Exhibit 05d - Cal Yr 2024 City of Miami CIGNA Dental HMO and PPO Utilization and Claims.ppt

Month Day, Year Presenter Name

Copyright 2025 Cigna - Confidential and Privileged - Not for Distribution EXHIBIT 05d Dental Reports Cal Yr 2024 3 Mo Run Out

Table of Contents

• Dental

Dental Care - Utilization by Type of Service Dental Reports Cal Yr 2024 3 Mo Run Out

Current Period reflects claims incurred between Jan. 2024 and Dec. 2024, paid through Mar. 2025 Base Period reflects claims incurred between Jan. 2023 and Dec. 2023, paid through Mar. 2024

CITY OF MIAMI-Request 1563906-View 1937755-RPT_ID 277_BCN-Tier 4 Comments

· There is an increase in utilization per thousand in 4 categories and a decrease in utilization per thousand in 4 categories for an overall utilization trend of -0.1%

· High utilization for Diagnostic/Preventive services can lead to lower usage of other service categories

Gross Services by Type Base

Current

Trend

Norm

Count Percent of Total

Diagnostic/Preventive 3,152 63.3%

3,031 65.2%

-3.8%

72.1%

Basic Restorative 4.4%

3.9%

-16.5%

5.9%

Major Restorative 2.2%

3.1%

27.7%

3.6%

Endodontics 0.7%

1.0%

35.3%

0.9%

Periodontics 16.0%

14.0%

-18.2%

8.7%

Oral Surgery 2.2%

2.2%

-6.4%

3.0%

Orthodontics 7.8%

7.6%

-9.5%

3.5%

Other Services 3.4%

3.0%

-16.8%

2.3%

Total 4,978 100.0%

4,647 100.0%

-6.6%

100.0%

Services per 1,000 Members by Type Base

Current

Diagnostic/Preventive 2,127.7 63.3%

2,190.2 65.2%

2.9%

2,360.9 72.1%

Basic Restorative 147.2 4.4%

131.5 3.9%

-10.6%

193.7 5.9%

Major Restorative 75.6 2.2%

103.3 3.1%

36.7%

116.4 3.6%

Endodontics 23.0 0.7%

33.2 1.0%

44.8%

29.2 0.9%

Periodontics 538.0 16.0%

471.1 14.0%

-12.4%

286.2 8.7%

Oral Surgery 74.3 2.2%

74.4 2.2%

0.2%

98.8 3.0%

Orthodontics 261.9 7.8%

253.6 7.6%

-3.2%

113.8 3.5%

Other Services 112.7 3.4%

100.4 3.0%

-10.9%

77.0 2.3%

Total 3,360.3 100.0%

3,357.9 100.0%

-0.1%

3,276.0 100.0%

Plan cost & trend

Dental PPO - Claims Summary Dental Reports Cal Yr 2024 3 Mo Run Out

CITY OF MIAMI-Request 1563906-View 1937755-RPT_ID 377_BCN-Tier 4

· Net effective discount increased from 31.3% to 31.4%, and compares to a norm of 25.8%

· Network utilization decreased from 72.7% to 72.0% of submitted charges, and compares to a norm of 71.0%

$80 $60 $40 $20 $0

EE Spend PMPM

Plan Spend PMPM

Total Spend PMPM

Current Norm $32.27 $35.46 $25.59 $30.57 $31.63 $29.86 $62.84 $67.08 $55.44

Submitted Charges

$2,595,067

$2,881,836

11.1%

Network Charges

Total Network Charges

$1,887,848 72.7%

$2,075,342 72.0%

9.9%

71.0%

Provider Discounts

Total Dentists Discounts

$811,915 43.0%

$905,004 43.6%

11.5%

36.3%

Net Effective Discount

31.3%

31.4%

0.1%

25.8%

Plan Design Savings

$490,066 18.9%

$565,100 19.6%

15.3%

19.6%

Utilization Management & Review

$425,694 16.4%

$479,805 16.6%

12.7%

14.0%

Total Savings

$1,727,675 66.6%

$1,949,909 67.7%

12.9%

59.4%

Plan Paid Amount

$867,392 33.4%

$931,928 32.3%

7.4%

39.2%

Plan Paid Amount Per Month

Employees

$32.56

$33.85

4.0%

$30.60 Spouses

$33.20

$32.19

-3.0%

$31.60 Dependent

$25.69

$27.53

7.2%

$27.63 Member

$30.57

$31.63

3.5%

$29.86

Percent of membership by age band and product Percent of spend by age band and product

Dental - Membership Summary Dental Reports Cal Yr 2024 3 Mo Run Out Comments

· Average membership in the current period was 3,840, a decrease of 0.2%

· Average family size decreased from 1.92 to 1.91, a decrease of 0.5%. Average family size measures the ratio of members to employees

· Employees represented 52.4% of the population in the current period, spouses 17.4% and dependents 30.2%

Summary of membership

Average Populations Employees Spouses & Dependents Members Average Family Size Percent Female Percent Male

Dental Care 1,481 1.90 50.5% 49.5%

DPPO

1,218 1,147 2,365 1.94 52.8% 47.2%

Total 1,998 1,848 3,846 1.92 51.9% 48.1% 20% 15% 10% 5% 0%

Current Period reflects claims incurred between Jan. 2024 and Dec. 2024, paid through Mar. 2025 Base Period reflects claims incurred between Jan. 2023 and Dec. 2023, paid through Mar. 2024 24% 18% 12% 6% 0%

CITY OF MIAMI-Request 1563906-View 1937755-RPT_ID 371_BCN-Tier 4 <1 1-17 18-29 30-39 40-49 50-59 60-64 65+

Average Populations Employees Spouses & Dependents Members Average Family Size Percent Female Percent Male

1,384 1.85 50.2% 49.8%

DPPO

1,264 1,192 2,456 1.94 53.0% 47.0%

Total 2,011 1,828 3,840 1.91 52.0% 48.0% <1 1-17 18-29 30-39 40-49 50-59 60-64 65+

DPPO Demographic Summary

Current Trend Norm Average Number of Employees 1,218 1,264 3.8%

Average Number of Members 2,365 2,456 3.9%

Average Member Age 39.7 40.1 1.0% 36.5 Services per Claimant 9.1 9.4 3.3% 7.8 % of Members Using Plan 68.6% 68.5% -0.1% 66.8% % of Unique Members Receiving a Cleaning 60.9% 61.5% 0.6% 59.4% DPPO Dental Care

DPPO Dental Care

Average plan members

CITY OF MIAMI-Request 1563906-View 1937755-RPT_ID 370_BCN-Tier 4 Dental Dashboard Dental Reports Cal Yr 2024 3 Mo Run Out Base Current DPPO Oral Health Behavior Savings Member population

DPPO

Network performance

Current Trend Norm Total network charges 72.7% 72.0% -0.7% 71.0% Achieved discounts 43.0% 43.6% 0.6% 38.2% Healthy behaviors Base Current Trend Norm

Exams 56.5% 57.1% 0.5% 57.5%

Cleanings 53.9% 54.4% 0.5% 55.9%

Fluoride 19.0% 19.3% 0.4% 20.8%

Periodontal cleanings 8.2% 8.4% 0.2% 4.4% Treatment

Fillings 16.7% 16.7% 0.0% 14.2%

Crowns 8.2% 7.4% -0.8% 6.9%

Root canals 2.2% 2.0% -0.2% 1.7%

Extractions - all 4.6% 4.7% 0.1% 3.8% Gum disease

Non surg perio 5.2% 5.4% 0.2% 2.2%

Current Period

Members with 1 or More Cleanings

Total Plan Members

Norm

Current Period

Total Network Charges

Total Submitted Charges

Norm

Current Period

Family Size

Total Group

Norm Employees & dependents all products

Base Current Trend Norm Employees 1,998 2,011 0.7%

Dependents 1,848 1,828 -1.1%

Family Size 1.92 1.91 -0.8% 1.95 Total Members 3,846 3,840 -0.2%

Base 2,365 1,481 Current 2,456 1,384 Trend 3.9% -6.6% 2,600 1,950 1,300 % of Unique members by service type % of Unique members receiving cleaning Base Current Trend Norm 60.9% 61.5% 0.6% 59.4% Month with greatest overall change:

Base :

June 0.9% Current :

December 0.9%

Trend

Net effective discount

0.1% 27.1%

Plan design savings

18.9%

0.7%

Utilization management & review

16.4% 16.6% 0.2% 14.0%

Total savings

66.6% 67.7% 1.1% 60.7%

Plan paid claims PMPM

$30.57 $31.63 3.5% $29.86

Member savings on services provided

84.3% 84.9% 0.6% 85.0%

Dental PPO - Claim Cost and Savings Summary

CITY OF MIAMI-Request 1563906-View 1937755-RPT_ID 378_BCN-Tier 4

· Total savings represents total submitted dollars not paid due to plan design mechanics (e.g.deductible, coordination of benefits, discounts, utilization management etc) while net effective discount represents total network discount savings

PMPM

Account Summary Base Current Base Current Trend Norm Submitted Charges $2,595,067 $2,881,836 $91.46 $97.80 6.9% $76.08 Employer Paid $867,392 $931,928 $30.57 $31.63 3.5% $29.86 Discount Dollars $811,915 $905,004 $28.61 $30.71 7.3% $20.63 Net Effective Discount

Plan Design Savings

Deductible $75,633 $80,107 $2.67 $2.72 2.0% $1.21 Coinsurance $296,220 $319,842 $10.44 $10.85 4.0% $8.44 Coordination of Benefits $1,823 $2,012 $0.06 $0.07 6.2% $0.25 Annual/Lifetime Maximum $35,090 $46,951 $1.24 $1.59 28.8% $1.70 Maximum Reimbursable Charge $69,221 $89,834 $2.44 $3.05 25.0% $2.57 Scheduled Plan Savings $0 $0 $0.00 $0.00 0.0% $0.23 Other Savings $12,079 $26,354 $0.43 $0.89 110.1% $0.54 Total $490,066 $565,100 $17.27 $19.18 11.0% $14.93 Savings as % of submitted 18.9%

Utilization Management and Utilization Review Savings

Missing Tooth Limitation $0 $1,331 $0.00 $0.05 0.0% $0.07 Age/Frequency Limitation $53,920 $55,374 $1.90 $1.88 -1.1% $1.40 Additional Plan Design $151,540 $134,990 $5.34 $4.58 -14.2% $2.72 Alternative Benefit Provision $48,110 $49,091 $1.70 $1.67 -1.7% $1.21 Utilization Review $172,124 $239,018 $6.07 $8.11 33.7% $5.26 Total $425,694 $479,805 $15.00 $16.28 8.5% $10.66 Savings as % of submitted 16.4% 16.6%

Total Savings $1,727,675 $1,949,909 $60.89 $66.17 8.7% $46.22 Total Savings as % of submitted 66.6% 67.7%

Glossary

Additional Plan Design Savings Savings generated from contractual limitations and benefits exclusions.

Adjunctive General Services Palliative treatments, consultations, emergency care, second opinions and anesthesia.

Age Maximum Savings due to age limits on fluoride treatments, sealants, orthodontic services and other services.

Alternate Benefit Provision This provision includes a three-tier claim review process monitored by Dental Claim Analysts, Dental Reviewers and Dental Consultants. Under this process, proposed treatment plans are examined by Dental Reviewers and approved, denied, or referred to Dental Consultants for alternate treatment decisions. Where appropriate, the Dental Consultant will recommend alternate treatments considered to be less costly and consistent with professional dental standards.

Annual Maximum Savings due to a patient reaching the maximum payment under the plan, often per calendar year.

Average Area Charge Average charge based on the number of dentist in the geographical area pertaining to your membership.

Basic Restorative Dental treatments or procedures performed to repair and restore individual teeth due to decay, erosion, trauma or improper function. Basic services may include fillings, oral surgery, endodontics (root canals) and periodontics (tissue/bone treatment).

Benefit Option This code is used to identify different Cigna product lines purchased by a customer.

Charges The amount charged by a dentist for dental services rendered.

Children Children are defined as child, step-child, handicapped child, eligible students and adult dependent.

Claim Branch This term describes the different ways an account can be sub-divided into groups for reporting purposes based on the account structure.

Coinsurance The percentage of covered expenses paid by the member when costs are being shared by both the plan and the individual member.

Coordination of Benefits (COB) The amount saved when Cigna is the secondary insurer. It represents the difference between what Cigna pays and (COB) what it would have paid if it were primary.

Covered Employees The number of Covered Employees for the reporting period equals the number of active employees in the first reporting period month and includes any active employee additions made in the following months within the reporting period. To be counted as a covered employee addition the employee must have had atone day of coverage.

Deductible An amount specified in plan design that must be paid by member for covered expenses in a benefit period before the plan will pay benefits.

Dental care The term utilized to represent the Cigna Dental Care product (formerly represented as DHMO). In most states, the Cigna Dental Care plan requires the selection of a general dentist for routine, preventive, diagnostic and emergency care. Referrals to specialists are provided, as needed. Data for this product can be found in the sections labeled Dental Care.

DHMO

Dental Health Maintenance Organization. Cigna's DHMO product is called Cigna Dental Care. In most states, the Cigna Dental Care plan requires the selection of a general dentist for routine, preventive, diagnostic and emergency care. Referrals to specialists are provided, as needed. Data for this product can be found in the sections labeled Dental Care.

Diagnostic/Preventive Dental treatments or procedures focused on the prevention and diagnosis of dental diseases. These services may include oral examinations, cleanings, X-rays, sealants and fluoride treatments.

DPPO

Cigna Dental Preferred Provider Organization. With the Dental Preferred Provider Organization plan (DPPO), customers can see any licensed dentist or specialist, but may pay less for covered services when utilizing in-network dentists for care. Data for this product can be found in the sections labeled DPPO.

Endodontics The dental specialty that concentrates on the treatment of root canals or other injuries/diseases of the pulp, or nerve, of the tooth.

Frequency Maximum Savings due to frequency limits on examinations, cleanings, radiographs, crowns and other services.

Ineligible Charges Ineligible Charges include savings attributable to limitations of the plan (Missing Tooth Limitation, Age/Frequency, Annual/Lifetime Maximums); charges submitted for ineligible participants; application of Alternate Benefit Provisions which may be a result of the Pre-Determination of Benefits (PDB) process; services that exceed the maximum reimbursable charge limits per service, or the Scheduled Plan benefits, if applicable; and Utilization Management Services.

In-Network Services rendered by providers who are part of a network and with whom Cigna has a contractual relationship.

Major Restorative Dental treatments or procedures targeting the restoration of teeth using services such as crowns, inlays, or onlays. Major services also may include prosthodontics (i.e. dentures).

Member An individual who is eligible for coverage and enrolled under a dental plan. Includes employee and any covered dependents.

Missing Tooth Limitation A contractual provision which limits or excludes payment for the replacement of teeth that are missing prior to the patient's effective date of plan coverage.

Norm Norm refers to the comparison group based on book of business or industry experience for the defined parameters. Norms are annualized unless otherwise stated.

Oral Surgery Non-surgical and surgical extractions, and other surgical procedures.

Orthodontics Dental treatments or procedures performed to correct misalignments of the teeth and restore the teeth to their proper alignment and bite function. Services may include braces or retainers.

Other Savings Other Savings is a category in which savings is captured when a claim has multiple plan design savings reasons.

Out-of-Network Services rendered by providers who are not part of the Cigna network based on your benefit plan design.

Paid Claims That portion of the dentist's charges paid by Cigna to a patient or provider for dental services covered under the benefit plan.

Patient A unique individual participant (employee or dependent) who received one or more dental services during the reporting period in-network and/or out-of-network.

Periodontics Scaling and root planing, surgical procedures of the gingiva/bone, and other gum-related treatment.

Pre-Determination of Benefits (PDB) A process that allows the patient and dentist learn what benefits are provided by the dental plan in advance of treatment. The PDB process provides the dentist and participant with a detailed explanation of what specific benefits are available at the time the claim is reviewed so that the dentist may discuss the information with the patient before treatment is rendered and expenses are incurred. Savings from this process are also realized through the avoidance of more costly dental treatments where a less costly alternative is recommended.

Provider Discounts The difference between the contracted payment amount and the average area charge for a procedure.

Scheduled Plan Savings Savings due to the application of set scheduled dollar payment amounts for dental services set forth in a scheduled benefit plan.

Services The number of individual dental procedures rendered by dental care providers.

Utlization Management The set of administrative practices used on behalf of purchasers of dental benefits to manage the necessity, appropriateness, frequency and mix of dental services. It entails practices used in claims review for predetermination or payment of benefits, statistical review of individual provider utilization profiles and appropriate follow-up procedures.

Report Parameters

Global Parameters

Overall Dates

Incurred 01/2024 to 12/2024 01/2023 to 12/2023

Incurred Runout 01/2024 to 03/2025 01/2023 to 03/2024

Catastrophic Threshold $50,000 Exclude Pharmacy No Package :1937755

Package Name:

Structure:

Status = *, Division = *, Product Codes = DHMO,DPPO,HMO,HMOOA,IND,NET,NETOA,NETPOS,NETPOSOA,OAP,RX

Package Parameters PMPM,BCN,Override:No

Normative Values

NETPOS ,HMOOA ,NET ,RX ,NETPOSOA ,DPPO ,IND ,NETOA ,HMO ,DHMO ,OAP ,202412

CITY OF MIAMI:3202272