Forest_Service_Benefit-Loss_Report2.xlsx
XLSX spreadsheet 14 KB Posted
- Solicitation number
- AG-3187-S-14-0064
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Attachment Forest Service Benefit-Loss Report2.xlsx
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| File | Type | Posted |
|---|---|---|
| Forest_Service_Detailed_Loss_Report(2).xlsx | XLSX spreadsheet | |
| SF30.pdf | ||
| Q_ _A_Amend_One.pdf | ||
| InsuranceSolicitation_J-1_Basic-final.pdf |
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Sheet1
| Organization | Forest Service International Programs |
| Data as of | 12.31.2013 |
| Premium | Losses | Loss Ratio | |
| 2007 | $ 48,640.00 | $ 35,211.15 | 72.39% |
| 2008 | $ 21,704.00 | $ 16,741.19 | 77.13% |
| 2009 | $ 42,240.00 | $ 11,721.68 | 27.75% |
| 2010 | $ 61,980.00 | $ 24,744.10 | 39.92% |
| 2012 | $ 36,808.00 | $ 11,835.10 | 32.15% |
| TOTALS | $ 211,372.00 | $ 100,253.22 | 47.43% |
Current Year $ 33,046.00 $ 3,854.13 11.66%
| Policy Year | ||
| 2013 | Benefit Code and Description | Total Paid |
| DRU - MEDICATIONS | 443.22 | |
| DVM - PHYSICIAN VISIT | 1049.22 | |
| ERA - EMERGENCY ROOM ACCIDENT | 981.90 | |
| LAB - LABORATORY CHARGES | 905.62 | |
| MNI- M/N INPATIENT | 0.00 | |
| MNO- M/N OUTPATIENT | 0.00 | |
| PRO - PROCEDURE | 0.00 | |
| PRX- PRE-EXISTING CONDITION | 0.00 | |
| REN - ROUTINE EXAMS | 0.00 | |
| REV - RE-PRICING FEE | 163.25 | |
| URG - URGENT CARE ILLNESS | 227.80 | |
| XRP - X-RAY PROFESSIONAL COMPONENT | 38.80 | |
| XRY - X-RAY | 44.32 | |
| Report Totals: | ||
| 3854.13 |
| 2012 | Benefit Code and Description | Total Paid |
| ANC - HOSPITAL ANCILLARY CHARGES | 0.00 | |
| DRU - MEDICATIONS | 362.00 | |
| DVM - PHYSICIAN VISIT | 708.09 | |
| EDT - CLAIM EDITING FEE | 6.27 | |
| ERA - EMERGENCY ROOM ACCIDENT | 263.15 | |
| ERI - EMERGENCY ROOM ILLNESS | 2586.66 | |
| ERP - EMERGENCY ROOM PHYSICIAN | 1671.00 | |
| HRB - HOSPITAL ROOM & BOARD CHARGES | 0.00 | |
| LAB - LABORATORY CHARGES | 2058.33 | |
| MAT - MATERNITY COVERAGE | 0.00 | |
| MNI- M/N INPATIENT | 0.00 | |
| MNO - M/N OUTPATIENT | 160.00 | |
| MRI - MRI | 2200.00 | |
| NCV - NOT COVERED UNDER YOUR PLAN | 0.00 | |
| NEG - FEE NEGOTIATION-PHX | 52.28 | |
| PRX- PRE-EXISTING CONDITION | 704.72 | |
| REN - ROUTINE EXAMS | 93.15 | |
| REV - RE-PRICING FEE | 539.79 | |
| SUR - SURGERY | 40.32 | |
| URG - URGENT CARE ILLNESS | 389.34 | |
| Report Totals: | ||
| 11835.10 |
| 2010-2011 | Benefit Code and Description | Total Paid |
| AMB - AMBULANCE | 0.00 | |
| ANC - HOSPITAL ANCILLARY CHARGES | 149.54 | |
| ANE - ANESTHESIA | 400.00 | |
| CAT - CAT SCAN | 542.30 | |
| DME - DURABLE MEDICAL EQUIPMENT | 14.00 | |
| DRU - MEDICATIONS | 358.65 | |
| DVM - PHYSICIAN VISIT | 2609.47 | |
| ERA - EMERGENCY ROOM ACCIDENT | 0.00 | |
| ERI - EMERGENCY ROOM ILLNESS | 3412.26 | |
| ERP - EMERGENCY ROOM PHYSICIAN | 1196.00 | |
| HRB - HOSPITAL ROOM & BOARD CHARGES | 689.04 | |
| LAB - LABORATORY CHARGES | 2334.28 | |
| MAM - MAMMOGRAPHY | 0.00 | |
| MAT - MATERNITY COVERAGE | 4414.42 | |
| MNI- M/N INPATIENT | 0.00 | |
| MNO- M/N OUTPATIENT | 0.00 | |
| MSP - MEDICAL SUPPLIES | 8.00 | |
| NCV - NOT COVERED UNDER YOUR PLAN | 0.00 | |
| NEG - FEE NEGOTIATION-PHX | 465.42 | |
| PRO - PROCEDURE | 54.40 | |
| PRX- PRE-EXISTING CONDITION | 174.00 | |
| REN - ROUTINE EXAMS | 0.00 | |
| REV - RE-PRICING FEE | 951.93 | |
| RIM - ROUTINE IMMUNIZATIONS | 0.00 | |
| SUR - SURGERY | 5082.56 | |
| URG - URGENT CARE ILLNESS | 115.00 | |
| XRP - X-RAY PROFESSIONAL COMPONENT | 0.00 | |
| XRT - X-RAY TECHNICAL COMPONENT | 565.02 | |
| XRY - X-RAY | 1207.81 | |
| Report Totals: | 24744.10 |
| 2009 | Benefit Code and Description | Total Paid |
| ANE - ANESTHESIA | 960.00 | |
| CAT - CAT SCAN | 1354.50 | |
| DEL - DELETED OR INVALID CODE | 0.00 | |
| DME - DURABLE MEDICAL EQUIPMENT | 690.00 | |
| DRU - MEDICATIONS | 325.46 | |
| DVM - PHYSICIAN VISIT | 2425.07 | |
| ERA - EMERGENCY ROOM ACCIDENT | 0.00 | |
| ERI - EMERGENCY ROOM ILLNESS | 961.11 | |
| ERP - EMERGENCY ROOM PHYSICIAN | 273.00 | |
| INJ - INJECTIONS | 0.00 | |
| LAB - LABORATORY CHARGES | 1046.01 | |
| MNI- M/N INPATIENT | 0.00 | |
| MNO- M/N OUTPATIENT | 0.00 | |
| MSP - MEDICAL SUPPLIES | 17.60 | |
| NCV - NOT COVERED UNDER YOUR PLAN | 0.00 | |
| OPH - OUT PATIENT HOSPITAL | 2766.00 | |
| PRO - PROCEDURE | 25.00 | |
| PRX- PRE-EXISTING CONDITION | 0.00 | |
| REV - RE-PRICING FEE | 72.64 | |
| SUR - SURGERY | 585.29 | |
| XRP - X-RAY PROFESSIONAL COMPONENT | 0.00 | |
| XRY - X-RAY | 220.00 | |
| Report Totals: | ||
| 11721.68 |
Sheet2
Sheet3
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