RFP_31786-00192_Appendix_7.7_Basic_Plan_Vision_Utilization_by_Year2023-June2026.xlsx

This file is an appendix to RFP 31786-00192 for the State of Tennessee's Voluntary, Fully-Insured Vision Insurance Plan, presenting detailed utilization data for the Basic Plan Vision coverage from 2023 through June 2026. The document provides comprehensive monthly and annual projections for subscriber counts, members, and paid claims across the specified period. Subscriber counts are projected to grow from 23,679 in January 2023 to 28,371 by May 2026, while member counts are anticipated to increase from 46,814 to 56,372 over the same timeframe. The appendix includes service utilization counts across multiple vision care categories, including exams, retinal imaging, contacts, frames, and various lens options with coatings and treatments, providing baseline expectations for plan utilization across the contract period.

Paid claims data demonstrates monthly variation ranging from approximately $105,000 to $191,000 throughout the projection period, with total annual claims reaching $1.5 million to $1.8 million across full contract years. The service-level breakdown reveals that exams represent the highest volume service with 13,420 to 15,637 annual procedures, followed by frames and polycarbonate lenses as significant utilization categories. This utilization data serves as a critical planning and forecasting tool for the contracted vision insurance provider, enabling accurate financial modeling, resource allocation, and service delivery capacity planning for the State of Tennessee's employees and beneficiaries during the contract term.