RFP - COG-GUC - December 2024 Experience Reports.xls

This file is a monthly healthcare experience report for the City of Greenville and Greenville Utilities Commission (GUC) covering the period from January through September 2024. The report documents claims data for self-funded, experience-rated healthcare plans administered on an ASO (Administrative Services Only) basis. The plans include dental (PPO Plus and standard PPO options), medical (Core Open Access Plan, Enhanced Open Access Plan, HSA Family, and HSA Individual plans), and vision coverage through CIGNA. The report tracks claims by benefit option, branch/department, and employee category (active employees, pre-65 retirees, and COBRA participants) across multiple City of Greenville departments including Housing, Library, Administration, Fire/Rescue, Finance, Police, Parks & Recreation, Public Works, Planning, Airport, Engineering, and Convention/Visitor Center, as well as GUC active and pre-65 retiree populations. The data spans nine months of the 2024 contract year.

The experience report presents detailed claims information including fixed charges, in-network and out-of-network claims, pharmacy claims, gross claims, stop-loss adjustments, and net claims. Total claims for the nine-month period (January-September 2024) across both entities exceeded $13.3 million, with significant variation month-to-month. The report indicates a self-funded structure with stop-loss protection in place, evidenced by occasional stop-loss adjustments appearing in select months and benefit plans. Subscriber and member counts are detailed by plan type and department, with total combined membership ranging approximately 8,300-8,500 members across both entities during this period. This claims history serves as the basis for experience-rating future premium contributions under the self-funded arrangement and demonstrates actual healthcare utilization patterns for the consortium's employee population.