Exhibit 50 - Cal Yr 2024 City of Miami CIGNA Vision Plans Claim Summary Report.pdf

PDF 271 KB Posted

Attached to
RFP No. 2130386 - Employee Health Benefits Plan
Solicitation number
RFP No. 2130386
Issued by
Florida

About this file

This document is a Cigna Vision Claim Summary for the City of Miami, specifically for the Cigna Sub Account Number 3202272, covering the period from January 1, 2024 through December 31, 2024. The report provides a detailed breakdown of vision care services across in-network and out-of-network doctors, categorizing claims by service type including exams, single vision, bifocal, trifocal, contact lenses, and frames.

The claim summary reveals a total of 2,743 combined network services, with 2,600 services from in-network doctors and 143 from out-of-network doctors. The total claim and copay allowed services amount to $468,493.22, with actual copays of $7,210.00, resulting in a total claim amount of $461,283.22. The average cost per claim is $168.17. The in-network services comprise 94.79% of total services, while out-of-network services account for 5.21%. The count of claims is 1,533, with an average cost per claim of $300.90, indicating a predominantly in-network utilization of vision care services.

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Other files

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Exhibit 51 - Cal Yr 2023 City of Miami CIGNA Claims by Benefits and ASO Fees Monthly Healthcare Experience by Benefit Option Rolling 12 BenOpt-1.xlsx XLSX spreadsheet
Exhibit 52a - Cal Yr 2022 City of Miami CIGNA Pooled Stop Loss High Claims Greater than 50K Experience De-ID.xlsx XLSX spreadsheet
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Exhibit 06c - Cal Yr 2025 City of Miami CIGNA Dental PPO Certificate Riders and Coverage for other states ETALLD25B Plan 3202272 HC-IMP35.pdf PDF
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Exhibit 25 - Cal Yr 2025 City of Miami Cobra Monthly Premiums.pdf PDF
Exhibit 03 - City of Miami AFSCME 1907 General Employees Union Contract Oct 1 2023 - Sep 30 2026.pdf PDF
Exhibit 45 - Cal Yr 2024 City of Miami EAP - EAP Utilization.pptx PPTX presentation
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Exhibit 38 - Cal Yr 2023 City of Miami Stop Loss - Greater than 50K High Claimant Report De-ID Dx.xlsx XLSX spreadsheet
Exhibit 44 - Cal Yrs 2025 _ 2026 EAP Renewal Letter.pdf PDF
Exhibit 74 - Cal Yr 2023 City of Miami ASO Fixed Charges and Fees Per Product Type Monthly Healthcare Detail Experience.xlsx XLSX spreadsheet
Exhibit 37 - Cal Yr 2022 City of Miami Stop Loss - Greater than 50K High Claimant Report De-ID Dx.xlsx XLSX spreadsheet
Questionnaire No. 8 - COBRA.pdf PDF
Exhibit 55 - Cal Yr 2025 as of Apr EAP Network Analysis Report Access 118974.pdf PDF
Exhibit 57c - Cal Yr 2025 YTD as of Jul - City of Miami CIGNA Pharmacy RX Dispensed Report.xlsx XLSX spreadsheet
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Exhibit 16 - Cal Yr 2024 City of Miami CIGNA Open Access Plan (OAP) Medicare No Rx - Comp EEs Plan 80 Percent Ded 500 Max Out of Pocket 2K ASO66.pdf PDF
Exhibit 49 - Cal Yr 2023 City of Miami CIGNA Vision Plans Claim Summary Report.pdf PDF
Exhibit 54b - Cal Yr 2025 City of Miami Stop CIGNA ISL and ASL Coverage Information Amendment Plan 3202272 CSL-SCH(10-15).pdf PDF
Exhibit 34 - Cal Yr 2025 City of Miami CIGNA Dental HMO Summary with Patient Charge Schedule.pdf PDF
Exhibit 42 - Cal Yr 2025 City of Miami CIGNA TC19 Disruption Report - Total Records Total Claimants Total Eligible Charges Summary.xlsx XLSX spreadsheet
Exhibit 61 - Cal Yr 2025 City of Miami CIGNA FSA Dependent Care - Summary Plan Document.pdf PDF
Exhibit 41a - Cal Yr 2025 City of Miami CIGNA Medical - Disruption Detail with Provider TIN - Option 1 - OAP-OA001 RITM9284277_TC19.xlsx XLSX spreadsheet
Exhibit 59 - City of Miami CIGNA Medical - Professional Services Agreement AMENDMENT NO 1 May 6 2021 ASO Agreement with Fees.pdf PDF
Exhibit 02 - City of Miami AFSCME 871 Sanitation Employees Union Contract Oct 1 2023 - Sep 30 2026.pdf PDF
Exhibit 15 - City of Miami Cal Yr 2024 CIGNA Medical - Comp EEs Plan 70 Percent Ded 300 Max Out of Pocket 1K ASO64.pdf PDF
Exhibit 30a - Cal Yr 2025 City of MIami CIGNA VIS Vision Benefit imbedded in Medical Plan Document ASO71.pdf PDF
Exhibit 18 - Cal Yrs 2023 _ 2024 City of Miami CIGNA FIXED Charges Report - PRR.xlsx XLSX spreadsheet
Exhibit 22 - Cal Yr 2025 City of Miami CIGNA Sum Ben Cov Comp EEs No Rx- Out Of Area Plan - Plan 70 Pct Ded 300 Max Out of Pocket 1K ASO67.pdf PDF
Attachment A - City of Miami Living Wage Ordinance.pdf PDF
Exhibit 19 - Cal Yr 2025 City of Miami CIGNA Medical - SBC Comp Ded 300 Max Out of Pocket 1K.pdf PDF
Exhibit 63 - Aug 2024 to Jul 2025 City of Miami CIGNA Claims by Benefits and ASO Fees Monthlty Healthcare Experience by Ben Option Rlg 12.xlsx XLSX spreadsheet
Exhibit 17c - Cal Yr 2025 City of Miami CIGNA Healthcare Massachusetts Rider for OAP Plans HC-RDR1.pdf PDF
Exhibit 54a - Cal Yr 2025 City of Miami CIGNA Medical - Administrative Services Only ASO And Stop Loss Fees Schedule.pdf PDF
Exhibit 05c - Cal Yr 2025 City of Miami CIGNA Dental HMO Certificate Riders and Coverage for 7 States ETALLD25A Plan 3202272 HC-ETRDR.pdf PDF
Exhibit 06d - Cal Yr 2025 City of Miami CIGNA Dental PPO Territorial Legislation - 23 States ETALLD25B.pdf PDF
Exhibit 31 - Cal Yr 2024 City of Miami CIGNA Lag Report Incurred Date included - Monthly Healthcare Experience by Acct Rolling 12-1.xlsx XLSX spreadsheet
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