Blue_Insight_Report_October_2025_-_May_2026.pdf

Blue Insight℠ Monthly Financial Report

10/01/2025 to 05/31/2026

CITY OF EDINBURG 000243483: ALL

- Multiple selected Groups

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2026 Health Care Service Corporation. All rights reserved.

Table of Contents

Data Parameters 3

Enrollment Overview 4-5

Financial Overview

Financial Summary 6

Network Overview 7

Blue Card Savings Analysis 8

Medical Claim Expense Distribution 9

High Cost Claimants 10

Medical Out of Pocket 11

Lag Report 12

Overall Medical Paid PMPM Leading Diagnostic Category 13

PLAN PERFORMANCE

Pharmacy

Financial Summary 14

Key Indicators 15

Generic vs. Formulary Experience 16

Top Non-Specialty Drug Classes and Drugs 17

Specialty Drug Analysis 18

Dental

Dental Financial Summary 19

Appendix 20

Glossary 23

CITY OF EDINBURG 000243483: ALL - Multiple selected Groups

Data Parameters

Reporting Support Contact Information

For reporting support, please contact Client Reporting Service Center Email: client_reporting@bcbsil.com Hours of Operation: Monday - Friday: 8:00am - 5:00pm CT

Report prepared on 06/16/2026

Current Period: The current reporting period represents claims paid from October 1, 2025 through May 31, 2026.

Prior Period: The prior reporting period represents claims paid from October 1, 2024 through May 31, 2025.

The report includes medical claims, pharmacy claims and dental claims.

Reporting Segments: ALL

Characteristics: ALL

Group/Sections: ALL Member MSA: ALL

Group: 000433949 - CITY OF EDINBURG, 000433950 - CITY OF EDINBURG

Enrollment Overview

Report Description: Provides the current enrollment based on the current period.

Month Medical

Subscribers Medical Members

Pharmacy Subscribers

Pharmacy Members

Dental Subscribers

Dental Members

Oct 2025 1,105 1,716 1,105 1,716 Nov 2025 1,103 1,712 1,103 1,712 Dec 2025 1,113 1,716 1,113 1,716 Jan 2026 1,110 1,714 1,110 1,714 Feb 2026 1,104 1,702 1,104 1,702 Mar 2026 1,116 1,715 1,116 1,715 Apr 2026 1,114 1,711 1,114 1,711 May 2026 1,110 1,707 1,110 1,707

Enrollment Overview

• Overall, membership remained stable at 0.0% between reporting periods.

• The average age was 33.5 and remained stable by 0.0% between reporting periods.

• Contract size remained stable by 0.0% between reporting periods.

• Females between the ages of 20 and 44 increased from 0.0% to 16.7% between reporting periods.

Report Description: Provides medical demographics for the current period compared to the prior period and percent change.

Medical Demographics Oct 2024 - May 2025 Oct 2025 - May 2026 % Change

Average Membership 1,712 0.0%

Employee 1,109

Spouse 111

Dependent 491

Average Contract Size 1.5

Average Age 33.5

Employee 41.5

Spouse 42.8

Dependent 13.2

% Under 30 43.7%

% 30 to 49 34.6%

% 50 to 64 20.1%

% 65+ 1.6%

Gender

Proportion of Males 62.8%

Proportion of Females 37.2%

Females Ages 20-44 16.7%

Financial Overview: Financial Summary

Medical Order of Reduction

Paid Month May 2026 Oct 2024 - May 2025 Oct 2025 - May 2026 % Change Billed $4,055,928 $27,561,789 Not Covered $1,290,648 $4,879,630 Covered $2,765,280 $22,682,159 Discount $1,976,538 $16,781,098 Allowed $788,742 $5,901,061 Out of Pocket $128,055 $1,011,947

COB $3,622 $27,108

COB Medicare $0 $23,797 Other Reductions $22,813 $24,698 Other Adjustments $0 $0 Paid - Provider $634,253 $4,813,511 Other Payments $48 $2,173 Medical Paid $634,301 $4,815,685

Report Description: Provides a breakdown of the medical order of reduction from billed to paid for the current month, current period, prior period and a percent change. This report may highlight key measures and their potential impact on paid expenses.

Group Liability Breakdown Paid Month May 2026 Oct 2024 - May 2025 Oct 2025 - May 2026 % Change

Medical Paid $634,301 $4,815,685 Pharmacy Paid $266,255 $1,460,142 Dental Paid $0 $0

VBC Payments $1,075 $5,784

Total Paid Claims $901,631 $6,281,610 Recoveries $0 $0 Total Paid Claims + Recoveries $901,631 $6,281,610

Fees & Credits ($46,420) ($395,991) HCA Draft Amount $0 $0 Capitation Paid $0 $0 Group Liability $855,211 $5,885,619

Fees and Credits Breakdown Paid Month May 2026 Oct 2024 - May 2025 Oct 2025 - May 2026 % Change

Access Fee $0 $0 Admin Fee $40,271 $320,045 ASO Adjustments $0 $0 Rx Credit Fees ($103,235) ($820,437) Aggregate Stop Loss $0 $0 Specific Stop Loss $0 $0 Extra Fees $0 $0 ASO Other Services $0 $0 ASO All Other $16,544 $104,401 Summary ($46,420) ($395,991)

Other reductions includes penalties, workers compensation savings, and subrogation savings.

Other payments includes Blue Card access fees and surcharges. Also displayed are other adjustments.

Financial Overview: Medical & Pharmacy Loss Ratio

Report Description: Provides the medical and pharmacy loss ratio and claims for the most recent reported twelve months.

Month Premium Medical Paid Claims Pharmacy Paid Claims Capitation VBC Payments Total Paid Medical and Pharmacy Loss Ratio Jun 2025 Jul 2025 Aug 2025 Sep 2025 Oct 2025 $0 $0 $0 $0 $0 $0 0.0% Nov 2025 $0 $0 $0 $0 $0 $0 0.0% Dec 2025 $0 $0 $0 $0 $0 $0 0.0% Jan 2026 $0 $0 $0 $0 $0 $0 0.0% Feb 2026 $0 $0 $0 $0 $0 $0 0.0% Mar 2026 $0 $0 $0 $0 $0 $0 0.0% Apr 2026 $0 $0 $0 $0 $0 $0 0.0% May 2026 $0 $0 $0 $0 $0 $0 0.0% Summary $0 $0 $0 $0 $0 $0 0.0%

Key Findings: The medical and pharmacy loss ratio for the most recent reported month was 0.0% was similar to than the average of the most recent reported twelve months, which was 0.0%.

Financial Overview: Network Overview

Report Description: This report displays the discount amount, discount percent, paid amount and paid percent for medical claims split by Medicare/Non-Medicare, in/out of network and service category for the current period.

Key Findings: The overall network savings discount (excluding Medicare) was 74.1% for the current period. The in-network paid percent was 99.8% for the current period.

Medicare Primary Indicator Network Indicator Service Category Covered Discount Discount % Paid % Of Paid

No

In Network

Facility Inpatient $6,483,410 $5,227,390 80.6% $1,128,575 23.4%

Facility Outpatient $11,180,317 $8,381,518 75.0% $2,281,392 47.4%

Professional $4,949,713 $3,158,300 63.8% $1,396,095 29.0%

Summary $22,613,441 $16,767,208 74.1% $4,806,063 99.8%

Out of Network

Facility Inpatient

Facility Outpatient

Professional $38,034 $13,653 35.9% $9,377 0.2%

Summary $38,034 $13,653 35.9% $9,377 0.2%

Summary $22,651,475 $16,780,861 74.1% $4,815,440 100.0%

Yes

In Network

Facility Inpatient

Facility Outpatient $29,881 $111

Professional $803 $237 29.5% $134

Summary $30,684 $237 0.8% $245

Out of Network

Facility Inpatient

Facility Outpatient

Professional

Summary

Summary $30,684 $237 0.8% $245

Summary $22,682,159 $16,781,098 74.0% $4,815,685 100.0%

Financial Overview: Blue Card Savings Analysis

Report Description: The Blue Card Savings report illustrates the value of having access to other BCBS contracts within the United States through the Blue Card program. Savings from BCBS network discounts are passed to the client, providing savings on potentially costly out of state claims that would otherwise be paid at full provider billed amount.

Oct 2025 - May 2026

Par Plan State Billed Allowed Effective Allowed Rate Discount Paid Effective

Paid Rate Blue Card Access Fee

GA $95,717 $37,645 39.3% $52,072 $33,024 34.5% $1,674

OH $7,248 $1,384 19.1% $5,773 $1,415 19.5% $185

FL $6,409 $2,649 41.3% $3,760 $1,609 25.1% $93

NJ $3,800 $469 12.3% $3,331 $576 15.2% $107

LA $3,155 $1,045 33.1% $2,110 $470 14.9% $67

IL $16,945 $15,042 88.8% $708 $15,042 88.8% $0

BS CA $1,120 $629 56.2% $491 $560 50.0% $16

OR $1,260 $364 28.9% $381 $364 28.9% $0

BC CA $296 $137 46.2% $159 $142 48.0% $5

AR $280 $87 31.1% $53 $89 31.7% $2

All Other Blue Card $378 $336 89.0% $41 $302 80.1% $1

All Other Non-Blue Card $27,425,182 $5,841,273 21.3% $16,712,220 $4,762,092 17.4% $0

Summary $27,561,789 $5,901,061 21.4% $16,781,098 $4,815,685 17.5% $2,150

Key Findings: GA had the greatest Blue Card savings amount, with a Discount amount of $52,072. The overall Effective Allowed Rate for the current period was 21.4%.

Financial Overview: Medical Claim Expense Distribution

Report Description: The distribution of medical paid expense by claimant and the average medical paid per claimant amount are shown for the current period.

Paid Band Claimants Claimants % Paid Paid % Paid/Claimant

Less than $200 301 23.3% $29,319 0.6% $97

$200 - $1,000 487 37.6% $234,970 4.9% $482

$1,001 - $5,000 364 28.1% $824,958 17.1% $2,266

$5,001 - $10,000 57 4.4% $397,388 8.3% $6,972

$10,001 - $30,000 61 4.7% $981,866 20.4% $16,096

$30,001 - $50,000 11 0.9% $423,678 8.8% $38,516

Summary <= $50,000 1,281 99.0% $2,892,179 60.1% $2,258

Paid Band Claimants Claimants % Paid Paid % Paid/Claimant

$50,001 - $75,000 4 0.3% $227,240 4.7% $56,810

$75,001 - $100,000 1 0.1% $82,833 1.7% $82,833

$100,001 - $150,000 3 0.2% $331,881 6.9% $110,627

$150,001 - $200,000 2 0.2% $355,672 7.4% $177,836

$200,001 - $250,000 1 0.1% $218,839 4.5% $218,839

$250,001 - $500,000 2 0.2% $707,042 14.7% $353,521

$500,001+

Summary $50,001 or Greater 13 1.0% $1,923,506 39.9% $147,962

Combined Summary 1,294 100.0% $4,815,685 100.0% $3,722

Key Findings: The proportion of claimants who received less than $200 in services for the current period was 23.3%. These claimants spent 0.6% of the total paid expenses and the average paid expense per claimant was $97. 1.0% of claimants had expenses over $50,001 for the current period. These claimants spent 39.9% of the total paid expenses and the average paid expense per claimant was $147,962.

Financial Overview: High Cost Claimants

Report Description: This report provides a detailed listing of the top 20 high cost claimants with paid expenses of $50,000 or more for the current period.

Oct 2025 - May 2026

Encrypted Member ID Relationship Age/Gender Band Leading Diagnostic Category

Inpatient Paid

Outpatient Paid

Professional Paid

Pharmacy Paid Paid

Currently Enrolled

7782240017087466827 Spouse Male 40-49 Neoplasms $18,168 $370,013 $6,119 $645 $394,945 Yes

3795325029536780273 Dependent Male <1-19 Circulatory $259,937 $16,178 $36,626 $278 $313,019 Yes

6256278474578588260 Spouse Female 50-59 Neoplasms $16,465 $17,012 $185,361 $845 $219,683 Yes

4433474454332789707 Subscriber Male 40-49 Nervous $0 $93,417 $86,481 $21 $179,919 Yes

3930449381088790402 Subscriber Female 40-49 Ear $0 $156,349 $19,424 $138 $175,911 Yes

2545960716789373389 Subscriber Male 40-49 Health Status $76,373 $15,145 $26,211 $9,965 $127,694 Yes

248888401134241393 Subscriber Male 40-49 Injury/Poisoning $106,775 $278 $5,270 $12 $112,335 Yes

941239853399443063 Subscriber Male 50-59 Circulatory $91,052 $0 $10,779 $348 $102,179 Yes

489746019241504119 Subscriber Female 40-49 Infectious/Parasitic $40,979 $27,952 $13,902 $10,784 $93,617 Yes

4198927596083438987 Subscriber Female 30-39 Not Available $0 $612 $904 $74,244 $75,760 Yes

1094884564257948605 Dependent Female <1-19 Not Available $0 $63,089 $4,695 $95 $67,879 Yes

6857144571589587445 Subscriber Female 50-59 Not Available $0 $2,632 $11,205 $47,128 $60,965 Yes

4183665694084730189 Dependent Female <1-19 Endocrine $49,207 $2,806 $3,337 $1,204 $56,554 Yes

386634004531145816 Subscriber Male 50-59 Nervous $0 $29,299 $21,400 $5,731 $56,430 Yes

2201986040204944444 Subscriber Male 30-39 Infectious/Parasitic $50,395 $0 $3,012 $0 $53,407 No

7499255550340173410 Subscriber Female 50-59 Not Available $0 $5,641 $4,030 $43,096 $52,767 Yes

High Cost Claimant Total $709,351 $800,423 $438,756 $194,534 $2,143,064

Financial Overview: Medical Out of Pocket

Oct 2024 - May 2025 Oct 2025 - May 2026 % Change Out of Pocket Band Claimants Claimants % Out of Pocket Out of Pocket % Claimants Claimants % Out of Pocket Out of Pocket % Claimants Change Out of Pocket Change

Less than $100 508 39.3% $22,498 2.2% -100.0% -100.0%

$101 - $200 214 16.5% $29,380 2.9% -100.0% -100.0%

$201 - $300 98 7.6% $24,079 2.4% -100.0% -100.0%

$301 - $400 48 3.7% $16,756 1.7% -100.0% -100.0%

$401 - $500 34 2.6% $15,441 1.5% -100.0% -100.0%

$501 - $750 73 5.6% $46,538 4.6% -100.0% -100.0%

$751 - $1,000 47 3.6% $40,100 4.0% -100.0% -100.0%

$1,001 - $1,500 57 4.4% $69,288 6.8% -100.0% -100.0%

$1,501 - $2,000 49 3.8% $85,524 8.5% -100.0% -100.0%

$2,001 - $2,500 33 2.6% $73,639 7.3% -100.0% -100.0%

$2,501 - $3,000 29 2.2% $79,688 7.9% -100.0% -100.0%

$3,001 - $4,000 45 3.5% $154,794 15.3% -100.0% -100.0%

$4,001 - $5,000 20 1.5% $88,039 8.7% -100.0% -100.0%

$Greater than $5,001 39 3.0% $266,181 26.3% -100.0% -100.0%

Summary 100% 100% 1,294 100% $1,011,947 100% -100.0% -100.0%

Report Description: Provides a distribution of claimants by their total medical out of pocket expenses for the current period compared to the prior period and percent change.

This report helps determine the impact of any changes in plan design on out of pocket.

Coverage Tier Allowed Deductible Deductible % of Allowed Copayment Copay % of Allowed Coinsurance Coins % of Allowed Out of Pocket OPX % of Allowed Paid

Employee Only $2,360,898 $177,778 7.5% $117,139 5.0% $167,661 7.1% $462,579 19.6% $1,885,993 Employee + One $340,691 $35,959 10.6% $26,295 7.7% $31,475 9.2% $93,730 27.5% $221,692 Employee + Dependent(s) $1,836,376 $92,944 5.1% $93,578 5.1% $117,508 6.4% $304,030 16.6% $1,528,302 Family $1,363,097 $48,853 3.6% $41,437 3.0% $61,319 4.5% $151,608 11.1% $1,179,698 Summary $5,901,061 $355,534 6.0% $278,449 4.7% $377,964 6.4% $1,011,947 17.1% $4,815,685

This is a claimant analysis, where only members who had a claim are included. The tables exclude all medical enrolled members that did not submit a claim.

This report is based on claim data and may not reflect client specific benefits being applied to member out of pocket. Please contact your Account Executive for ACCUMS reporting.

Claimant Distribution by Out of Pocket Expense Bands

Out of Pocket Expense by Coverage Tier Oct 2025 - May 2026

Financial Overview: Lag Report

Incurred Month

Paid Month Jun 2025 Jul 2025 Aug 2025 Sep 2025 Oct 2025 Nov 2025 Dec 2025 Jan 2026 Feb 2026 Mar 2026 Apr 2026 May 2026 Summary

All Prior

Jun 2024

Jul 2024

Aug 2024

Sep 2024

Oct 2024

Nov 2024

Dec 2024

Jan 2025

Feb 2025

Mar 2025

Apr 2025

May 2025

Jun 2025

Jul 2025

Aug 2025

Sep 2025

Oct 2025 $321,174 $179,108 $75,895 $15,236 $6,775 $1,624 $80 $204 $600,096

Nov 2025 $293,004 $268,219 $28,979 $2,031 $40,083 $41,433 $520 $674,269

Dec 2025 $273,605 $157,169 $11,920 $39,321 $36,577 ($5,719) $512,875

Jan 2026 $383,579 $134,855 $17,258 $33,376 $29,457 $598,524

Feb 2026 $300,148 $363,045 $30,652 $2,303 $696,147

Mar 2026 $291,260 $462,749 $68,560 $822,569

Apr 2026 $372,227 $230,697 $602,924

May 2026 $308,280 $308,280

Summary $321,174 $472,112 $617,720 $584,963 $455,730 $752,591 $977,094 $634,301 $4,815,685

Report Description: Displays, by paid month, the medical dollars paid and the corresponding month incurred for a 12 month rolling paid period (if available for your account).

This report provides insight into the monthly claim lag and can help identify IBNR.

Pharmacy: Financial Summary

Report Description:

This report provides an overview of the pharmacy order of reduction from billed to paid for the current month, current period, prior period, and percent change.

Pharmacy Order of Reduction May 2026 Oct 2024 - May 2025 Oct 2025 - May 2026 % Change

Billed $492,845 $3,077,066 Discount $199,358 $1,409,197 Allowed $293,488 $1,667,869 Out of Pocket $27,368 $208,174 Other Adjustments ($135) ($447) Paid - Provider $266,255 $1,460,142 Paid $266,255 $1,460,142

Pharmacy: Key Indicators

Report Description: This report provides an overview of the prescription expenses for the current month. Prescription expenses and percent changes between the current and prior reporting periods are provided as well.

Key Indicators Summary Key Indicators Summary May 2026 Oct 2024 - May 2025 Oct 2025 - May 2026 % Change Unique Pharmacy Members 1,707 1,885 Claimants 534 1,198 Prescriptions 1,863 13,066 Prescriptions PMPM 1.09 0.95 Paid $266,255 $1,460,142 Paid PMPM $155.98 $106.63 Allowed $293,488 $1,667,869 Allowed PMPM $171.93 $121.80 Avg. Ingredient Cost/Prescription $157.36 $127.48 Generic Dispensing Rate 83.8% 83.5% Generic Substitution Rate 99.4% 98.6% Out of Pocket Percent of Allowed 9.3% 12.5% Retail as a Percent of Prescriptions 99.8% 99.8% Mail Order as a Percent of Prescriptions 0.2% 0.2% Specialty Percent of Total Prescriptions 0.6% 0.4% Specialty Percent of Total Paid 29.1% 18.1% Specialty Average Ingredient Cost/Prescription $6,851.31 $6,195.25

Cost Sharing Distribution

Cost Sharing Distribution May 2026 Oct 2024 - May 2025 Oct 2025 - May 2026 % Change

Retail Mail Retail Mail Retail Mail Retail Mail Member Out of Pocket 9.3% 100.0% 12.5% 91.9% Plan Paid 90.7% 0.0% 87.5% 8.1%

Pharmacy: Generic vs. Formulary Experience

Report Description: For the current period, the prescription drug expenses are displayed below for retail and mail order providers and broken out by drug type and formulary indicator.

Total Expense Member Expense Plan Expense

Total Prescriptions Prescriptions % of Total

Prescriptions Allowed Allowed /

Prescription Out of Pocket Out of Pocket /

Prescription Paid Paid/

Prescription Generic 10,906 83% $152,242 $13.96 $75,207 $6.90 $77,035 $7.06 Brand 2,160 17% $1,515,627 $701.68 $132,967 $61.56 $1,383,107 $640.33 Summary 13,066 100% $1,667,869 $127.65 $208,174 $15.93 $1,460,142 $111.75

Brand Type Breakdown Single-Source Brand 1,900 15% $1,438,958 $757.35 $123,801 $65.16 $1,318,790 $694.10 Multi-Source Brand 260 2% $76,669 $294.88 $9,166 $35.25 $64,318 $247.38 Multi-Source Brand w/ DAW1 68 1% $11,249 $165.43 $2,330 $34.26 $8,919 $131.16 Multi-Source Brand w/ DAW2 136 1% $47,659 $350.43 $4,834 $35.54 $39,639 $291.47

Brand Formulary 2,151 16% $1,442,053 $670.41 $129,156 $60.04 $1,313,345 $610.57 Brand Non-Formulary 9 0% $73,573 $8,174.81 $3,811 $423.46 $69,762 $7,751.35

Total Expense Member Expense Plan Expense

Mail Prescriptions Prescriptions % of Total

Prescriptions Allowed Allowed /

Prescription Out of Pocket Out of Pocket /

Prescription Paid Paid/

Prescription Generic 27 100% $167 $6.19 $154 $5.69 $14 $0.50 Brand Summary 27 100% $167 $6.19 $154 $5.69 $14 $0.50

Single-Source Brand Multi-Source Brand Multi-Source Brand w/ DAW1 Multi-Source Brand w/ DAW2

Brand Formulary Brand Non-Formulary

Total Expense Member Expense Plan Expense

Retail Prescriptions Prescriptions % of Total

Prescriptions Allowed Allowed /

Prescription Out of Pocket Out of Pocket /

Prescription Paid Paid/

Prescription Generic 10,879 83% $152,075 $13.98 $75,054 $6.90 $77,021 $7.08 Brand 2,160 17% $1,515,627 $701.68 $132,967 $61.56 $1,383,107 $640.33 Summary 13,039 100% $1,667,702 $127.90 $208,020 $15.95 $1,460,128 $111.98

Brand Type Breakdown Single-Source Brand 1,900 15% $1,438,958 $757.35 $123,801 $65.16 $1,318,790 $694.10 Multi-Source Brand 260 2% $76,669 $294.88 $9,166 $35.25 $64,318 $247.38 Multi-Source Brand w/ DAW1 68 1% $11,249 $165.43 $2,330 $34.26 $8,919 $131.16 Multi-Source Brand w/ DAW2 136 1% $47,659 $350.43 $4,834 $35.54 $39,639 $291.47

Brand Formulary 2,151 16% $1,442,053 $670.41 $129,156 $60.04 $1,313,345 $610.57 Brand Non-Formulary 9 0% $73,573 $8,174.81 $3,811 $423.46 $69,762 $7,751.35

Pharmacy: Top Non-Specialty Therapeutic Drug Classes

Report Description: The top 10 therapeutic and prescription drug classes for the current period are displayed below ranked by ingredient cost.

Current/ Prior Rank Plan Therapeutic Class Prescriptions

Utilizing Members Ingredient Cost

Avg. Ingredient Cost/

Prescription (Current)

Avg. Ingredient Cost/

Prescription (Prior)

Generic

Rank by Volume

1 Incretin Mimetic Agents 774 137 $720,026 $930.27 $0 2 2 Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors 248 45 $99,203 $400.01 $0 2.0% 13 3 Antidiabetic Combinations 215 41 $80,257 $373.29 $0 3.3% 16 4 Calcitonin Gene-Related Peptide (CGRP) Receptor Antag 24 6 $31,401 $1,308.39 $0 91 5 Insulin 112 26 $22,171 $197.96 $0 34 6 Sympathomimetics 183 106 $21,109 $115.35 $0 68.3% 20 7 Anti-infective Agents - Misc. 37 32 $20,550 $555.42 $0 83.8% 69 8 Viral Vaccines 165 127 $16,146 $97.85 $0 23 9 Eczema Agents 7 3 $14,184 $2,026.29 $0 131

10 Direct Factor Xa Inhibitors 30 7 $12,942 $431.40 $0 3.3% 82 All Other 11,218 1,165 $299,259 $26.68 $0 95.7% Summary 13,013 1,198 $1,337,249 $102.76 $0 83.8%

Current/ Prior Rank Drug Product Name Plan Therapeutic Class Prescriptions

Utilizing Members

Ingredient Cost

Avg. Ingredient Cost/

Prescription (Current)

Avg. Ingredient Cost/

Prescription (Prior)

Generic Indicator

Rank by Volume

1 MOUNJARO Incretin Mimetic Agents 367 60 $379,065 $1,032.88 NO 6 2 OZEMPIC Incretin Mimetic Agents 351 72 $287,731 $819.75 NO 7 3 JARDIANCE Sodium-Glucose Co-Transporter 2 (SGLT2 140 27 $53,810 $384.36 NO 19 4 FARXIGA Sodium-Glucose Co-Transporter 2 (SGLT2 103 18 $43,320 $420.58 NO 27 5 SYNJARDY XR Antidiabetic Combinations 114 19 $41,860 $367.20 NO 21 6 RYBELSUS Incretin Mimetic Agents 41 9 $39,174 $955.47 NO 75 7 XIFAXAN Anti-infective Agents - Misc. 6 3 $20,413 $3,402.09 NO 283 8 SYNJARDY Antidiabetic Combinations 54 9 $16,669 $308.68 NO 57 9 UBRELVY Calcitonin Gene-Related Peptide (CGRP) R 10 3 $14,898 $1,489.80 NO 214

10 OPZELURA Eczema Agents 7 3 $14,184 $2,026.29 NO 263 All Other 11,820 1,195 $426,124 $36.05 $0 Summary 13,013 1,198 $1,337,249 $102.76 $0

Pharmacy: Specialty Drug Analysis

Report Description: Specialty drugs generally have unique uses, require special dosing or administration, are typically prescribed by a specialist provider and are significantly more expensive than alternative drugs or therapies. This report provides specialty drug analysis for the current month, current period, prior period and percent change.

Top 10 Specialty Drugs by Ingredient Cost for the Current Period

Brand Name Specialty Class Ingredient

Cost Prescriptions

Avg. Ingredient Cost/

Prescription Specialty Claimants

ENBREL SRCLK INJ 50MG/ML AUTOIMMUNE $97,453 12 $8,121.05 2

BIMZELX INJ 320MG/2 AUTOIMMUNE $81,640 7 $11,662.83 2

SKYRIZI INJ 150MG/ML AUTOIMMUNE $46,362 6 $7,726.99 1

DUPIXENT INJ 300/2ML AUTOIMMUNE $32,029 8 $4,003.58 1

HUMIRA PEN INJ 40/0.4ML AUTOIMMUNE $26,595 4 $6,648.83 1

REZDIFFRA TAB 100MG GASTROINTESTINAL $25,656 6 $4,275.96 1

TYENNE INJ 162MG AUTOIMMUNE $9,273 6 $1,545.53 1

DUPIXENT INJ 200/1.14 AUTOIMMUNE $7,777 2 $3,888.25 1

TYENNE INJ 162MG AUTOIMMUNE $1,539 1 $1,539.48 1

HEPARIN SOD INJ 5000/ML ! $25 1 $24.88 1

Summary $328,348 53 $6,195.25 11

Specialty Drug Key Indicators May 2026 Oct 2024 - May 2025 Oct 2025 - May 2026 % Change

Unique Pharmacy Members 1,707 1,885

Claimants 9 11

Percent of Utilizing Members 0.5% 0.6%

Prescriptions 12 53

Specialty Percent of Total Paid 29.1% 18.1%

Percent of Total Prescriptions Paid 0.6% 0.4%

Paid $77,518 $264,808

Paid PMPM $45.41 $19.34

Average Ingredient Cost/Prescription $6,851 $6,195

Prior period is reflected only as it pertains to the Top 5 Specialty Classes of current period.

Note: The report reflects claims processed during the reporting period and may include prescriptions filled in prior months. For example, a prescription filled at the end of one month may not be processed until the following month.

Dental Financial Analysis

Financial Overview: Oct 2025 - May 2026

Service Category Claimants Claims Average Cost per Claim

Previous Average Cost per Claim % Change PMPM Benchmark % Variance from

Benchmark

Totals

Top 10 Procedure Service Type

Description Counts Prior Reporting period count PMPM by Service Type Service Type PMPM

Benchmark

* Service Type is the procedure detail of Service Category

Dental: Loss Ratio

Report Description: Provides the dental loss ratio and claims for the most recent reported twelve months.

Month Premium Dental Paid Claims Dental Loss Ratio Jun 2025 Jul 2025 Aug 2025 Sep 2025 Oct 2025 Nov 2025 Dec 2025 Jan 2026 Feb 2026 Mar 2026 Apr 2026 May 2026 Summary -

Key Findings: The dental loss ratio for the most recent reported month was 0.0% was similar to than the average of the most recent reported twelve months, which was 0.0%.

Appendix: ICD Category Definitions

Certain Conditions Original in the Perinatal Period: Includes infant-related conditions associated with prematurity and the newborn period until one month of age. Example conditions include prematurity, low birth weight, multiple births, various birth-related injuries, respiratory distress syndrome, and jaundice.

Certain Infectious and Parasitic Diseases: Includes communicable or transmissible diseases caused by bacteria and viruses that commonly cause widespread infection.

Example conditions include sepsis, infectious shock, tuberculosis, and COVID-19. Of note: immunization claims, which were previously in this category in the CCS diagnostic category system, are now in the Factors Influencing Health Status category.

Congenital Malformations, Deformations, and Chromosomal Abnormalities: Includes any genetic condition and/or organ malformations present at birth. Example conditions within this category include Down Syndrome, various heart defects, diaphragmatic hernia, spina bifida, cleft palate, polycystic kidney disease, and limb malformations.

Diseases of the Blood and Blood Forming Organs and Certain Disorders Involving the Immune Mechanism: Includes conditions related to white or red blood cells, platelets, or plasma. Example conditions include various types of anemias (e.g., iron deficiency, aplastic, sickle cell) and coagulation disorders such as hemophilia, and various immunodeficiency conditions.

Diseases of the Circulatory System: Includes conditions involving the heart, arteries, and veins. Example conditions within this category include hypertension, heart attack, coronary heart disease, congestive heart failure, arrhythmias, aneurysms, atherosclerosis, blood clots, and stroke.

Diseases of the Digestive System: Includes conditions involving the digestive organs, which includes the mouth, esophagus, stomach, intestines, gall bladder, liver, and pancreas. Example conditions within this category include stomach and intestinal ulcers, acid reflux, gallstones, cirrhosis, autoimmune hepatitis, pancreatitis, appendicitis, and various hernias.

Diseases of the Ear and Mastoid Process: Includes conditions involve in the ears, such as hearing loss, ear infection, earache, and tinnitus. Of note: This category is new within the CCSR system; these conditions were previously included in the Diseases of the Nervous System and Sense Organs category in the CCS system.

Diseases of the Eye and Adnexa: Includes conditions involving the eyes, such as cataracts, myopia, glaucoma, macular degeneration, and conjunctivitis. Of note: This category is new within the CCSR system; these conditions were previously included in the Diseases of the Nervous System and Sense Organs category in the CCS system.

Diseases of the Genitourinary System: Includes conditions involving the kidneys, bladder, and genitalia, including infertility diagnoses. Example conditions within this category include chronic kidney disease, kidney stones, incontinence, endometriosis, ovarian cysts, female and male infertility, and prostate enlargement. Of note: management related to infertility falls within the Pregnancy, Childbirth and the Puerperium category.

Diseases of the Musculoskeletal System: Includes conditions involving the bones, cartilage, joints, muscles, and connective soft tissue. Example conditions include osteoarthritis, osteoporosis, spinal stenosis, spondylosis, intervertebral disc disorders, radiculopathy, rheumatoid arthritis, and lupus.

Certain Conditions Original in the Perinatal Period: Includes infant-related conditions associated with prematurity and the newborn period until one month of age. Example conditions include prematurity, low birth weight, multiple births, various birth-related injuries, respiratory distress syndrome, and jaundice.

Certain Infectious and Parasitic Diseases: Includes communicable or transmissible diseases caused by bacteria and viruses that commonly cause widespread infection.

Example conditions include sepsis, infectious shock, tuberculosis, and COVID-19. Of note: immunization claims, which were previously in this category in the CCS diagnostic category system, are now in the Factors Influencing Health Status category.

Congenital Malformations, Deformations, and Chromosomal Abnormalities: Includes any genetic condition and/or organ malformations present at birth. Example conditions within this category include Down Syndrome, various heart defects, diaphragmatic hernia, spina bifida, cleft palate, polycystic kidney disease, and limb malformations.

Diseases of the Blood and Blood Forming Organs and Certain Disorders Involving the Immune Mechanism: Includes conditions related to white or red blood cells, platelets, or plasma. Example conditions include various types of anemias (e.g., iron deficiency, aplastic, sickle cell) and coagulation disorders such as hemophilia, and various immunodeficiency conditions.

Diseases of the Circulatory System: Includes conditions involving the heart, arteries, and veins. Example conditions within this category include hypertension, heart attack, coronary heart disease, congestive heart failure, arrhythmias, aneurysms, atherosclerosis, blood clots, and stroke.

Diseases of the Digestive System: Includes conditions involving the digestive organs, which includes the mouth, esophagus, stomach, intestines, gall bladder, liver, and pancreas. Example conditions within this category include stomach and intestinal ulcers, acid reflux, gallstones, cirrhosis, autoimmune hepatitis, pancreatitis, appendicitis, and various hernias.

Diseases of the Ear and Mastoid Process: Includes conditions involve in the ears, such as hearing loss, ear infection, earache, and tinnitus. Of note: This category is new within the CCSR system; these conditions were previously included in the Diseases of the Nervous System and Sense Organs category in the CCS system.

Diseases of the Eye and Adnexa: Includes conditions involving the eyes, such as cataracts, myopia, glaucoma, macular degeneration, and conjunctivitis. Of note: This category is new within the CCSR system; these conditions were previously included in the Diseases of the Nervous System and Sense Organs category in the CCS system.

Diseases of the Genitourinary System: Includes conditions involving the kidneys, bladder, and genitalia, including infertility diagnoses. Example conditions within this category include chronic kidney disease, kidney stones, incontinence, endometriosis, ovarian cysts, female and male infertility, and prostate enlargement. Of note: management related to infertility falls within the Pregnancy, Childbirth and the Puerperium category.

Diseases of the Musculoskeletal System: Includes conditions involving the bones, cartilage, joints, muscles, and connective soft tissue. Example conditions include osteoarthritis, osteoporosis, spinal stenosis, spondylosis, intervertebral disc disorders, radiculopathy, rheumatoid arthritis, and lupus.

Diseases of the Nervous System: Includes conditions involving the brain, spinal cord, and nerves. Example conditions include multiple sclerosis, sleep apnea, migraine, fibromyalgia, carpal tunnel syndrome, myasthenia gravis, Parkinson’s disease, Guillain-Barre syndrome, and spinal muscular atrophy. Of note: In the CCS system, this category previously included conditions related to the ears and eyes, but those conditions are now reported in the Diseases of the Ear and Mastoid Process and Diseases of the Eye and Adnexa categories, respectively.

Diseases of the Respiratory System: Includes conditions related to the airway and breathing, which includes the nose, bronchial tree, and lungs. Example conditions within this category include respiratory failure, throat infections, sinusitis, bronchitis, asthma, COPD, and pneumonia.

Diseases of the Skin and Subcutaneous Tissue: Includes conditions involving the skin, hair, and nails. Example conditions would be various skin/decubitus ulcers, cellulitis, psoriasis, dermatitis, alopecia, and fungal infections.

Endocrine, Nutritional and Metabolic Diseases: Includes conditions related to immune system functioning, nutrition, metabolism, and function of the endocrine glands, which include the thyroid, pituitary, pancreas, adrenal glands, ovaries, and testes. Example conditions would be diabetes, cystic fibrosis, thyroid disease, malnutrition, obesity, and hyperlipidemia. Of note: The immunodeficiency conditions that were previously reported in this category in the CCS system are now reported in the Diseases of the Blood and Blood Forming Organs and Certain Disorders Involving the Immune Mechanism category.

External Causes of Morbidity: Includes conditions related to accidents and exposure to harmful substances. Examples of conditions include injuries from motor vehicle accidents, exposure to the elements, and wounds from weapons or firearms.

Factors Influencing Health Status and Contact with Health Services: Includes diagnosis codes that are used for preventive screenings, immunizations, contraceptive management, post-operative rehabilitation, monitoring of post-operative organ transplants, and personal or family history of certain hereditary conditions such as cancer and heart disease. Note: Chemotherapy claims technically fall within this CCSR category, but the logic in Blue Insight ignores these codes to ensure that chemotherapy claims are categorized based on the underlying diagnoses they are treating, most of which are in the Neoplasms category. Also note: diagnosis codes for COVID-19 testing were previously reported in the Infectious and Parasitic Diseases category in the CCS system, but they are now reported under the Factors Influencing Health Status category.

Injury, Poisoning and Certain Other Consequences of External Causes: Includes treatment for injuries to the body, including various poisonings, as well as any complications from medical procedures and devices. Example conditions include sprains and strains, fractures, burns, lacerations, various drug or environmental poisonings, and complications from surgery.

Mental, Behavioral, and Neurodevelopmental Disorders: Includes psychiatric and behavioral conditions related to thinking, feeling, social skills or substance abuse. Example conditions include depression, anxiety, schizophrenia, eating disorders, autism, learning disorders, speech delay, Tourette's syndrome, and substance use disorders.

Neoplasms: Includes any abnormal growth of cells, either benign or malignant (cancer). Includes various cancer conditions and any abnormal growth of cells, including related chemotherapy, immunotherapy, and radiation therapy services. Example conditions within this category would be Leukemia, Hodgkin’s Disease, breast, lung, prostate, skin, and colon cancers. Of note: Diagnosis codes for personal or family history of cancer (as opposed to an active cancer diagnosis) were previously included in this category in the CCS system, but they are now included in the Factors Influencing Health Status category.

Pregnancy, Childbirth and the Puerperium: Includes vaginal and cesarean deliveries, maternally-related conditions associated with contraception and fertility management, and any complication of pregnancy. Example claims include fertility testing, artificial insemination, tubal ligation, IUD placement, pregnancy-induced hypertension, bleeding related to pregnancy, gestational diabetes, early or threatened labor, ectopic pregnancy, and delivery procedures. Of note: An actual diagnosis of infertility falls in the Diseases of the Genitourinary System category.

Signs, Symptom and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified: Includes abnormal lab results that may suggest, but do not always confirm, a more specific diagnosis, as well as general symptoms for which a more specific diagnosis cannot be found after medical evaluation, which is common for urgent care and emergency room claims. Example conditions include abdominal pain, shortness of breath, chest pain, fainting, nausea, fever, swelling, and abnormal test results. Note: Preventive screening claims were previously included in this category in the CCS system but are now included in the Factors Influencing Health Status category.

Glossary

Admin Fees: The charge to an account for HCSC's operational cost of doing business.

Administrative Services Only (ASO): A contract between HCSC and a self-funded plan where HCSC performs administrative services only and does not assume any financial risk. Services usually include claims processing but may include other services such as actuarial analysis and utilization review.

Aggregate: Constituting or amounting to a whole. For example, an aggregate account report includes data for the entire account.

Aggregate Stop Loss: A form of reinsurance that provides protection for medical expenses above a certain limit, generally on a year-by-year basis. Aggregate stop loss provides protection against the accumulation of total claims for a group as a whole exceeding a stated level.

Allowed: Amount considered eligible for payment by the plan

ASO Adjustments: An amount added or deducted from ASO (Administrative Services Only) fees. This includes Stop Loss Reimbursements.

Average Age: The difference between the claimant's year of enrollment and year of birth. Calculated using the measure Average Age divided by the members represented in the report.

Average Contract Size: The average number of members per subscriber. It is calculated as: Medical Members / Medical Subscribers

Average Dependents: Calculated using the measure Member Months (filtered on the Relationship = Dependents) divided by the number of months in the report.

Average Ingredient Cost: Represents the cost of the medication and is determined from the lowest submission of the pharmacy network rate, Usual & Customary amount, or Maximum Allowable Cost (MAC)

Average Members: Calculated using the measure Member Months divided by the number of months included in the report.

Average Subscribers: Calculated using the measure Subscriber Months divided by the number of months included in the report.

Billed: Amount submitted for payment by the provider

Billing and Accounts Receivable System (BARS): An HCSC financial system where all Administrative Services Only (ASO) customer bills are generated.

Blue Card Access Fee: Interplan Teleprocessing Services fee charged on out-of-state claims for accessing the local plan's provider network

Brand Formulary: Brand name medications that are listed on the formulary

Brand Non-Formulary: Brand name medications that are not listed on the formulary

Claimants: Number of individual members submitting a claim

Claim Lag: The amount of time between the date a claim is incurred and the date the claim payment is made.

COB: Portion of amount considered eligible for payment that has been paid by another insurance company (Coordination of Benefits)

COB Medicare: Portion of amount considered eligible for payment that has been paid by Medicare

COBRA Members: Consolidated Omnibus Budget Reconciliation Act - A federal law which requires most employers sponsoring group health plans to offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) when coverage under the plan would otherwise end.

Coinsurance: Portion of covered amount member is responsible to pay for the claim

Co-payment: Flat rate that the member is responsible to pay for the claim

Coverage Tier: Eligibility tiers which stratify enrollment data based on the employee and others enrolled under the employee's coverage. Varying benefits can be assigned to tiers.

Covered Amount: Amount eligible for payment based on the terms of the medical/dental benefits agreement.

DAW/1: Indicates that the physician has specified 'do not substitute' on the prescription.

DAW2: Indicates that the Physician has allowed a substitution, but the patient requested brand to be dispensed

Deductible: Portion of annual deductible amount member is responsible to pay applied to the claim.

Dental Loss Ratio: Calculated as the Dental Paid Claims Amount divided by the Billed Dental Premium Amount

Dental Paid Claims: An amount paid to cover the Health Plan's liability for dental services provided to members for claims that have been processed and approved for payment

Discount: Amount of reduction from billed amount that has been negotiated with the provider

Discount %: For medical claims, the discount percent is calculated as Discount / Covered

Dispensing Rate: The proportion of total drugs claims a certain drug or drug type is being dispensed

Drug Type: An indicator on each Rx claim that tells whether a prescription is single source brand, multi-source brand or generic item.

Effective Discount %: The effective discount percentage is calculated as: Discount / (Discount + Paid)

Fees and Credits: Includes all account-specific member and account level fees. Can include Specific Stop Loss, Aggregate Stop Loss, Administration, Access Fees, ASO Adjustments (either debits or credits), Rx Credits and other miscellaneous fees.

Females (20-44 years): The total number of members who are women between the ages of 20 and 44 years. The proportion of females (20-44 years) is calculated as: Member Months for Women between 20-44 years / Member Months

Formulary Compliance Rate: The percentage of drugs dispensed that were included in the formulary

Generic Dispensing Rate: Proportion of potential generic prescriptions that were filled as generic (excludes COVID claims).

Generic Drugs: A medication for which the patent has expired, allowing any manufacturer to produce and distribute the product under the chemical name.

Generic Substitution Rate: The rate in which generics were dispensed when a generic was available (excludes COVID claims).

Group Liability: Total Claim Expense plus Fees and Credits

HCC: High Cost Claimant, a claimant with total paid amount over a specified threshold (e.g., $30,000 or $50,000) within the reporting period

IBNR: An acronym for 'incurred but not reported'. IBNR claims are that group which are incurred before the fund reserving date, but not reported until after that date.

Ingredient Cost: The cost of the drug including sales tax, excluding dispensing fees.

In-Network Paid %: Percent of total paid expenses for in-network claims. It is calculated as: In-Network Paid / Paid

Inpatient Facility: Refers to Facility Inpatient claims

International Classification of Diseases (ICD): An official list of categories of diseases, physical and mental, issued by the World Health Organization (WHO).

Leading ICD Diagnostic Category: For each patient, summarize total paid amount for each diagnosis and its corresponding MDC. The MDC with the greatest paid amount for the patient becomes the Leading ICD Diagnostic Category for the reporting period

MAC Program Savings: Savings achieved by using the MAC (maximum allowable cost) discount on generic medications

Medical Paid Claims: An amount paid to cover the Health Plan's liability for medical (healthcare) services provided to members for claims that have been processed and approved for payment

Medical/Pharmacy Loss Ratio: Calculated as the combined Medical and Pharmacy Paid Claims Amount divided by the total Billed Premium Amount for Medical and Pharmacy, where appropriate

Member Months: Count of months of eligibility for members

Multi-Source Brand: Brand name medications with a generic equivalent

Network Indicator: An indicator that shows whether the claim was processed as in-network (e.g., in the Preferred Provider Organization network) or out-of-network and paid accordingly

Network Savings Discount: The discount that is applied when a member receives services from a contract provider.

Not Covered: Amount considered not eligible for payment by the plan (excludes the discount amount)

Other Adjustments: Minor payments or credits not captured in other specific expense measures

Other Payments: Combination of Blue Card access fees and surcharge expenses

Other Reductions: Combination of maximum reductions, penalties, workers compensation savings, and subrogation savings

Out of Pocket: Total amount that is the responsibility of the claimant. It is calculated as: (Copay + Deductible + Coinsurance)

Outpatient Facility: Refers to Facility Outpatient claims

Paid: Total amount paid by the plan, including access fees, adjustments, and surcharges

Paid-Provider: Amount paid to the provider by the plan

Paid/Claimant: Amount paid to the provider by the plan per claimant. It is calculated as: Paid / Claimants

Paid/Service: Amount paid to the provider by the plan per admission (inpatient facility), per visit (outpatient facility and professional) or per script (prescription Rx). It is calculated as: Paid / Services

Paid PEPM: Amount paid to the provider by the plan per employee per month. It is calculated as: Paid / Subscriber Member Months

Paid PMPM: Amount paid to the provider by the plan per member per month. It is calculated as: Paid / Member Months

Penalty: Amount charged to the user of health care services for a non-approved contractual service

PEPM: Per employee per month

Pharmacy Discount %: For pharmacy claims, the discount percent is calculated as Discount / (Discount + Allowed)

Pharmacy Paid Claims: An amount paid to pharmacies (or members where applicable) to cover the Health Plan’s liability for pharmacy services provided to members for claims that have been processed and approved for payment. The calculation of “pharmacy paid claims” does not include pharmaceutical manufacturer rebates

Pharmacy Tier: An indicator on each Rx claim that tells whether a prescription is generic, preferred brand, non-preferred brand, specialty, or other

Plan Eligibility: Eligibility derived directly from the plan's enrollment system. It excludes eligibility created during data processing for claims without matching records in the enrollment system.

PMPM: Per member per month

Premium: An agreed upon fee paid to the Health Plan for coverage of medical and/or dental benefits for an established benefit period and set intervals

Professional: Services provided by physicians or other professional providers

Recoveries: Subrogation and/or Reimbursements for claims that are included in BARS but not in HCSC's data warehouse (since some of the reimbursements could be for members or claims that are no longer in our data warehouse). Recoveries are loaded from the BARS System and included in Blue Insight for reconciliation purposes.

Rx Credit Fees: Drug rebates that are credited back to the account.

Rx Paid PEPM: Prescription drug paid amount per employee per month

Rx Paid PMPM: Prescription drug paid amount per member per month

Service Category: A classification based on claim type

Service Type: Classification based on principal diagnosis or ICD Procedure Code

Services: Number of admissions (inpatient facility), number of visits (outpatient facility), number of claim lines (professional), or number of scripts (prescription Rx)

Services/1000: Number of services per 1,000 members. It is calculated as: (Services / Member Months) * 1000 * 12

Single Source Brand: Brand name medications with no generic equivalent

Specialty Drugs: Medications that generally have unique uses, require special dosing or administration, are typically prescribed by a specialist provider and are significantly more costly than alternative drugs or therapies.

Specific Stop Loss: A form of reinsurance that provides protection for medical expenses above a certain limit, generally on a year-by-year basis. Specific (or individual) stop loss limits the cost of eligible medical expenses for each covered individual.

Subrogation Savings: Portion of amount eligible for payment originally paid by the plan but that has since been recovered through a legal action

Surcharge: Amount charged as a tax by certain States on facility claims

Therapeutic Drug Class: Used to categorize or group prescription drugs which are considered similar by the disease they treat or by the effect they have on the body

Total Paid: The total amount of medical and pharmacy dollars paid to cover healthcare services provided to members for claims that have been processed and approved for payment

Total Paid Claims + Recoveries: The total amount paid by the plan plus any amount recovered through subrogation.

Workers Compensation Savings: Portion of amount eligible for payment that has been paid a third party Workers Compensation carrier