Sample Monthly Actuarial Report.pdf

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Health & Welfare Actuarial & Broker Consultant
Solicitation number
RFP AABA 2027000049 3
Issued by
Denver County, Denver City, Colorado

About this file

This is a Monthly Actuarial Report prepared by The Segal Group for the State of Colorado Department of Personnel and Administration's (DPA) self-funded health and welfare plans, covering financial results through August 31, 2026 (the first two months of Fiscal Year 2027). The report analyzes performance of the state's self-funded medical, prescription drug, and dental plans, as well as the fully insured Kaiser Permanente plans. The medical and prescription drug plans are administered through Cigna and MedImpact, while dental claims are managed by Delta Dental. The report projects that the self-funded medical and prescription drug plans will generate a deficit of approximately $9.8 million (1.7% higher than budget) by the end of FY2027, with a reserve ending balance expected to reach $23.2 million after the additional advanced contributions infusion in June 2027. Year-to-date through August 2026, the self-funded plans generated a paid surplus of approximately $15.8 million (16.7% of budget), while the self-funded dental plan generated a paid loss of approximately $350,000 (6.3% of budget).

Key financial metrics indicate that medical and prescription drug claims and administrative fees for the two-month period were $1,653.27 PEPM ($814.73 PMPM), representing a 1.9% decrease from the prior month. Prescription drug costs continue to experience double-digit trends with a 41.9% increase year-over-year, while rebates decreased 26.4% primarily due to changes in anti-obesity medication strategy and implementation of the Zepbound program effective May 1, 2026. The stop loss threshold was increased from $500,000 to $1,500,000 combined medical and pharmacy individual specific deductible, resulting in reduced stop loss premiums of $1.1 million year-to-date compared to $3.5 million in the prior year period. No members had medical and pharmacy paid claims exceeding the new threshold through August 2026. The actuarial certification was provided by Deborah Donaldson, FSA, MAAA, Senior Vice President and Actuarial Consultant at Segal, confirming the proprietary pricing model's assumptions and aggregate results are reasonable.

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Deborah Donaldson, FSA, MAAA Senior Vice President M 303.908.9031 Ddonaldson@segalco.com

7951 E Maplewood Avenue Suite 327

Greenwood Village, CO 80111-4774 segalco.com

6006857v6/14622.001

October 7, 2026

Ms. Jennifer Valdez Statewide Benefits Manager State of Colorado Department of Personnel & Administration 1525 Sherman Street Denver, CO 80203

Dear Jennifer:

Segal has completed its review of financial results for the State of Colorado Department of Personnel and Administration’s (DPA’s) self-funded plan through August 2026, which represents the first two months of Fiscal Year 2027. The exhibits included in this report provide experience on both a paid and an incurred basis.

The results rely on medical and prescription drug claims provided by Cigna and MedImpact, as well as paid dental claims provided by Delta Dental. In addition, the attachment also provides performance on the Kaiser plans through July 2026.

Medical/Rx The self-funded medical and prescription drug plans through August 2026 are estimated to generate an incurred surplus of approximately $11.2M or 11.9% of budget. Medical and prescription drug claims and administrative fees for this period were $1,653.27 PEPM, or $814.73 PMPM, or roughly a 1.9% decrease from last month. It is anticipated that the plans will generate a surplus over the first few months of the plan year as members meet their deductibles and out of pocket maximums.

We project FY27 incurred medical and prescription drug experience will end in a deficit of approximately $9.8M or 1.7% higher than budget. As noted on the Budget Summary results page, the reserve ending balance at the end of August 2026 is approximately -$14.0M, and by the end of FY27, expected to be $23.2M with the additional advanced contributions infusion in June 2027.

Prescription drugs continue to have double digit trends with a 41.9% increase from the same period last year. In addition, the table below indicates a 26.4% reduction in PMPM rebates this year. The plan continues to experience reductions to prescription drug rebates. This is primarily a result of the change in anti-obesity medication strategy adopted by DPA, which included grandfathering in PY 2026 and more recently the implementation of the Zepbound program effective May 1, 2026.

Prior Fiscal Year

(July-Aug.)

Current Fiscal Year

(July-Aug.)

Percent Change

Gross PMPM Rx Claim Cost $227.64 $268.40 17.9% Expected PMPM Rebates ($79.90) ($58.81) -26.4% Net PMPM Rx Cost $147.74 $209.59 41.9%

The financial summary reflects estimated stop loss reimbursements based upon our projections of historical data given the lag in actual reimbursements. The stop loss threshold was increased from $500,000 to $1,500,000 combined medical and pharmacy individual specific deductible.

There are no members with medical and pharmacy paid claims exceeding this amount through August 2026.

Projected stop loss reimbursements on an incurred basis for FY2026 were $14.2M under the $500,000 threshold, and under the higher stop-loss threshold of $1,500,000, reimbursements are projected to be $2.5M for FY2027. As a result of moving to the $1,500,000 threshold, DPA will take on additional claims liability, which has been factored into the projections. Results will vary to the extent that actual large claims experience and resulting reimbursements are higher or lower than expected. Stop loss premiums were also reduced for FY2027 with a total of $1.1M paid year-to-date compared to $3.5M for the same period in FY2026.

The self-funded medical and prescription drug plans generated a paid surplus year-to-date of approximately $15.8M or 16.7% lower than budget.

Dental The self-funded dental plan has generated an incurred loss year-to-date of approximately $374K or 6.8% of budget. Claims and administrative fees for this period were $80.81 PEPM, or

$39.47 PMPM.

The self-funded dental plans generated a paid loss year-to-date of approximately $350K or 6.3% of budget.

Actuarial Certification Our internal proprietary pricing model develops aggregate revenue and expense projections.

Our Health Technical Services unit, comprised of actuaries and programmers, is responsible for the initial development and maintenance of this model. The client team programs the assumptions and the calculation methods, validates the model, and reviews the results under my supervision. We are not aware of any material inconsistencies among the assumptions used in the model and the combination of assumptions used in the model does not produce unreasonable results in the aggregate.

This document has been prepared for the exclusive use and benefit of the State of Colorado DPA, based upon information provided by you and your other service providers or otherwise made available to Segal at the time this document was created. Segal makes no representation or warranty as to the accuracy of any forward-looking statements and does not guarantee any particular outcome or result. Except as required by law or required for DPA’s proper administration, this document should not be copied, reproduced, or shared with other parties without Segal’s consent and, in such instances, should only be shared in its entirety. This document does not constitute legal, tax or investment advice or create or imply a fiduciary relationship. You are encouraged to discuss any issues raised with your legal, tax and other advisors before taking, or refraining from taking, any action

I am a Fellow of the Society of Actuaries, a Fellow of the Conference of Consulting Actuaries, and a Member of the American Academy of Actuaries. I meet the Qualification Standards for Actuaries Issuing Statements of Opinion in the United States promulgated by the American Academy of Actuaries and am qualified to render an opinion with regard to loss reserves, actuarial liabilities, and related items.

Sincerely yours, Debbie Donaldson, FSA, MAAA Senior Vice President and Actuarial Consultant

State of Colorado Division of Human Resources Self-Funded Medical and Dental Plans Historical and Projected Incurred Costs

Based on actual experience through 8/31/2026

Time Period Plan Member Months

Contributions Incurred Claims Incurred Reinsurance

Recoveries Net Incurred Claims Claims Loss Ratio Incurred Rx Rebates Expenses Profit/(Loss) Profit/Loss Percent

FY2026 Medical/Rx (12 months) Copay Basic 260,830 $207,354,162 $187,545,282 ($4,540,796) $183,004,486 88.3% ($12,839,439) $19,673,973 $17,515,143 8.4%

Copay Plus 217,273 $180,800,568 $254,388,889 ($8,562,048) $245,826,841 136.0% ($20,526,179) $16,388,541 ($60,888,635) -33.7% HDHP with HSA 120,777 $96,064,102 $70,359,259 ($1,138,913) $69,220,346 72.1% ($4,964,715) $12,451,545 $19,356,926 20.2% Sub-total 598,880 $484,218,832 $512,293,430 ($14,241,757) $498,051,673 102.9% ($38,330,333) $48,514,059 ($24,016,566) -5.0%

Dental Basic 315,003 $10,461,977 $7,779,538 $7,779,538 74.4% $856,128 $1,826,311 17.5% Basic Plus 572,078 $22,700,028 $21,473,010 $21,473,010 94.6% $1,554,818 ($327,799) -1.4% Sub-total 887,081 $33,162,005 $29,252,548 $29,252,548 88.2% $2,410,946 $1,498,512 4.5%

Self-funded plan Total $517,380,837 $541,545,978 ($14,241,757) $527,304,220 101.9% ($38,330,333) $50,925,005 ($22,518,055) -4.4%

FY2027 Medical/Rx (Actual YTD - 2 month) Copay Basic 45,124 $41,046,319 $31,337,404 ($153,247) $31,184,157 76.0% ($2,151,678) $2,305,421 $9,708,420 23.7%

Copay Plus 36,959 $35,230,521 $42,524,324 ($206,140) $42,318,184 120.1% ($3,216,466) $1,996,084 ($5,867,280) -16.7% HDHP with HSA 20,035 $18,167,413 $9,665,853 ($56,156) $9,609,697 52.9% ($637,070) $1,790,607 $7,404,178 40.8% Sub-total 102,118 $94,444,253 $83,527,581 ($415,543) $83,112,038 88.0% ($6,005,215) $6,092,112 $11,245,318 11.9%

Dental Basic 51,739 $1,645,325 $1,444,309 $1,444,309 87.8% $150,981 $50,034 3.0% Basic Plus 98,133 $3,895,218 $4,071,576 $4,071,576 104.5% $247,904 ($424,262) -10.9% Sub-total 149,872 $5,540,543 $5,515,885 $5,515,885 99.6% $398,886 ($374,228) -6.8%

Self-funded plan Total $99,984,796 $89,043,465 ($415,543) $88,627,923 88.6% ($6,005,215) $6,490,997 $10,871,091 10.9%

FY2027 Medical/Rx (Projected - 12 months) Copay Basic 270,344 $245,931,534 $213,833,009 ($919,482) $212,913,527 86.6% ($12,886,440) $13,816,328 $32,088,119 13.0%

Copay Plus 221,389 $211,052,115 $287,637,301 ($1,236,840) $286,400,461 135.7% ($20,641,278) $11,948,648 ($66,655,715) -31.6% HDHP with HSA 119,905 $108,756,513 $78,357,032 ($336,935) $78,020,097 71.7% ($4,721,802) $10,722,015 $24,736,203 22.7% Sub-total 611,638 $565,740,163 $579,827,342 ($2,493,258) $577,334,084 102.0% ($38,249,520) $36,486,992 ($9,831,394) -1.7%

Dental Basic 307,099 $9,772,798 $7,970,952 $7,970,952 81.6% $896,650 $905,195 9.3% Basic Plus 582,903 $23,157,392 $22,476,138 $22,476,138 97.1% $1,473,119 ($791,865) -3.4% Sub-total 890,002 $32,930,190 $30,447,091 $30,447,091 92.5% $2,369,769 $113,331 0.3%

Self-funded plan Total $598,670,353 $610,274,433 ($2,493,258) $607,781,175 101.5% ($38,249,520) $38,856,761 ($9,718,063) -1.6%

(2) Medical/Rx expenses include administration fees, Stop Loss premiums, EBU, Wellness, HSA and Marathon fees.

(3) Dental expenses include administration and EBU fees.

(4) The FY2026 figures include emergency supplemental funding effective November 1, 2025.

(1) Contribution amounts shown above reflect an estimate of # employees x PEPM budget rate by coverage tier. In practice, no contributions are collected by CO DPA in July and contributions are doubled in June.

State of Colorado, DPA Loss Ratio Exhibit

102% 100% 106% 104%

89%

102%

0%

25%

50%

75%

100%

125%

$0

$100,000,000

$200,000,000

$300,000,000

$400,000,000

$500,000,000

$600,000,000

$700,000,000

FY23 FY24 FY25 FY26 FY27 (2 Months) FY27 (Projection)

Self Funded Plan Performance & Projection (Includes Cigna and Delta Dental)

Expenses Budget Loss Ratio

Expenses and budget are shown on an incurred basis.

L os s R at io

State of Colorado Division of Human Resources Self-Funded Medical and Dental Plans

Paid Costs Based on actual experience through 8/31/2026

Time Period Plan Member Months Contributions Paid Claims Paid Reinsurance

Recoveries Net Paid Claims Claims Loss Ratio Paid Rx Rebates Expenses Profit/(Loss)

Profit/Loss Percent

FY2025 Medical/Rx (12 months) Copay Basic 237,452 $163,900,007 $150,216,022 ($3,410,450) $146,805,572 89.6% ($9,901,132) $16,488,959 $10,506,609 6.4%

Copay Plus 212,794 $154,219,332 $226,704,820 ($4,108,338) $222,596,482 144.3% ($19,213,160) $14,776,677 ($63,940,667) -41.5% HDHP with HSA 124,701 $87,345,049 $66,149,023 ($1,305,418) $64,843,605 74.2% ($4,688,233) $8,659,391 $18,530,286 21.2% Sub-total 574,947 $405,464,388 $443,069,865 ($8,824,206) $434,245,659 107.1% ($33,802,525) $39,925,027 ($34,903,772) -8.6%

Dental Basic 316,708 $10,659,270 $7,669,903 $7,669,903 72.0% $866,158 $2,123,209 19.9% Basic Plus 550,477 $18,517,071 $20,182,789 $20,182,789 109.0% $1,505,487 ($3,171,205) -17.1% Sub-total 867,185 $29,176,341 $27,852,692 $27,852,692 95.5% $2,371,645 ($1,047,996) -3.6%

Self-funded plan Total $434,640,730 $470,922,558 ($8,824,206) $462,098,351 106.3% ($33,802,525) $42,296,672 ($35,951,768) -8.3%

FY2026 Medical/Rx (12 months) Copay Basic 260,830 $205,457,281 $184,784,729 ($5,074,434) $179,710,295 87.5% ($13,777,490) $19,673,973 $19,850,502 9.7%

Copay Plus 217,273 $178,751,016 $253,471,430 ($8,814,879) $244,656,551 136.9% ($24,021,327) $16,388,541 ($58,272,749) -32.6% HDHP with HSA 120,777 $95,047,993 $70,370,273 ($1,587,761) $68,782,512 72.4% ($5,793,594) $9,110,008 $22,949,067 24.1% Sub-total 598,880 $479,256,290 $508,626,431 ($15,477,073) $493,149,358 102.9% ($43,592,410) $45,172,522 ($15,473,180) -3.2%

Dental Basic 315,003 $10,970,170 $7,767,700 $7,767,700 70.8% $856,128 $2,346,341 21.4% Basic Plus 572,078 $19,876,818 $21,404,803 $21,404,803 107.7% $1,554,818 ($3,082,803) -15.5% Sub-total 887,081 $30,846,987 $29,172,503 $29,172,503 94.6% $2,410,946 ($736,462) -2.4%

Self-funded plan Total $510,103,278 $537,798,935 ($15,477,073) $522,321,861 102.4% ($43,592,410) $47,583,468 ($16,209,642) -3.2%

FY2027 Medical/Rx (2 months) Copay Basic 45,124 $41,046,319 $30,916,603 ($283,563) $30,633,040 74.6% ($3,690,191) $2,305,421 $11,798,049 28.7%

Copay Plus 36,959 $35,230,521 $43,628,894 ($837,450) $42,791,444 121.5% ($5,673,278) $1,996,084 ($3,883,729) -11.0% HDHP with HSA 20,035 $18,167,413 $10,688,685 ($104,939) $10,583,745 58.3% ($1,418,851) $1,151,607 $7,850,911 43.2% Sub-total 102,118 $94,444,253 $85,234,182 ($1,225,952) $84,008,229 89.0% ($10,782,319) $5,453,112 $15,765,231 16.7%

Dental Basic 51,739 $1,645,325 $1,376,984 $1,376,984 83.7% $150,981 $117,359 7.1% Basic Plus 98,133 $3,895,218 $4,114,453 $4,114,453 105.6% $247,904 ($467,139) -12.0% Sub-total 149,872 $5,540,543 $5,491,437 $5,491,437 99.1% $398,886 ($349,780) -6.3%

Self-funded plan Total $99,984,796 $90,725,619 ($1,225,952) $89,499,666 89.5% ($10,782,319) $5,851,997 $15,415,451 15.4%

(2) Medical/Rx expenses include administration fees, Stop Loss premiums and Marathon fees. Please note that these expenses do not include HSA funds provided by the State.

(3) Dental expenses include administration fees.

(4) Rebates paid on a quarterly basis.

(5) The FY2026 projections include emergency supplemental funding effective November 1, 2025.

(1) For FY2025, FY2026, and FY2027, contribution amounts shown above reflect an estimate of # employees x PEPM budget rate by coverage tier. In practice, no contributions are collected by CO DPA in July and contributions are doubled in June.

Plan Year Reserve Beginning Balance Revenue Expense Reserve Ending Balance Premium Stablization Reserve

2022 $68,215,954 $506,988,125 $514,706,232 $60,497,847 $22,131,062 2023 $60,497,847 $536,030,895 $558,949,174 $37,579,568 $24,767,960 2024 $37,579,568 $615,886,096 $606,176,345 $47,289,319 $28,480,336 2025 $47,289,319 $693,934,774 $720,261,511 $20,962,582 $39,547,817 2026 $20,962,582 $787,384,540 $799,428,407 $8,918,715 $40,295,143 Jul-26 $8,918,715 $3,276,925 $43,313,881 ($31,118,241) $3,006,642

Aug-26 ($31,118,241) $79,556,497 $62,420,662 ($13,982,406) $3,170,333 Sep-26 ($13,982,406) $69,182,966 $68,101,985 ($12,901,425) $3,878,105 Oct-26 ($12,901,425) $69,203,962 $72,329,662 ($16,027,125) $3,383,832 Nov-26 ($16,027,125) $77,892,966 $70,265,463 ($8,399,622) $3,475,443 Dec-26 ($8,399,622) $69,043,431 $70,182,240 ($9,538,431) $4,314,259 Jan-27 ($9,538,431) $69,047,875 $71,897,278 ($12,387,833) $3,323,770 Feb-27 ($12,387,833) $78,167,764 $72,390,640 ($6,610,710) $3,468,542 Mar-27 ($6,610,710) $69,073,145 $74,375,051 ($11,912,616) $4,655,260 Apr-27 ($11,912,616) $69,088,669 $76,451,324 ($19,275,271) $4,046,025 May-27 ($19,275,271) $78,447,411 $76,568,233 ($17,396,093) $3,706,438 Jun-27 ($17,396,093) $138,165,965 $97,522,702 $23,247,170 $5,154,937 2027 $8,918,715 $870,147,577 $855,819,122 $23,247,170 $45,583,588

Notes

(1) Historical plan year balances tie to the operating reports provided by CO DPA.

(2) Based on data through August 2026.

(3) The fund balance for PY2026 includes emergency supplemental funding effective November 1, 2025.

State of Colorado, DPA Fund Balance Tracking

(4) Revenue and Expense amounts include income and costs associated with self-funded and fully insured coverages, including medical, prescription drug, dental, vision, life, disability, wellness, and spending accounts.

(5) Due to timing of contribution payments, it is likely that the reserve ending balance will be negative as of July 2027.

$0.0

$10.0

$20.0

$30.0

$40.0

$50.0

$60.0

$70.0

$80.0

2022 2023 2024 2025 2026 2027

M ill io ns

Plan Year Ending Fund Balance vs. Premium Stabilization Reserve (PSR)

Premium Stablization Reserve Reserve Ending Balance

State of Colorado DPA Monthly Financial Report

July 2026-August 2026

© 2026 by The Segal Group Inc.

The fees listed below are included in the Actuarial Exhibits (Page 4 & 6) HSA Contributions, EBU fees, Wellness credits and Marathon fees

Monthly Financial Report:

Items included in self-funded budget, and have been included in the following exhibits are:

EBU fees, approximate annual cost $2.9M

Cigna/MedImpact Rx EBU fees: $1.7M Dental EBU fees: $1.2M

Items that were not included in the budget but that are paid from the fund include:

Wellness Program Funds approximate annual cost: $904K Vision, approximate annual cost: $3.9M

Total annual Marathon fees for both fully and self insured business: $10.7M Marathon fees are included in the Medical/Rx Administration Fees of the Monthly Financial Report

State of Colorado, DPA Self-Funded Plan Notes

Medical/Rx Budget

Total $ PEPM

Budget $94,444,253 $1,877

Total Plan Costs $78,880,941 $1,567

Surplus / (Deficit) $15,563,312 $309.26

Costs as a Percentage of Budget 83.5%

Dental Budget

Total $ PEPM

Budget $5,540,543 $75.70

Total Plan Costs $5,690,336 $77.75

Surplus / (Deficit) ($149,793) ($2.05)

Costs as a Percentage of Budget 102.7% Note: Amounts shown reflect actual totals year-to-date, net of ISL reimbursements and Rx rebates.

Note: Total Plan Costs include HSA funds provided by the State

YTD Performance to Self Funded Budget State of Colorado, DPA

$99,984,796

$79,687,946

$1,118,244

$3,205,197 $559,890

$15,413,519

Budget Actual Surplus

Total Net Claims Cost Stop Loss Premium Medical/Rx/Dental Administration HSA Funding Surplus

25,162 24,633 23,718 22,151

2 12 12 12

FY2027 FY2026 FY2025 FY2024

Category Total Paid PEPM Medical/Rx Administration $3,006,298 $59.74 $80.95 $74.32 $72.92 Stop Loss Premium $1,118,244 $22.22 $70.95 $65.09 $44.87 HSA Funding $559,890 $11.13 $11.30 $12.14 $13.18 Gross Medical Claims $58,074,135 $1,154.00 $1,222.01 $1,096.75 $1,010.95 ISL Reimbursements ($1,225,952) ($24.36) ($52.36) ($31.00) ($44.40) Gross Rx Claims $27,160,046 $539.70 $498.68 $460.01 $347.68 Rx Rebates ($9,811,720) ($194.97) ($129.67) ($136.31) ($117.11) Total $78,880,941 $1,567.46 $1,701.86 $1,541.00 $1,328.10 Increase/Decrease -7.9% 10.4% 16.0%

* Medical/Rx Administration fees in FY24-FY27 include Base Admin fees, Marathon Fees and EBU fees.

36,595 36,174 35,368 33,882

2 12 12 12

FY2027 FY2026 FY2025 FY2024

Category Total Paid PEPM Dental Administration $198,899 $2.72 $5.55 $5.59 $5.74 Gross Dental Claims $5,491,437 $75.03 $67.20 $65.63 $63.72 Total $5,690,336 $77.75 $72.76 $71.21 $69.46 Increase/Decrease 6.9% 2.2% 2.5%

* Dental Administration fees in FY24-FY27 include ASO fees and EBU fees.

Historical Self-Funded Plan Cost Summary State of Colorado, DPA

Number of Months in Year to Date July 01, 2026 - August 31, 2026

Average Medical/Rx Enrollment Number of Months in Year-to-Date

July 01, 2026 - August 31, 2026

Average Dental Enrollment

Employee/Employer Share of Total Plan Cost

Date EE Lives Total Medical/Rx

Plan Cost Total Dental Plan

Cost Employee Medical

Contributions Employee Dental

Contributions Net Employer

Cost

Jul-26 25,217 $47,087,196 $2,842,344 $4,170,907 $776,801 $45,168,532

Aug-26 25,107 $31,793,745 $2,847,992 $4,156,481 $759,812 $44,952,263

Sep-26

Oct-26

Nov-26

Dec-26

Jan-27

Feb-27

Mar-27

Apr-27

May-27

Jun-27

Total 50,324 $78,880,941 $5,690,336 $8,327,388 $1,536,613 $90,120,795

Employee Total Costs: $9,864,001 Total Employee Percentage: 10% Employer Total Costs: $90,120,795 Total Employer Percentage: 90%

Total Overall Cost: $99,984,796

Employer/Employee Contribution Share State of Colorado, DPA

8.8%

91.2%

Medical/Rx

EE Medical Contributions

Net Employer Cost

27.7%

72.3%

Dental

EE Dental Contributions

Net Employer Cost

FY2027 as of 08/31/2026 FY2026 FY2025

Claimants over ISL as a Percentage Gross Claims

0% 6% 5%

Specific Stop Loss - Paid Basis

FY2027 as of 08/31/2026 FY2026 FY2025 Specific Deductible $1,500,000 $500,000 $500,000

Specific Contract Basis Incurred Incurred Incurred ISL Claims Type Medical/Rx Medical/Rx Medical/Rx

ISL Premium $1,118,244 $20,972,206 $18,525,260 Reimbursements $1,225,952 $15,477,073 $8,824,206

Loss Ratio 110% 74% 48%

Specific Stop Loss - Incurred Basis

FY2027 as of 08/31/2026 FY2026 FY2025 Specific Deductible $1,500,000 $500,000 $500,000

Specific Contract Basis Incurred Incurred Incurred ISL Claims Type Medical/Rx Medical/Rx Medical/Rx

Claimants over ISL 0 37 26 ISL Premium $1,118,244 $20,972,206 $18,525,260

Reimbursements $406,383 $14,021,794 $8,002,766

Note: The large claims are medical and pharmacy claims

Large Paid Claims & Stop Loss Detail State of Colorado, DPA

FY2027 FY2026 FY2025

100% 94% 95%

0% 6% 5%

Other Claimants Claimants over ISL

FY2027 as of 08/31/2026 FY2026 # Claimants Plan Paid Avg Spend Per Patient # Claimants Plan Paid Avg Spend Per Patient

$25,000 - $100,000 314 $13,449,584 $42,833 3,071 $146,614,867 $47,742 $100,000 - $199,999 17 $2,290,284 $134,723 519 $70,964,760 $136,734 $200,000 - $299,999 3 $754,848 $251,616 128 $30,624,001 $239,250 $300,000 - $399,999 0 $0 $0 44 $15,340,316 $348,644 $400,000 - $499,999 0 $0 $0 32 $14,145,526 $442,048 $500,000 - $599,999 0 $0 $0 11 $5,939,347 $539,941 $600,000 - $699,999 0 $0 $0 9 $6,036,907 $670,767 $700,000 - $799,999 0 $0 $0 4 $2,977,751 $744,438 $800,000 - $899,999 0 $0 $0 4 $3,378,710 $844,678 $900,000 - $999,999 0 $0 $0 2 $1,849,339 $924,669 $1,000,000 - $1,499,999 0 $0 $0 6 $7,252,400 $1,208,733 $1,500,000 - $1,999,999 0 $0 $0 0 $0 $0 $2,000,000 and Up 0 $0 $0 1 $3,239,320 $3,239,320 Total 334 $16,494,716 $49,385 3,831 $308,363,244 $80,492 Note: The distribution table does not include claimants that have claims under $25,000

Large Claimants Above $500,000

# Plan Patient Relationship Medical Pharmacy Claimant Total Amount Above ISL Diagnosis

Total $0 $0

Note: The large claims include Medical and Pharmacy claims

Note: Due to differences in timing, the stop loss reimbursements shown above may differ from actual claims experience shown on other exhibits.

State of Colorado, DPA FY2027 Claim Distribution

Plan Paid Range

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

Under $100,000 $100,000 - $199,999

$200,000 - $299,999

$300,000 - $399,999

$400,000 - $499,999

$500,000 - $599,999

$600,000 - $699,999

$700,000 - $799,999

$800,000 - $899,999

$900,000 - $999,999

$1,000,000 - $1,499,999

$1,500,000 - $1,999,999

$2,000,000 and Up

Distribution of Large Claims

FY2025 FY2026 FY2027

Self-funded Medical/Rx Financial Exhibits

Fixed Costs Paid Claims Employee

Medical/Rx Lives

Medical/Rx Administration*

Stop Loss Premium HSA Funding Total Fixed Cost

Gross Paid Medical Claims Gross Rx Claims Total Claims

Amounts over ISL Rx Rebates Net Claims Cost

Medical/Rx Plan Costs

Medical/Rx Budget Surplus / (Deficit) Cost/Budget

Jul-25 24,445 $822,345 $1,750,970 $279,121 $2,852,437 $26,451,540 $11,689,707 $38,141,247 $713,947 $0 $37,427,300 $40,279,737 $38,534,995 ($1,744,742) 104.5%

Aug-25 24,431 $2,901,530 $1,721,782 $277,381 $4,900,694 $27,954,948 $10,959,086 $38,914,033 $2,482,204 ($10,014,802) $26,417,027 $31,317,721 $38,523,037 $7,205,316 81.3%

Sep-25 24,447 $1,109,442 $1,732,244 $278,119 $3,119,805 $26,207,543 $12,201,297 $38,408,841 $376,697 $0 $38,032,144 $41,151,949 $38,567,893 ($2,584,056) 106.7%

Oct-25 24,494 $2,016,713 $1,736,921 $273,206 $4,026,841 $28,268,358 $12,725,732 $40,994,090 $315,202 $0 $40,678,887 $44,705,728 $38,661,335 ($6,044,393) 115.6%

Nov-25 24,598 $2,911,941 $1,744,306 $274,096 $4,930,343 $28,436,506 $11,758,354 $40,194,859 $317,826 ($10,760,970) $29,116,063 $34,046,406 $41,046,713 $7,000,307 82.9%

Dec-25 24,716 $1,996,279 $1,752,039 $268,896 $4,017,214 $32,503,949 $12,592,160 $45,096,109 $285,909 $0 $44,810,200 $48,827,414 $41,228,138 ($7,599,276) 118.4%

Jan-26 24,697 $1,111,800 $1,758,285 $266,345 $3,136,430 $29,218,731 $11,267,646 $40,486,378 $1,355,703 $0 $39,130,675 $42,267,105 $41,217,630 ($1,049,474) 102.5%

Feb-26 24,738 $2,038,394 $1,749,769 $279,855 $4,068,018 $28,704,778 $11,155,349 $39,860,126 $301,429 ($12,181,185) $27,377,511 $31,445,530 $41,266,315 $9,820,786 76.2%

Mar-26 24,757 $2,027,385 $1,755,084 $309,449 $4,091,919 $35,085,148 $12,340,231 $47,425,380 $4,450,093 $0 $42,975,287 $47,067,205 $41,287,799 ($5,779,406) 114.0%

Apr-26 24,767 $2,017,238 $1,762,398 $277,581 $4,057,217 $34,386,061 $13,810,407 $48,196,468 $892,110 $0 $47,304,358 $51,361,575 $41,305,615 ($10,055,960) 124.3%

May-26 24,775 $2,897,304 $1,750,833 $277,398 $4,925,536 $30,426,001 $13,113,619 $43,539,620 $2,590,627 ($9,636,487) $31,312,506 $36,238,042 $41,340,233 $5,102,191 87.7%

Jun-26 24,730 $2,349,944 $1,757,573 $280,082 $4,387,600 $33,575,269 $13,794,012 $47,369,281 $1,395,325 $0 $45,973,956 $50,361,556 $41,239,129 ($9,122,427) 122.1%

Jul-26 25,217 $1,781,488 $561,464 $279,945 $2,622,896 $31,473,704 $13,629,121 $45,102,825 $638,525 $0 $44,464,300 $47,087,196 $47,314,662 $227,466 99.5%

Aug-26 25,107 $1,224,810 $556,780 $279,945 $2,061,536 $26,600,431 $13,530,925 $40,131,356 $587,427 ($9,811,720) $29,732,209 $31,793,745 $47,129,591 $15,335,846 67.5%

Sep-26

Oct-26

Nov-26

Dec-26

Jan-27

Feb-27

Mar-27

Apr-27

May-27

Jun-27

Total: Current Plan YTD 50,324 $3,006,298 $1,118,244 $559,890 $4,684,432 $58,074,135 $27,160,046 $85,234,182 $1,225,952 ($9,811,720) $74,196,509 $78,880,941 $94,444,253 $15,563,312 83.5%

PEPM $59.74 $22.22 $11.13 $93.09 $1,154.00 $539.70 $1,693.71 $24.36 ($194.97) $1,474.38 $1,567.46 $1,876.72 $309.26

% Change -37.0% -219.3% -1.6% -76.3% -5.9% 7.6% -1.6% -114.9% 26.1% -3.4% -7.7% 12.7% 116.2% -23.4%

FY2026 295,595 $24,200,316 $20,972,206 $3,341,530 $48,514,052 $361,218,831 $147,407,600 $508,626,431 $15,477,073 ($42,593,444) $450,555,914 $499,069,966 $484,218,832 ($14,851,134) 103.1%

FY2026 PEPM $81.87 $70.95 $11.30 $164.12 $1,222.01 $498.68 $1,720.69 $52.36 ($144.09) $1,524.23 $1,688.36 $1,638.12 ($50.24)

* Medical/Rx Administration fees include Base Admin fees, Marathon Fees and EBU fees.

State of Colorado, DPA Total Plan Cost Detail, Medical/Rx

$0

$10,000,000

$20,000,000

$30,000,000

$40,000,000

$50,000,000

$60,000,000

Aug-2025 Sep-2025 Oct-2025 Nov-2025 Dec-2025 Jan-2026 Feb-2026 Mar-2026 Apr-2026 May-2026 Jun-2026 Jul-2026 Aug-2026

Medical/Rx Plan Costs

Medical/Rx Budget

$0.0

$50.0

$100.0

$150.0

$200.0

$250.0

$300.0

$350.0

$400.0

$450.0

$500.0

$550.0

Budget Actual

M ill io ns

FY2026

FY2027

Medical/Rx

Lives Medical/Rx

Administration* Stop Loss Premium HSA Funding Total Fixed Cost

Gross Paid Medical Claims

Gross Rx Claims Total Claims

Amounts over ISL Rx Rebates Net Claims Cost

Medical/Rx Plan Costs

Medical/Rx Budget

Surplus / (Deficit) Cost/Budget

Jul-26 5,338 $377,110 $118,852 $279,945 $775,907 $4,274,951 $1,452,548 $5,727,499 $1,419 $0 $5,726,080 $6,501,987 $9,108,503 $2,606,516 71.4%

Aug-26 5,312 $259,139 $117,801 $279,945 $656,884 $3,530,112 $1,431,074 $4,961,186 $103,520 ($1,291,129) $3,566,536 $4,223,420 $9,058,910 $4,835,490 46.6%

Sep-26

Oct-26

Nov-26

Dec-26

Jan-27

Feb-27

Mar-27

Apr-27

May-27

Jun-27

Total: Current Plan YTD 10,650 $636,249 $236,653 $559,890 $1,432,791 $7,805,063 $2,883,622 $10,688,685 $104,939 ($1,291,129) $9,292,616 $10,725,407 $18,167,413 $7,442,006 59.0%

Average 5,325 $318,124 $118,326 $279,945 $716,396 $3,902,531 $1,441,811 $5,344,342 $52,470 ($645,565) $4,646,308 $5,362,704 $9,083,706 $3,721,003

PEPM $59.74 $22.22 $52.57 $134.53 $732.87 $270.76 $1,003.63 $9.85 ($121.23) $872.55 $1,007.08 $1,705.86 $698.78

% Change -0.7% -37.0% -219.3% 1.2% -52.2% -8.4% -10.4% -9.0% -150.4% 27.4% -12.4% -17.7% 12.5% 56.0%

FY2026 64,349 $5,267,003 $4,565,516 $3,341,530 $13,174,049 $51,141,822 $19,228,451 $70,370,273 $1,587,761 ($5,660,827) $63,121,684 $76,295,734 $96,064,102 $19,768,368 79.4%

FY2026 Average 5,362 $438,917 $380,460 $278,461 $1,097,837 $4,261,819 $1,602,371 $5,864,189 $132,313 ($471,736) $5,260,140 $6,357,978 $8,005,342 $1,647,364

FY2026 PEPM $81.85 $70.95 $51.93 $204.73 $794.76 $298.82 $1,093.57 $24.67 ($87.97) $980.93 $1,185.66 $1,492.86 $307.21

* Medical/Rx Administration fees include Base Admin fees, Marathon Fees and EBU fees.

Total Plan Cost Detail, HDHP Plan State of Colorado, DPA

$0

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

$6,000,000

$7,000,000

$8,000,000

$9,000,000

$10,000,000

Jul-2026 Aug-2026 Sep-2026 Oct-2026 Nov-2026 Dec-2026 Jan-2027 Feb-2027 Mar-2027 Apr-2027 May-2027 Jun-2027

Medical/Rx Plan Costs

Medical/Rx Budget

$0.0

$10.0

$20.0

$30.0

$40.0

$50.0

$60.0

$70.0

$80.0

$90.0

$100.0

FY2026 FY2027

M ill io ns

Budget Actual

Medical/Rx Lives

Medical/Rx Administration*

Stop Loss Premium HSA Funding Total Fixed Cost

Gross Paid Medical Claims

Gross Rx Claims Total Claims

Amounts over ISL Rx Rebates

Net Claims Cost

Medical/Rx Plan Costs

Medical/Rx Budget

Surplus / (Deficit) Cost/Budget

Jul-26 10,639 $751,606 $236,880 $0 $988,486 $11,892,745 $4,802,135 $16,694,880 $134,800 $0 $16,560,080 $17,548,567 $20,557,798 $3,009,231 85.4%

Aug-26 10,608 $517,497 $235,246 $0 $752,743 $9,250,933 $4,970,789 $14,221,722 $148,763 ($3,358,008) $10,714,951 $11,467,694 $20,488,521 $9,020,827 56.0%

Sep-26

Oct-26

Nov-26

Dec-26

Jan-27

Feb-27

Mar-27

Apr-27

May-27

Jun-27

Total: Current Plan YTD 21,247 $1,269,103 $472,127 $0 $1,741,229 $21,143,678 $9,772,924 $30,916,603 $283,563 ($3,358,008) $27,275,032 $29,016,261 $41,046,319 $12,030,059 70.7%

Average 10,624 $634,551 $236,063 $0 $870,615 $10,571,839 $4,886,462 $15,458,301 $141,781 ($1,679,004) $13,637,516 $14,508,130 $20,523,160 $6,015,029

PEPM $59.73 $22.22 $0.00 $81.95 $995.14 $459.97 $1,455.10 $13.35 ($158.05) $1,283.71 $1,365.66 $1,931.86 $566.20

% Change 3.5% -37.2% -219.3% 0.0% -86.5% -10.4% 12.4% -3.2% -209.0% 30.8% -5.3% -10.1% 12.8% 68.0%

FY2026 123,041 $10,080,505 $8,729,620 $0 $18,810,125 $135,207,533 $49,577,196 $184,784,729 $5,074,434 ($13,461,764) $166,248,531 $185,058,656 $207,354,162 $22,295,506 89.2%

FY2026 Average 10,253 $840,042 $727,468 $0 $1,567,510 $11,267,294 $4,131,433 $15,398,727 $422,869 ($1,121,814) $13,854,044 $15,421,555 $17,279,514 $1,857,959 FY2026 PEPM $81.93 $70.95 $0.00 $152.88 $1,098.88 $402.93 $1,501.81 $41.24 ($109.41) $1,351.16 $1,504.04 $1,685.24 $181.20

* Medical/Rx Administration fees include Base Admin fees, Marathon Fees and EBU fees.

Total Plan Cost Detail, Copay Basic Plan State of Colorado, DPA

$0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

$12,000,000

$14,000,000

$16,000,000

$18,000,000

$20,000,000

$22,000,000

Jul-2026 Aug-2026 Sep-2026 Oct-2026 Nov-2026 Dec-2026 Jan-2027 Feb-2027 Mar-2027 Apr-2027 May-2027 Jun-2027

Medical/Rx Plan Costs

Medical/Rx Budget

$0.0

$20.0

$40.0

$60.0

$80.0

$100.0

$120.0

$140.0

$160.0

$180.0

$200.0

$220.0

FY2026 FY2027

M ill io ns

Budget

Actual

Medical/Rx Lives

Medical/Rx Administration*

Stop Loss Premium HSA Funding Total Fixed Cost

Gross Paid Medical Claims

Gross Rx Claims Total Claims

Amounts over ISL Rx Rebates

Net Claims Cost

Medical/Rx Plan Costs

Medical/Rx Budget

Surplus / (Deficit) Cost/Budget

Jul-26 9,240 $652,772 $205,731 $0 $858,503 $15,306,008 $7,374,438 $22,680,446 $502,306 $0 $22,178,140 $23,036,643 $17,648,362 ($5,388,281) 130.5%

Aug-26 9,187 $448,175 $203,734 $0 $651,909 $13,819,386 $7,129,062 $20,948,448 $335,144 ($5,162,583) $15,450,722 $16,102,630 $17,582,159 $1,479,529 91.6%

Sep-26

Oct-26

Nov-26

Dec-26

Jan-27

Feb-27

Mar-27

Apr-27

May-27

Jun-27

Total: Current Plan YTD 18,427 $1,100,947 $409,465 $0 $1,510,412 $29,125,394 $14,503,500 $43,628,894 $837,450 ($5,162,583) $37,628,862 $39,139,274 $35,230,521 ($3,908,752) 111.1%

Average 9,214 $550,473 $204,732 $0 $755,206 $14,562,697 $7,251,750 $21,814,447 $418,725 ($2,581,291) $18,814,431 $19,569,637 $17,615,261 ($1,954,376)

PEPM $59.75 $22.22 $0.00 $81.97 $1,580.58 $787.08 $2,367.66 $45.45 ($280.16) $2,042.05 $2,124.02 $1,911.90 ($212.12)

% Change 2.1% -36.9% -219.3% 0.0% -86.4% -2.2% 7.7% 1.1% -79.3% 22.6% -0.1% -3.4% 12.6% -148.0%

FY2026 108,205 $8,852,808 $7,677,070 $0 $16,529,878 $174,869,477 $78,601,953 $253,471,430 $8,814,879 ($23,470,853) $221,185,698 $237,715,576 $180,800,568 ($56,915,008) 131.5%

FY2026 Average 9,017 $737,734 $639,756 $0 $1,377,490 $14,572,456 $6,550,163 $21,122,619 $734,573 ($1,955,904) $18,432,142 $19,809,631 $15,066,714 ($4,742,917) FY2026 PEPM $81.82 $70.95 $0.00 $152.76 $1,616.09 $726.42 $2,342.51 $81.46 ($216.91) $2,044.14 $2,196.90 $1,670.91 ($525.99)

* Medical/Rx Administration fees include Base Admin fees, Marathon Fees and EBU fees.

State of Colorado, DPA Total Plan Cost Detail, Copay Plus Plan

$0

$5,000,000

$10,000,000

$15,000,000

$20,000,000

$25,000,000

Jul-2026 Aug-2026 Sep-2026 Oct-2026 Nov-2026 Dec-2026 Jan-2027 Feb-2027 Mar-2027 Apr-2027 May-2027 Jun-2027

Medical/Rx Plan Costs

Medical/Rx Budget

$0.0

$50.0

$100.0

$150.0

$200.0

$250.0

FY2026 FY2027

M ill io ns

Budget

Rolling 12 Paid Claims - Medical/Rx

$529.24 $536.60 $550.40 $562.50 $581.98 $595.41 $606.21

$208.63 $221.61 $231.78 $239.40 $241.44 $245.30 $252.39

$737.87 $758.21 $782.18 $801.89 $823.42 $840.71 $858.60

$100.00

$200.00

$300.00

$400.00

$500.00

$600.00

$700.00

$800.00

$900.00

$1,000.00

Medical Rolling 12 PMPM Rx Rolling 12 PMPM Total Claims PMPM July 2026 Trended Forward at 9%

Self-funded Dental

Paid Claims Employee Dental

Lives Dental

Administration Dental Basic

Claims Dental Basic Plus

Claims Total Dental Plan

Cost Dental Budget Budget Surplus /

(Deficit)

Jul-25 35,994 $0 $690,682 $2,005,821 $2,696,503 $2,753,180 $56,677

Aug-25 35,946 $200,084 $619,757 $1,892,331 $2,712,173 $2,749,977 $37,804

Sep-25 35,986 $199,696 $677,085 $1,854,746 $2,731,527 $2,752,595 $21,068

Oct-25 36,067 $199,929 $698,580 $1,889,327 $2,787,835 $2,757,831 ($30,005)

Nov-25 36,161 $200,289 $503,555 $1,369,527 $2,073,371 $2,763,791 $690,420

Dec-25 36,306 $200,167 $648,012 $1,789,002 $2,637,180 $2,773,562 $136,382

Jan-26 36,240 $201,849 $655,783 $1,760,919 $2,618,551 $2,769,389 $150,838

Feb-26 36,272 $201,348 $636,543 $1,697,449 $2,535,340 $2,769,490 $234,151

Mar-26 36,235 $201,570 $692,231 $1,796,104 $2,689,905 $2,765,680 $75,775

Apr-26 36,245 $201,456 $674,816 $1,815,015 $2,691,288 $2,766,177 $74,889

May-26 36,240 $201,478 $597,387 $1,609,158 $2,408,023 $2,765,035 $357,012

Jun-26 36,397 $403,080 $673,269 $1,925,405 $3,001,754 $2,775,298 ($226,456)

Jul-26 37,027 $0 $687,847 $2,154,496 $2,842,344 $2,801,578 ($40,765)

Aug-26 36,163 $198,899 $689,137 $1,959,956 $2,847,992 $2,738,965 ($109,028)

Sep-26

Oct-26

Nov-26

Dec-26

Jan-27

Feb-27

Mar-27

Apr-27

May-27

Jun-27

Total: Current Plan YTD 73,190 $198,899 $1,376,984 $4,114,453 $5,690,336 $5,540,543 -$149,793

PEPM $2.72 $18.81 $56.22 $77.75 $75.70 -$2.05

% Change -104.4% 4.9% 12.3% 6.4% -0.9% 277.7%

FY2026 434,089 $2,410,946 $7,767,700 $21,404,803 $31,583,449 $33,162,005 $1,578,556

FY2026 PEPM $5.55 $17.89 $49.31 $72.76 $76.39 $3.64

* Dental Administration fees include ASO fees and EBU fees.

State of Colorado, DPA Total Plan Cost Detail, Dental

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

$3,500,000

Total Dental Plan Cost Dental Budget $0.0

$5.0

$10.0

$15.0

$20.0

$25.0

$30.0

$35.0

FY2026 FY2027

M ill io ns

Budget

Rolling 12 Paid Claims - Dental

$32.17

$32.06

$32.03 $32.09

$32.44 $32.57

$33.11

$30.50

$31.00

$31.50

$32.00

$32.50

$33.00

$33.50

Dental Rolling 12 PMPM July 2026 Trended Forward at 3%

Kaiser Permanente

Premiums shown in the following exhibits reflect premiums collected by Kaiser.

Medical and pharmacy claims shown reflect the amounts paid by Kaiser on a fully insured basis.

The fully insured exhibits do not include the following plan expenses:

EBU fees, approximate annual cost: $719K

Wellness Program Funds, approximate annual cost: $384K

State of Colorado, DPA Fully Insured Plan Notes

Medical/Rx

Lives Gross Paid

Medical Claims Gross Paid Rx Claims Total Claims

HSA

Contributions

Medical/Rx Premium Surplus / (Deficit) Loss Ratio

Jul-25 10,918 $13,382,151 $1,686,307 $15,068,458 $85,620 $14,180,855 ($973,223) 106.9%

Aug-25 10,885 $10,261,518 $1,399,084 $11,660,602 $85,740 $14,145,700 $2,399,358 83.0%

Sep-25 10,899 $9,828,135 $1,517,174 $11,345,309 $86,640 $14,154,592 $2,722,643 80.8%

Oct-25 10,927 $10,444,900 $1,558,065 $12,002,965 $86,880 $14,190,943 $2,101,097 85.2%

Nov-25 10,927 $12,496,421 $1,494,095 $13,990,516 $87,660 $14,191,765 $113,589 99.2%

Dec-25 10,955 $12,127,490 $1,576,562 $13,704,052 $87,840 $14,233,518 $441,626 96.9%

Jan-26 10,927 $10,864,020 $1,741,700 $12,605,720 $87,540 $14,205,696 $1,512,437 89.4%

Feb-26 10,922 $11,546,427 $1,451,752 $12,998,179 $87,660 $14,182,380 $1,096,541 92.3%

Mar-26 10,905 $12,612,395 $1,648,269 $14,260,663 $88,080 $14,145,034 ($203,709) 101.4%

Apr-26 10,900 $12,645,861 $1,742,213 $14,388,075 $88,560 $14,144,606 ($332,028) 102.3%

May-26 10,889 $12,333,867 $1,676,358 $14,010,225 $88,560 $14,135,081 $36,296 99.7%

Jun-26 10,858 $12,489,206 $1,742,159 $14,231,365 $88,860 $14,091,153 ($229,072) 101.6%

Jul-26 10,656 $9,897,554 $1,772,889 $11,670,442 $88,020 $15,446,396 $3,687,933 76.1%

Aug-26

Sep-26

Oct-26

Nov-26

Dec-26

Jan-27

Feb-27

Mar-27

Apr-27

May-27

Jun-27

Total: Current Plan YTD 10,656 9,897,554 $1,772,889 $11,670,442 $88,020 $15,446,396 $3,687,933 76.1%

Average 10,656 9,897,554 $1,772,889 $11,670,442 $88,020 $15,446,396 $3,687,933 76.1%

PEPM $928.82 $166.37 $1,095.20 $8.26 $1,449.55 $346.09

% Change PEPM -2.4% -16.0% 11.7% -11.8% 2.9% 10.4% 80.8%

FY2026 130,912 $141,032,391 $19,233,737 $160,266,129 $1,049,640 $170,001,323 $8,685,554 94.9%

FY2026 Average 10,909 $11,752,699 $1,602,811 $13,355,511 $87,470 $14,166,777 $723,796 94.9%

FY2026 PEPM $1,077.31 $146.92 $1,224.23 $8.02 $1,298.59 $66.35

Note: Kaiser fully insured data is shown on a paid basis through July 31, 2026 due to the timing of Kaiser reporting.

Note: EBU and Wellness fees are not included in this exhibit.

State of Colorado, DPA Premium vs. Claims, Total Medical/Rx

$0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

$12,000,000

$14,000,000

$16,000,000

$18,000,000

Jul-2025 Aug-2025 Sep-2025 Oct-2025 Nov-2025 Dec-2025 Jan-2026 Feb-2026 Mar-2026 Apr-2026 May-2026 Jun-2026 Jul-2026

Gross Paid Rx Claims

Gross Paid Medical Claims

Medical/Rx Premium

Medical/Rx

Lives Gross Paid

Medical Claims Gross Rx

Claims Total Claims

HSA

Contributions Medical/Rx Premium Surplus / (Deficit) Loss Ratio

Jul-26 1,467 $699,524 $9,474 $708,998 $88,020 $1,903,414 $1,106,396 41.9%

Aug-26

Sep-26

Oct-26

Nov-26

Dec-26

Jan-27

Feb-27

Mar-27

Apr-27

May-27

Jun-27

Total: Current Plan YTD 1,467 $699,524 $9,474 $708,998 $88,020 $1,903,414 $1,106,396 41.9%

Average 1,467 $699,524 $9,474 $708,998 $88,020 $1,903,414 $1,106,396 41.9%

PEPM $476.84 $6.46 $483.30 $60.00 $1,297.49 $754.19

% Change PEPM 0.6% -50.8% -591.5% -58.0% 0.0% 13.2% 59.8%

FY2026 17,494 $12,579,190 $781,265 $13,360,455 $1,049,640 $19,712,499 $5,302,404 73.1%

FY2026 Average 1,458 $1,048,266 $65,105 $1,113,371 $87,470 $1,642,708 $441,867 73.1%

FY2026 PEPM $719.06 $44.66 $763.72 $60.00 $1,126.81 $303.10

Note: Kaiser fully insured data is shown on a paid basis through July 31, 2026 due to the timing of Kaiser reporting.

Note: EBU and Wellness fees are not included in this exhibit.

State of Colorado, DPA Premium vs. Claims, HDHP Plan

$0

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

$1,400,000

$1,600,000

$1,800,000

$2,000,000

Jul-2026 Aug-2026 Sep-2026 Oct-2026 Nov-2026 Dec-2026 Jan-2027 Feb-2027 Mar-2027 Apr-2027 May-2027 Jun-2027

Gross Rx Claims

Gross Paid Medical Claims

Medical/Rx

Lives Gross Paid

Medical Claims Gross Rx

Claims Total Claims

HSA

Contributions Medical/Rx Premium Surplus / (Deficit) Loss Ratio

Jul-26 9,189 $9,198,030 $1,763,415 $10,961,444 $0 $13,542,982 $2,581,538 80.9%

Aug-26

Sep-26

Oct-26

Nov-26

Dec-26

Jan-27

Feb-27

Mar-27

Apr-27

May-27

Jun-27

Total: Current Plan YTD 9,189 $9,198,030 $1,763,415 $10,961,444 $0 $13,542,982 $2,581,538 80.9%

Average 9,189 $9,198,030 $1,763,415 $10,961,444 $0 $13,542,982 $2,581,538 80.9%

PEPM $1,000.98 $191.90 $1,192.89 $0.00 $1,473.83 $280.94

% Change PEPM -2.9% -13.1% 15.2% -8.6% 10.1% 89.4%

FY2026 113,418 $128,453,202 $18,452,472 $146,905,674 $0 $150,288,824 $3,383,150 97.7%

FY2026 Average 9,452 $10,704,433 $1,537,706 $12,242,139 $0 $12,524,069 $281,929 97.7%

FY2026 PEPM $1,132.56 $162.69 $1,295.26 $0.00 $1,325.09 $29.83

Note: Kaiser fully insured data is shown on a paid basis through July 31, 2026 due to the timing of Kaiser reporting.

Note: EBU and Wellness fees are not included in this exhibit.

State of Colorado, DPA Premium vs. Claims, Copays Plans (Basic & Plus)

$0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

$12,000,000

$14,000,000

$16,000,000

Jul-2026 Aug-2026 Sep-2026 Oct-2026 Nov-2026 Dec-2026 Jan-2027 Feb-2027 Mar-2027 Apr-2027 May-2027 Jun-2027

Gross Rx Claims

Gross Paid Medical Claims

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