Appendix_7.5_Claims_History.xlsx

This is a claims history spreadsheet documenting monthly and annual payment data for the State of Tennessee's self-insured supplemental medical insurance plan (The Tennessee Plan) covering the period from January 2018 through December 2024, with partial data for 2025 through the second quarter. The spreadsheet tracks total paid amounts, number of claims processed, cost per claim, enrollment figures, and cost per enrolled member across all twelve months for each fiscal year. The data reveals consistent operational metrics and trend analysis, including year-over-year percentage changes in plan costs, claim volumes, and enrollment growth, establishing a historical baseline for contract evaluation and cost projections.

The claims history demonstrates significant growth in the plan's financial scope and operational volume. Annual plan costs increased from $63.0 million in 2018 to $89.0 million in 2024, representing a cumulative 41.2 percent increase over the six-year period, with an average annual cost increase of 4 percent. Claims volume expanded from 1,243,203 claims annually in 2018 to 1,499,794 claims in 2024, while enrollment grew from 41,809 members to 47,727 members during the same timeframe. Cost per claim remained relatively stable, ranging from $49.46 to $65.87 per claim, while cost per enrolled member increased from $125.38 in 2018 to $155.47 in 2024. The 2023 year-over-year increases showed the highest growth rates at 9.76 percent for total paid amounts and 7.73 percent for claims volume, while 2024 growth moderated to 2.81 percent and 1.74 percent respectively, suggesting stabilization in the plan's trajectory.