Appendix%207.7%20Enrollment%20by%20Plan.xlsx

XLSX spreadsheet 17 KB Posted

Attached to
Third Party Administrator Services for the State's Public Sector Health Plans
Solicitation number
RFP 31786-00190
Issued by
Davidson County, Tennessee

About this file

This is an enrollment data file documenting health plan participation across Tennessee's public sector health plans, including State, Local Education, and Local Government employee groups. The spreadsheet presents a comprehensive breakdown of 300,954 total enrollees distributed across four primary plan types: Limited PPO, CDHP (Consumer Driven Health Plan), Premier PPO, and Standard PPO. Enrollment data is segmented by employee classification (dependent versus employee), gender (female, male, and unspecified), and age brackets (0, 1-18, 19-39, 40-64, and 65 and older). The State group represents the largest enrollment segment with 147,139 members, followed by Local Education with 124,744 members and Local Government with 29,071 members. The Premier PPO plan is the most popular across all groups, with 76,146 enrollees in Local Education, 69,040 in State, and 12,519 in Local Government.

The enrollment distribution reveals significant demographic patterns relevant to benefits administration and actuarial planning. Premier PPO and Standard PPO plans dominate enrollment across all three jurisdictional groups, collectively accounting for the majority of covered lives. The State group shows relatively balanced enrollment between dependent and employee classifications, while Local Education demonstrates higher dependent enrollment. Age distribution indicates substantial concentration in the 40-to-64 age bracket across most plan types, reflecting an aging workforce demographic. This enrollment data serves as a critical baseline for the Third Party Administrator Services contract, as it quantifies the beneficiary population requiring claims processing, customer service, and administrative support across Tennessee's public sector health insurance programs.

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Sheet1

Count of HOC IDDep/Emp
GroupPlay TypeSexAge BracketDependentEmployeeGrand Total
Local EdLimited PPOF04343
1 to 181,4951,495
19 to 399741,6842,658
40 to 643863,4003,786
65 and older17162179
F Total2,9155,2468,161
M04848
1 to 181,58311,584
19 to 391,1376071,744
40 to 641,2289732,201
65 and older5882140
M Total4,0541,6635,717
Limited PPO Total6,9696,90913,878
Local CDHPF01313
1 to 181,0421,042
19 to 395097661,275
40 to 642381,4571,695
65 and older83139
F Total1,8102,2544,064
M02020
1 to 181,0621,062
19 to 39602342944
40 to 647165101,226
65 and older291645
M Total2,4298683,297
U1 to 1811
U Total11
Local CDHP Total4,2403,1227,362
Premier PPOF0314314
1 to 187,93917,940
19 to 395,0528,05513,107
40 to 642,11020,68522,795
65 and older1181,3371,455
F Total15,53330,07845,611
M0308308
1 to 188,7088,708
19 to 395,9642,1928,156
40 to 646,8715,40512,276
65 and older5345471,081
M Total22,3858,14430,529
U1 to 1822
19 to 3922
40 to 6422
U Total66
Premier PPO Total37,92438,22276,146
Standard PPOF0136136
1 to 183,18613,187
19 to 391,7203,5335,253
40 to 646396,6237,262
65 and older25319344
F Total5,70610,47616,182
M0139139
1 to 183,2653,265
19 to 392,2341,1233,357
40 to 642,3191,8004,119
65 and older137156293
M Total8,0943,07911,173
U1 to 1822
19 to 3911
U Total33
Standard PPO Total13,80313,55527,358
Local Ed Total62,93661,808124,744
Local GovLimited PPOF02222
1 to 187323735
19 to 395909631,553
40 to 643661,7352,101
65 and older21164185
F Total1,7312,8654,596
M03030
1 to 187312733
19 to 393651,2211,586
40 to 642631,5781,841
65 and older23119142
M Total1,4122,9204,332
Limited PPO Total3,1435,7858,928
Local CDHPF066
1 to 182211222
19 to 39159185344
40 to 64113275388
65 and older41014
F Total503471974
M099
1 to 18182182
19 to 3978333411
40 to 6450370420
65 and older51722
M Total3247201,044
Local CDHP Total8271,1912,018
Premier PPOF04646
1 to 189501951
19 to 397941,0581,852
40 to 647142,4543,168
65 and older72288360
F Total2,5763,8016,377
M03434
1 to 181,02571,032
19 to 395451,3801,925
40 to 643542,4202,774
65 and older56321377
M Total2,0144,1286,142
Premier PPO Total4,5907,92912,519
Standard PPOF02121
1 to 184061407
19 to 39342532874
40 to 642739501,223
65 and older25107132
F Total1,0671,5902,657
M02222
1 to 184121413
19 to 392378451,082
40 to 641251,1621,287
65 and older21124145
M Total8172,1322,949
Standard PPO Total1,8843,7225,606
Local Gov Total10,44418,62729,071
StateCDHP/HSAF08080
1 to 181,92811,929
19 to 391,3241,6382,962
40 to 641,0572,0883,145
65 and older6065125
F Total4,4493,7928,241
M09696
1 to 182,0352,035
19 to 391,0701,5732,643
40 to 649651,7882,753
65 and older64112176
M Total4,2303,4737,703
U1 to 1822
U Total22
CDHP/HSA Total8,6817,26515,946
Premier PPOF0215215
1 to 186,5736,573
19 to 395,4483,9009,348
40 to 645,70613,44419,150
65 and older7281,5542,282
F Total18,67018,89837,568
M0242242
1 to 186,9976,997
19 to 394,9422,6607,602
40 to 644,9189,25714,175
65 and older9281,5252,453
M Total18,02713,44231,469
U011
1 to 1822
U Total33
Premier PPO Total36,70032,34069,040
Standard PPOF0301301
1 to 186,9066,906
19 to 395,3256,48911,814
40 to 643,7899,38013,169
65 and older261631892
F Total16,58216,50033,082
M0271271
1 to 187,2397,239
19 to 394,5645,2179,781
40 to 643,7636,98010,743
65 and older3976371,034
M Total16,23412,83429,068
U1 to 1822
19 to 3911
U Total33
Standard PPO Total32,81929,33462,153
State Total78,20068,939147,139
Grand Total151,580149,374300,954

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