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CIGNA Domestic Medical
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CIGNA Domestic Experience Summary Report
A.
Medical & Rx
I.
All Medical Plans (All Benefit Plans, Management & Non-Management)
Experience Highlights
A
B
C
D
E
F = C - E G = C/B H = F/B
Average
Enrollment
Total
Premium
Total Paid
Claims
Total
Claims
Above
$150,000
Excess
Claims
Above
$150,000
Adjusted
Claims
Pure Loss
Ratio
Net Loss
Ratio
(Remove Ind.
Large Claims
above $150K)
2014 362
$3,263,502 $2,228,371 $243,815 $93,815 $2,134,556
0.68
0.65
2015 475
$5,421,797 $4,692,626 $822,430 $372,430 $4,320,196
0.87
0.80
2016 536
$6,310,989 $8,087,357 $3,106,331 $1,756,331 $6,331,026
1.28
1.00
2017 (4 mo)
534
$2,155,465 $2,243,172
$0
$0 $2,243,172
1.04
1.04
Rolling 12 535
$6,348,192 $7,979,230 $2,783,017 $1,583,017 $6,396,214
1.26
1.01
Rate Action: 29% - 45%
[(R12 Paid Claims Less Claims Above 150K x Trend)/.8]/Current Premium = Rate Action Ratio
II. Individual Large Paid Claims (From Utilization Report - assumed paid with no adjustment for IBNR)
Note: Med + Rx
2014 2015 2016 Rolling 12
1
$243,815 $386,841 $764,759 $539,628
2
$111,320 $274,024 $540,967 $505,536
3
$101,946 $161,565 $475,496 $442,026
4
$81,341 $115,362 $296,308 $363,658
5
$79,606 $110,602 $253,026 $267,162
6
$78,492 $102,773 $229,384 $236,144
7
$72,356 $102,138 $198,190 $230,673
8
$65,621 $101,978 $192,421 $198,190
9
$59,506 $101,888 $155,780 $142,820
10
$93,936 $109,102 $121,221
11
$74,588 $103,357 $96,930
12
$67,847 $102,217 $91,651
13
$67,372 $89,920 $85,592
14
$66,356 $73,334 $84,893
15
$62,628 $72,775 $82,890
16
$60,860 $72,008 $82,565
17
$57,670 $65,606 $76,065
18
$55,860 $63,691 $72,849