Appendix_7.5_Claims_History.xlsx

This is a claims history spreadsheet documenting monthly service utilization and costs for the State of Tennessee's self-insured supplemental medical insurance plan (The Tennessee Plan) for Medicare-eligible retirees administered by the Division of Benefits Administration. The spreadsheet provides detailed year-by-year data spanning from 2018 through 2024, with partial data for 2025 through the second quarter, tracking total paid amounts, number of claims processed, cost per claim, enrollment figures, and cost per enrolled member on a monthly and annual basis.

The claims data demonstrates consistent growth patterns across the six-year period, with total annual plan costs increasing from $63.0 million in 2018 to $89.0 million in 2024, representing an average annual increase of approximately 4 percent. The number of claims processed annually rose from 1.24 million in 2018 to 1.50 million in 2024, while enrollment grew modestly from approximately 41,809 members in 2018 to 47,727 members in 2024, indicating an average annual enrollment increase of 2.2 percent. The cost per claim has remained relatively stable, averaging $57.51 in 2022 and declining slightly to $59.05 in 2024, while the cost per enrolled member increased from $125.38 in 2018 to $155.47 in 2024. Year-over-year analysis reveals that 2022 and 2023 experienced the highest growth rates at 9.8 percent and 9.7 percent respectively, with growth moderating to 2.8 percent between 2023 and 2024, suggesting stabilization in plan cost trajectories and utilization patterns.