MB080 Member Ranking EGWP.pdf

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Attached to
SELF-FUNDED MEDICAL & PRESCRIPTION DRUG EXCESS STOP LOSS COVERAGE
Solicitation number
RFP_F - 25
Issued by
Hudson County, New Jersey

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Written by GovTribe AI ·

This document is a member ranking report from Evernorth Health Services for the Jersey City Office PDP (Pharmacy Benefit Plan), covering prescription service dates from September 1, 2024, to August 31, 2025. The report provides a detailed breakdown of the top 25 members ranked by plan cost, with comprehensive data including individual member plan costs, prescription counts, and associated metrics. Each member is assigned a ranking based on total plan cost, prescription count, and ingredient cost.

The data reveals significant variation in member healthcare costs, with the top-ranked member incurring a plan cost of $643,709.36 and 154 prescriptions, while the 25th ranked member has a plan cost of $123,242.02 and 269 prescriptions. The total aggregated data shows 1,406 total prescriptions across these top 25 members, with a cumulative plan cost of $5,329,886 and an average plan cost per prescription of $3,791. The report includes detailed columns for Plan Cost Rank, Plan Cost, Rx Count Rank, Rx Count, Ingredient Cost Rank, Ingredient Cost, Member Cost, and Plan Cost per Prescription, providing a comprehensive view of healthcare utilization and expenses.

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Appendix B - Medical Plan Summaries.pdf PDF
Appendix C - City of Jersey City - Rx Grid Summary.pdf PDF
City of Jersey City - EGWP Rx Summary by Month - Total Scripts.pdf PDF
City of Jersey City - Commercial Rx Summary by Month - Total Scripts.pdf PDF
City of Jersey City - MB080 Member Ranking Commercial.pdf PDF
Stop Loss RFP Large Claim Report 2025.xlsx XLSX spreadsheet
City of Jersey City - Monthly Rx Enrolled Membership.pdf PDF
Spec JC 2026 SELF-FUNDED MED _ PRESC DRUG EXCESS STOP LOSS COVERAGE.pdf PDF
Stop Loss RFP Large Claim Report 2024.xlsx XLSX spreadsheet

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Member Ranking - Top 25 by Plan Cost

THE JERSEY CITY OFFICE - PDP

Member ID Member Name Plan Cost

Rank Plan Cost

Rx Count

Rank

Rx

Count

Ing Cost

Rank Ing Cost Mbr Cost

Plan Cost

/Rx

1 $643,709.36 154 62 1 $643,746.19 $56.03 $10,382.41

2 $349,295.05 108 69 2 $349,348.75 $70.60 $5,062.25

3 $338,611.76 7 161 3 $338,643.78 $106.52 $2,103.18

4 $320,400.29 4 183 4 $319,680.54 $801.55 $1,750.82

5 $228,031.18 537 37 5 $228,013.14 $10.01 $6,163.00

6 $218,864.27 467 40 6 $218,877.33 $30.46 $5,471.61

7 $218,074.02 228 54 7 $218,159.60 $109.78 $4,038.41

8 $213,858.31 664 33 8 $213,917.85 $68.34 $6,480.55

9 $197,528.97 421 42 9 $197,516.47 $0.00 $4,703.07

10 $196,110.80 382 44 10 $196,091.39 $0.59 $4,457.06

11 $195,414.86 402 43 11 $195,409.36 $0.00 $4,544.53

12 $193,283.95 467 40 12 $193,301.62 $25.47 $4,832.10

13 $191,305.18 286 50 13 $191,300.67 $2.44 $3,826.10

14 $184,109.87 1150 21 14 $184,104.43 $3.36 $8,767.14

15 $182,820.49 1150 21 15 $182,811.39 $0.00 $8,705.74

16 $174,159.03 142 64 17 $174,133.33 $0.00 $2,721.23

17 $173,971.33 246 53 16 $174,196.13 $231.55 $3,282.48

18 $167,831.77 1544 12 18 $167,825.97 $0.00 $13,985.98

19 $148,626.02 934 26 19 $148,616.26 $2.24 $5,716.39

20 $141,286.05 848 28 20 $141,364.87 $106.32 $5,045.93

21 $137,650.87 48 86 21 $137,647.28 $24.36 $1,600.59

22 $132,489.97 269 51 22 $132,662.72 $182.80 $2,597.84

23 $131,388.28 170 60 23 $131,498.82 $133.14 $2,189.80

24 $127,822.31 82 75 24 $127,951.93 $143.47 $1,704.30

25 $123,242.02 269 51 25 $123,337.17 $108.00 $2,416.51

$5,329,886 1,406 $5,330,157 $2,217 $3,791

Prescription Service Dates: 09/01/2024 - 08/31/2025

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