Exhibit 42 - Cal Yr 2025 City of Miami CIGNA TC19 Disruption Report - Total Records Total Claimants Total Eligible Charges Summary.xlsx

This document is a CIGNA Total Records Summary Report for the City of Miami's health benefits plan, covering calendar year 2025. The report provides a comprehensive analysis of in-network and out-of-network healthcare providers, focusing on total records, claimants, and eligible billed charges. The data reveals that 99.68% of records are in-network, representing 31,162 total records and $200,835,113.44 in eligible billed charges.

The report breaks down provider categories, with Community Physician Facility (CPF) providers comprising the largest segment at 68.04% of total records and 92.36% of eligible billed charges. Hospital-based providers account for 25.32% of records, while behavioral health providers and non-par providers are also detailed. Geographically, Florida dominates the provider landscape, with 82.83% of out-of-network records. The document includes additional analyses of provider specialties, with Family Medicine and Internal Medicine representing significant portions of the out-of-network providers. A Collaborative Accountable Care (CAC) section notes that the report may underestimate the impact of Cigna's physician group programs, as it only reports at the physician level.