Exhibit 39 - Cal Yr 2024 City of Miami Stop Loss - High Claimant Report De-ID Dx.xlsx

This document is an Excel spreadsheet titled "Exhibit 39 - Cal Yr 2024 City of Miami Stop Loss - High Claimant Report De-ID Dx" detailing medical claims for the City of Miami's employee health benefits plan. The exhibit covers claims exceeding $50,000.00 for the calendar year 2024, with a pooled stop-loss and retrospective experience rating approach. The report includes detailed claims information across different employee benefit plans and classifications, such as OAP (Open Access Plan), Network POS (Point of Service), and various employee categories including general employees, SEA (Special Employees), and Executives/Elected Officials.

The claims data provides granular insights into medical expenses, categorized by factors like gender, age band, diagnosis (using ICD codes), and specific benefit options. The document reveals a wide range of medical conditions treated, including prostate cancer, appendicitis, end-stage renal disease, and various other diagnoses across different age groups. Drug claims and medical claims are separately tracked, with total claimant expenses ranging from minimal amounts to over $300,000 for some individual cases. The report is part of a broader Request for Proposals (RFP No. 2130386) for an Employee Health Benefits Plan in Florida, suggesting this exhibit is a supporting document for evaluating potential health insurance providers or assessing current healthcare spending.