Exhibit_7_Rate_Development_Supporting__Active_Employees.xlsx
XLSX spreadsheet 22 KB Posted
- Attached to
- OEIBA Program Commercial HMO, MSP, and MAPD Plans State and local contract opportunity
- Solicitation number
- EV00000681
- Issued by
- Oklahoma County, Hobart City, Oklahoma
About this file
This is an Excel-based Rate Development Supporting Data exhibit for an employee health insurance plan, specifically focused on Oklahoma's active employees, covering three experience segments from January 2023 through March 2025. The document provides a comprehensive template for tracking monthly and cumulative healthcare metrics across multiple years, including total premiums received, medical and prescription paid claims, capitated claims, prescription rebates, subscriber and member coverage, total admissions, inpatient days, and prescription volumes.
The exhibit is structured to capture detailed financial and utilization data across three distinct experience segments: January-December 2023, January-December 2024, and January-March 2025. While no specific pricing terms or funding sources are explicitly stated, the document appears to be a critical component of a health insurance rate development and analysis process, allowing for detailed tracking and comparison of healthcare utilization and associated costs over a multi-year period. The template suggests a systematic approach to evaluating healthcare plan performance and potential rate adjustments for active employees in Oklahoma.
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Text version
Exhibit 7 Exhibit 7 Rate Development Supporting Data - Active Employees [Supplier Name] Plan Year [Year] Instructions on providing the experience segments:
- Experience Segment 1: Provide requested information for the Oklahoma Active Employees.
- This Exhibit and Exhibit 6: Reports 6a and 6b should reconcile.
| Experience Segment 1 - January 2023 through December 2023 | January | February | March | April | May | June | July | August | September | October | November | December | Total | |
| 1. | Total Premium Received (In Dollars) | |||||||||||||
| 2. | Total Medical Paid Claims non-capitated (In Dollars) | |||||||||||||
| 3. | Total Rx Paid Claims (In Dollars) | |||||||||||||
| 4. | Total Capitated Paid Claims (In Dollars) | |||||||||||||
| 5. | Total Rx Rebates (Client Specific in Dollars) | |||||||||||||
| 6. | Total Subscribers Covered | |||||||||||||
| 7. | Total Members Covered | |||||||||||||
| 8. | Total Admissions | |||||||||||||
| 9. | Total Inpatient Days | |||||||||||||
| 10. | Total Non-Specialty Prescriptions | |||||||||||||
| 11. | Total Specialty Prescriptions | |||||||||||||
| Experience Segment 2 - January 2024 through December 2024 | January | February | March | April | May | June | July | August | September | October | November | December | Total | |
| 1. | Total Premium Received (In Dollars) | |||||||||||||
| 2. | Total Medical Paid Claims non-capitated (In Dollars) | |||||||||||||
| 3. | Total Rx Paid Claims (In Dollars) | |||||||||||||
| 4. | Total Capitated Paid Claims (In Dollars) | |||||||||||||
| 5. | Total Rx Rebates (Client Specific in Dollars) | |||||||||||||
| 6. | Total Subscribers Covered | |||||||||||||
| 7. | Total Members Covered | |||||||||||||
| 8. | Total Admissions | |||||||||||||
| 9. | Total Inpatient Days | |||||||||||||
| 10. | Total Non-Specialty Prescriptions | |||||||||||||
| 11. | Total Specialty Prescriptions | |||||||||||||
| Experience Segment 3 - January 2025 through March 2025 | January | February | March | Total | ||||||||||
| 1. | Total Premium Received (In Dollars) | |||||||||||||
| 2. | Total Medical Paid Claims non-capitated (In Dollars) | |||||||||||||
| 3. | Total Rx Paid Claims (In Dollars) | |||||||||||||
| 4. | Total Capitated Paid Claims (In Dollars) | |||||||||||||
| 5. | Total Rx Rebates (Client Specific in Dollars) | |||||||||||||
| 6. | Total Subscribers Covered | |||||||||||||
| 7. | Total Members Covered | |||||||||||||
| 8. | Total Admissions | |||||||||||||
| 9. | Total Inpatient Days | |||||||||||||
| 10. | Total Non-Specialty Prescriptions | |||||||||||||
| 11. | Total Specialty Prescriptions |
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