116-117 / 537
Employer Group ABC
Incurred:
Apr 2014 thru Dec 2015
Paid:
Apr 2014 thru Mar 2016
44
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Page
This table shows medical claim payments in relation to the date when the claims were incurred (date of service). The table is useful for developing completion factors which
allow forward projections of monthly payments and for estimating incurred but not reported (IBNR) claims.
Table 5.2.4 Medical Claim Lag Report
49
Paid
Date
Service Date
All Prior
Apr-15
May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15
Jan-16
Feb-16
Mar-16
Total
Apr-15
$4,875,382
$1,884,779
$6,760,161
May-15
$1,805,291
$2,706,685
$1,840,790
$6,352,765
Jun-15
$635,338
$884,086
$2,935,479
$1,769,395
$6,224,298
Jul-15
$433,455
$355,992
$586,604
$2,492,938
$1,884,466
$5,753,454
Aug-15
$274,873
$156,229
$410,628
$468,254
$2,448,305
$1,964,031
$5,722,321
Sep-15
$343,565
$112,010
$105,601
$202,562
$865,480
$2,814,703
$1,644,737
$6,088,659
Oct-15
$54,386
$52,691
$74,435
$82,551
$230,527
$639,214
$2,860,470
$2,021,821
$6,016,096
Nov-15
$124,359
$35,403
$19,585
$68,331
$71,441
$358,587
$615,814
$3,193,531
$1,974,759
$6,461,808
Dec-15
$53,776
$38,822
$24,460
$29,826
$61,778
$408,936
$192,436
$684,402
$3,082,148
$2,288,820
$6,865,404
Jan-16
$1,365
$22,271
$15,429
$21,678
$143,389
$24,436
$143,004
$290,169
$427,727
$2,895,397
$1,543,945
$5,528,811
Feb-16
$54,102
$8,610
$4,941
$17,811
$134,957
$41,617
$138,336
$37,502
$186,293
$654,486
$2,739,596
$1,465,364
$5,483,613
Mar-16
$89,215
$14,456
$23,776
$2,065
$14,077
($24,120)
$76,986
$93,252
$179,302
$492,998
$823,451
$2,584,625
$1,793,803
$6,163,887
Total
Plan Paid
Medical
$8,745,108
$6,272,035
$6,041,726
$5,155,410
$5,854,421
$6,227,403
$5,671,783
$6,320,678
$5,850,229
$6,331,701
$5,106,992
$4,049,988
$1,793,803
$73,421,277
49
Note:
1.
Utilization metrics are always calculated on an incurred basis.
2.
The last two or three months of the year will show decreased values due to 'claims lag', and should be interpreted with caution.