Exhibit A-6 - Vision Plan and Claim Information.xlsx

XLSX spreadsheet 27 KB Posted

Attached to
Medical, Dental, Vision Insurance Services
Solicitation number
2604-002
Issued by
Travis County, Austin City, Texas

About this file

This is a Vision Plan Claims Experience Exhibit for Travis County Healthcare District - Central Health, a Texas healthcare consortium. The document presents detailed claims data and subscriber information for vision insurance coverage over a 24-month rolling period from December 2023 through November 2025. The exhibit demonstrates the operational scope of the vision plan by tracking monthly subscriber counts, member enrollment, billed premiums, and incurred claims across this two-year timeframe. During the reporting period, subscriber counts increased from 1,274 in December 2023 to 1,654 in November 2025, while member counts grew from 2,328 to 2,904 respectively, indicating steady plan growth and increased covered lives.

The financial performance of the vision plan shows an aggregate premium billed of $363,687 against aggregate incurred claims of $273,767, resulting in a cost ratio of 75 percent. Monthly billing amounts increased notably beginning in March 2025, rising from approximately $13,200 to approximately $19,600 by November 2025, reflecting the growing membership base and associated premium adjustments. The claims data presented are unaudited and represent incurred and completed claims through November 2025, with payments processed through December 2025. This exhibit serves as the baseline experience data for evaluating the vision insurance plan's performance and financial sustainability under the current contract with Travis County Healthcare District.

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EXHIBIT F - Certificate of Secretary.pdf PDF
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Exhibit A-15 - Data Requirements.pdf PDF
Exhibit A-13 - Medical ASO, Dental, Vision Questionnaire.xlsx XLSX spreadsheet
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Text version

BTV_24

TRAVIS COUNTY HEALTHCARE DISTRICT - CENTRAL HEALTH
Group/Control#: 00285663

Experience Exhibit

- Claims displayed are incurred and completed through November 2025.
- Claims displayed are based on a rolling 24 months of data.
- Claims paid through December 2025.

Monthly Claims:

MonthSubscribersMembersMonthly BilledMonthly Vision
PremiumClaims
December 20231,2742,328$11,371$8,137
January 20241,2962,354$11,527$6,563
February 20241,3482,419$11,921$9,684
March 20241,4232,607$12,718$13,616
April 20241,4362,608$12,772$13,432
May 20241,4492,616$12,834$9,421
June 20241,4492,609$12,793$10,302
July 20241,4692,640$12,981$11,469
August 20241,4922,670$13,159$11,883
September 20241,4982,670$13,203$10,655
October 20241,5012,664$13,192$16,256
November 20241,5102,675$13,242$10,254
December 20241,5172,674$13,297$8,030
January 20251,5492,727$13,566$8,219
February 20251,5352,700$13,439$9,690
March 20251,5832,798$18,769$16,558
April 20251,5832,798$18,768$12,182
May 20251,5732,779$18,683$12,782
June 20251,5692,782$18,663$12,258
July 20251,6012,831$19,008$13,405
August 20251,6142,861$19,205$14,564
September 20251,6362,890$19,452$9,185
October 20251,6432,899$19,521$12,534
November 20251,6542,904$19,604$12,687
Aggregate Premium Billed$363,687
Aggregate Incurred Claims$273,767
Cost Ratio75%

Premium amounts and lives counts displayed on this report are unaudited image1.png

File details come from the government source that posted it. Updated .