVS Specific Deductible: $1,000,000 Contract Type: Paid Plan Year: 1/1/2023 - 12/31/2023

Claimant Plan Relationship ICD-10 Code Description Medical RX Drug Pooled Claim

Amount Total

Claimant 1 Seton Only Subscriber Sepsis, Unspecified Organism $717,985 $24,229 $0 $742,214

Claimant 2 Seton Only Subscriber Sepsis Due To Escherichia Coli (e. Coli) $681,894 $547 $0 $682,440

Claimant 3 HSA Seton Child Bronchopulmonary Dysplasia Originating In The Perinatal Period $578,202 $0 $0 $578,202

Claimant 4 Seton Only Subscriber Unspecified Fracture Of Shaft Of Right Tibia, Initial Encounter For Closed

Fracture $553,199 $1 $0 $553,200

Claimant 5 Open Access Subscriber Adult Osteomalacia, Unspecified $466,482 $28 $0 $466,510

Claimant 6 Seton Only Subscriber Multiple Myeloma Not Having Achieved Remission $381,889 $18,305 $0 $400,194

Claimant 7 Seton Only Child Encounter For Attention To Colostomy $391,212 $153 $0 $391,365

Claimant 8 Seton Only Child Chronic Constrictive Pericarditis $304,209 $845 $0 $305,054

Claimant 9 Seton Only Spouse Encounter For Antineoplastic Radiation Therapy $51,130 $253,879 $0 $305,009

Claimant 10 HSA Seton Subscriber Multiple Myeloma Not Having Achieved Remission $154,801 $129,731 $0 $284,533

Claimant 11 HSA Seton Subscriber Cystic Fibrosis With Pulmonary Manifestations $57,228 $226,494 $0 $283,721

Claimant 12 HSA Seton Subscriber Sepsis, Unspecified Organism $272,110 $58 $0 $272,168

Claimant 13 Seton Only Subscriber Pathological Fracture, Other Site, Initial Encounter For Fracture $8,593 $252,428 $0 $261,021

Total $4,618,933 $906,698 $0 $5,525,631

Dental Budget Summary

Reporting as of December 31, 2023

Carrier: Delta Dental Plan Year: 1/1/2023 - 12/31/2023

Paid Month Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Total PEPM

Enrollment Subscribers 5,121 5,130 5,123 5,121 5,109 5,083 5,062 5,039 5,288 5,309 5,311 5,304 Members 7,762 7,777 7,762 7,755 7,743 7,714 7,673 7,655 7,978 7,989 7,976 7,966 Contract Size 1.52 1.52 1.52 1.51 1.52 1.52 1.52 1.52 1.51 1.50 1.50 1.50

Claim Payments Dental Claims $225,252 $166,119 $242,424 $163,686 $192,431 $209,822 $239,770 $288,766 $153,082 $167,779 $197,515 $176,253 $2,422,900 $39.08

Fixed Costs Administrative Fees $14,543 $14,469 $14,458 $14,436 $14,405 $14,334 $14,272 $14,272 $14,737 $14,921 $15,087 $14,954 $174,888 $2.82

Total Plan Cost $239,795 $180,588 $256,882 $178,122 $206,836 $224,156 $254,042 $303,038 $167,820 $182,700 $212,602 $191,207 $2,597,787 $41.90 Employee Contributions $235,473 $236,444 $235,864 $235,525 $235,288 $234,339 $233,207 $232,621 $241,982 $242,281 $241,888 $241,705 $2,846,618 $45.91 Employer Cost $4,322 ($55,856) $21,018 ($57,403) ($28,452) ($10,183) $20,835 $70,417 ($74,163) ($59,581) ($29,286) ($50,498) ($248,830) ($4.01)

Budget Comparison Budgeted Cost $235,473 $236,444 $235,864 $235,525 $235,288 $234,339 $233,207 $232,621 $241,982 $242,281 $241,888 $241,705 $2,846,618 $45.91 Actual Cost $239,795 $180,588 $256,882 $178,122 $206,836 $224,156 $254,042 $303,038 $167,820 $182,700 $212,602 $191,207 $2,597,787 $41.90 Variance from Actual ($4,322) $55,856 ($21,018) $57,403 $28,452 $10,183 ($20,835) ($70,417) $74,163 $59,581 $29,286 $50,498 $248,830 $4.01

Year-to-Date

62,000 93,750

1.51

($20)

($10)

$0

$10

$20

$30

$40

$50

$60

$70

Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Actual Cost $47 $35 $50 $35 $40 $44 $50 $60 $32 $34 $40 $36

Budgeted Cost $46 $46 $46 $46 $46 $46 $46 $46 $46 $46 $46 $46

Variance ($1) $11 ($4) $11 $6 $2 ($4) ($14) $14 $11 $6 $10

Budget Comparison PEPM

This analysis is for illustrative purposes only, and is not a guarantee of future expenses, claims costs, managed care savings, etc. There are many variables that can affect future health care costs including utilization patterns, catastrophic claims, changes in plan design, health care trend increases, etc. This analysis does not amend, extend, or alter the coverage provided by the actual insurance policies and contracts. Please see your policy or contact us for specific information or further details in this regard.