8-Exhibit B-1 - 24-25 Large Claim Report.pdf

This is a Large Claim Report document prepared for the Schertz-Cibolo-Universal City Independent School District in relation to a stop loss insurance procurement (Contract ID: 27-002V). The report identifies five claimants within the district's benefit plan who incurred medical and pharmacy claims exceeding $100,000 during the plan year from September 1, 2024, through August 31, 2025. The largest claim totaled $350,502, while the smallest exceeded claim amount was $107,133. Individual member identifiers have been removed from the report to comply with state and federal health information privacy regulations. The underlying procurement solicitation seeks proposal responses from insurance companies licensed in Texas to provide stop loss insurance coverage, with Foundation Risk Partners, d/b/a Corporate Synergies serving as the district's consultant for distribution, evaluation, and negotiations.

The large claim data presented reflects both medical and pharmacy costs across subscriber and dependent relationships within the district's plan. Identified diagnoses associated with the high-cost claimants include paroxysmal atrial fibrillation, autistic disorder, sepsis, and acute respiratory failure conditions. This historical claims data serves as critical information for potential stop loss insurance carriers to evaluate and underwrite appropriate coverage that would protect the district from catastrophic claim expenses. The report was generated on October 21, 2026, and is intended to support the competitive bidding process for stop loss insurance coverage.