Exhibit 51a - Cal Yr 2024 City of Miami CIGNA ASO Monthly Fees Healthcare Experience by Benefit Option Rolling 12 BenOpt-1.xlsx
XLSX spreadsheet 21 KB Posted
- Attached to
- RFP No. 2130386 - Employee Health Benefits Plan
- Solicitation number
- RFP No. 2130386 - Employee Health Benefits Plan
- Issued by
- Florida
About this file
This document is a monthly healthcare experience report for the City of Miami's CIGNA Administrative Services Only (ASO) health benefits plan for calendar year 2024. The report details monthly healthcare experience metrics across multiple benefit options, including Network Open Access POS, OAP Plans, Vision, and Out of Area Plans. The report covers the entire 2024 calendar year from January through December, tracking total paid claims, ASO fees, subscribers, and members for various healthcare plan categories.
The financial data shows total annual paid claims of $42,302,321 with ASO fees totaling $979,663. The city's healthcare plan covers between 5,583 and 5,652 subscribers monthly, with total member counts ranging from 11,205 to 11,313 throughout the year. The report uses a retrospective experience-rated pricing model and breaks down healthcare costs by different plan types, including network and standalone options. Notable financial highlights include monthly variations in claims and fees, with some months showing negative adjustments in ASO fees, suggesting potential cost management or reconciliation mechanisms within the healthcare benefits structure.
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Rllg12 Client BenOpt-1
| CITY OF MIAMI | |||||||||||||||
| MONTHLY HEALTHCARE EXPERIENCE REPORT BY BENEFIT OPTION | |||||||||||||||
| January 2024 thru December 2024 | |||||||||||||||
| EXHIBIT 51a | |||||||||||||||
| Rating Type : RETROSPECTIVE EXPERIENCE RATED | |||||||||||||||
| Reported Premium: ASO Fees | |||||||||||||||
| Reported Claims: All Claims | |||||||||||||||
| YTD/MONTH | COH-CIGNA ONSITE HEALTH | NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NPOS2-STANDALONE NETWORK POS PLAN COPY NO RX | OAPAE-OAP PLAN ALL EMPLOYEES | OAPCE-OAP PLAN COMP EES | OAPCX-OAP COMP EES NO RX | OAPNX-OAP PLAN NO RX | OOA-OUT OF AREA PLAN | OOA2-STANDALONE OUT OF AREA PLAN COPY NO RX | VIS-CIGNA VISION FOR NETWORK PARTICIPANTS (B | VIS-VISION FOR NETWORK PARTICIPANTS (BUNDLED | TOTAL PAID CLAIMS | TOTAL ASO FEES | TOTAL SUBS | TOTAL MBRS |
| Jan-24 | $139 | $1,620,182 | $29,021 | $1,557,160 | $0 | $0 | $5,679 | $0 | $362 | $0 | $7,337 | $3,219,879 | $82,015 | 5,652 | 11,307 |
| Feb-24 | $0 | $546,496 | ($18,322) | $3,279,534 | $35 | $733 | $74,506 | $5 | $1,686 | $0 | $14,814 | $3,899,487 | $81,833 | 5,639 | 11,286 |
| Mar-24 | $0 | $388,593 | ($31,713) | $3,948,586 | $35 | $147 | $49,087 | ($5) | $32 | $0 | $19,473 | $4,374,234 | $82,013 | 5,637 | 11,291 |
| Apr-24 | $0 | $298,146 | $1,479 | $4,037,371 | $35 | $192 | $55,302 | $0 | $0 | $0 | $13,077 | $4,405,603 | $81,979 | 5,638 | 11,313 |
| May-24 | $0 | $31,427 | ($611) | $3,645,379 | $460 | $573 | $97,827 | $0 | $0 | $0 | $26,197 | $3,801,252 | $82,160 | 5,645 | 11,311 |
| Jun-24 | $0 | $99,997 | ($189) | $3,909,264 | $169 | $304 | $96,096 | $0 | $0 | $0 | $21,484 | $4,127,125 | $81,649 | 5,613 | 11,255 |
| Jul-24 | $0 | $42,477 | $282 | $4,226,291 | $704 | $693 | $130,183 | $0 | $0 | $0 | $21,263 | $4,421,894 | $81,430 | 5,597 | 11,227 |
| Aug-24 | $0 | $3,811 | ($891) | $3,778,285 | $64 | $349 | $192,797 | $0 | $0 | $0 | $21,937 | $3,996,353 | $81,575 | 5,599 | 11,235 |
| Sep-24 | $0 | $42,135 | $313 | $3,255,395 | $84 | $410 | $7,236 | $0 | $31 | $0 | $38,645 | $3,344,249 | $81,428 | 5,583 | 11,205 |
| Oct-24 | $0 | $158,961 | $12 | $3,419,486 | $203 | $1,823 | $76,067 | $0 | $0 | $0 | $30,279 | $3,686,831 | $81,098 | 5,593 | 11,231 |
| Nov-24 | $0 | ($33,360) | $64 | $2,440,922 | $141 | $344 | $51,586 | $0 | $40 | $41,156 | $0 | $2,500,892 | $81,206 | 5,599 | 11,232 |
| Dec-24 | $0 | ($7,980) | $1,499 | $4,804,648 | $288 | $369 | $165,433 | $0 | $0 | $41,496 | $0 | $5,005,753 | $81,278 | 5,601 | 11,226 |
| Grand Total | $139 | $3,190,885 | ($19,056) | $42,302,321 | $2,218 | $5,936 | $1,001,800 | $0 | $2,150 | $82,652 | $214,505 | $46,783,552 | $979,663 | 67,396 | 135,119 |
&G &7This report contains proprietary and/or confidential information. Disclosure is strictly prohibited except to the extent required by law. ADVICE Reporting System &8Page &P of &N Date: 1/7/2025 image1.png
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