Exhibit_4-_Medical_Claims_Report_2024-2025.xlsx
XLSX spreadsheet 13 KB Posted
- Solicitation number
- EVT0010856
- Issued by
- Sedgwick County, Kansas
About this file
This is a Medical Claims Report (Exhibit 4) for EVT0010856 detailing medical plan claims data for 2025 and 2024. The report presents claims information across multiple medical carriers and plan types, including Aetna (Plans A, C, J, and N), Blue Cross Blue Shield (Plans A, C, J, and N), and Caremark (Plans A, C, J, and N), as well as dental coverage through Delta Dental. The report tracks claim counts, allowed amounts, and net paid amounts for each carrier and plan combination across the two fiscal years.
The 2025 data shows significant claims volume across all carriers, with Blue Cross Blue Shield Plan A demonstrating the highest activity at 463,515 claims totaling $210,051,527.59 in allowed amounts and $180,070,963.34 in net paid claims. Caremark Plan A follows with 586,234 claims totaling $106,964,008.77 in allowed amounts and $82,425,277.67 in net paid amounts. Delta Dental processed 184,380 claims in 2025 with allowed amounts of $43,783,177.51 and net paid amounts of $30,930,978.24. Comparative 2024 data is provided for all carriers and plans, showing year-over-year variations in claim volumes and payment amounts across all medical and dental coverage options.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit_1-_Audit_Services_Technical_Proposal.docx | DOCX document | |
| Exhibit_3_-_Confidential_Section_(1).docx | DOCX document | |
| Agency_response_to_questions.xlsx | XLSX spreadsheet | |
| Exhibit_7-_Language_Standards_(1).docx | DOCX document | |
| RFP_-_Question_Format.xlsx | XLSX spreadsheet | |
| State_Employee_Health_Benefit_Plan_Audit_Services.pdf | ||
| Exhibit_2-_Audit_Services_Cost_Proposal.xlsx | XLSX spreadsheet | |
| Amendment_1_-_Response_to_Questions_.doc | DOC document | |
| Exhibit_6-_Performance_Guarantee_Standard.xlsx | XLSX spreadsheet | |
| Exhibit_5-_April_2026_Enrollment_with_Plan_Data.xlsx | XLSX spreadsheet | |
| SOKID_RFX0002907_0.00.pdf |
Show all 11
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Text version
Exhibit 4 Medical Claims Report
| Exhibit 4- Medical Claims Report EVT0010856 | |||||||
| 2025 | 2024 | ||||||
| Medical Carrier (Eligibility) | Medical Plan | Claim Count | Allowed Amount | Net Paid | Claim Count | Allowed Amount | Net Paid |
| Aetna | Aetna Plan A | 48,898.00 | $19,274,032.51 | $15,973,588.22 | 43,266.00 | $15,609,714.17 | $12,719,300.47 |
| Aetna | Aetna Plan C | 42,667.00 | $17,043,469.87 | $13,412,243.86 | 32,881.00 | $15,039,814.66 | $12,047,301.08 |
| Aetna | Aetna Plan J | 2,286.00 | $861,856.71 | $710,881.46 | 3,188.00 | $1,003,709.18 | $791,998.39 |
| Aetna | Aetna Plan N | 5,629.00 | $1,581,545.03 | $929,339.03 | 7,107.00 | $2,492,024.25 | $1,661,570.48 |
| BCBS | Blue Cross Blue Shield Plan A | 463,515.00 | $210,051,527.59 | $180,070,963.34 | 444,753.00 | $198,504,229.33 | $169,324,715.84 |
| BCBS | Blue Cross Blue Shield Plan C | 423,827.00 | $193,234,059.48 | $156,754,249.51 | 421,047.00 | $178,601,491.62 | $141,801,077.79 |
| BCBS | Blue Cross Blue Shield Plan J | 12,667.00 | $7,786,047.46 | $6,827,069.41 | 13,365.00 | $5,970,722.84 | $4,994,138.08 |
| BCBS | Blue Cross Blue Shield Plan N | 33,990.00 | $13,417,748.16 | $9,129,795.55 | 40,857.00 | $15,729,951.24 | $10,638,952.52 |
| Caremark | Plan A | 586,234.00 | $106,964,008.77 | $82,425,277.67 | 538,303.00 | $91,120,216.75 | $70,074,615.31 |
| Caremark | Plan C | 401,484.00 | $62,561,675.81 | $45,612,869.90 | 368,268.00 | $56,131,745.75 | $39,605,831.33 |
| Caremark | Plan J | 13,324.00 | $2,275,916.51 | $1,791,179.28 | 14,488.00 | $2,158,255.76 | $1,622,365.44 |
| Caremark | Plan N | 33,578.00 | $3,007,299.91 | $1,812,050.59 | 37,009.00 | $3,481,131.74 | $2,074,293.46 |
Dental
| Exhibit 4 Medical Claims Report | 2025 | 2024 | ||||
| Claims Count | Allowed Amount | Net Paid | Claims Count | Allowed Amount | Net Paid | |
| Delta Dental | 184,380.00 | 43,783,177.51 | 30,930,978.24 | 173,291.00 | 39,772,938.05 | 28,101,883.17 |
File details come from the government source that posted it. Updated .