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ABC Company
Medical ASO Options
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Prepared by:
CBIZ Employee Benefits & Insurance Services
Fee Summary
page 1 of 3
7/18/2017
2016
Florida Blue Current
Average PEPM, Year 1
$35.20
$33.64
-$1.56
$24.42
-$10.77
Year 1 - Annual ASO Fees
$6,981,709.32
$6,672,751.32
-$308,958.00
$4,844,976.00
-$2,136,733.32
Year 2 - Annual ASO Fees
N/A
$6,672,751.32
$4,920,571.26
Year 3 - Annual ASO Fees
N/A
$6,672,751.32
$4,920,571.26
Total over 3 years
---
$20,018,253.96
$14,686,118.52
Rate Guarantee
Wellness/Communication Fund
Year 1
$140,000.00
Wellness Fund
$365,000.00
Transition Credit
$1,000,000.00
Year 2
Wellness Fund
$365,000.00
Comm/Wellness
$200,000.00
Year 3
Wellness Fund
$365,000.00
Comm/Wellness
$200,000.00
Total over 3 years
$1,095,000.00
$1,400,000.00
Total Yrs ASO less Incentives
$6,841,709.32
$18,923,253.96
Health Fit Annual Cost
$1,212,053.00
Optional Service per year:
$952,185.60
Optional Service per year:
$0.00
Year 1 Spend with add'l services
$8,053,762.32
1st yr spend w/noted clinical
services:
$7,624,936.92
1st yr spend w/noted clinical
services:
$4,844,976.00
Compared to Base ASO Fees
Compared to Base ASO Fees
$643,227.60
Compared to Base ASO Fees
-$2,136,733.32
Compared to ASO Fee + Wellness
Compare to ASO + Health Fit
-$428,825.40
2.5 x Monthly base ASO fee
$1,223,294.00
Average GEO Access
Percentage of Savings Fee
on non-contracted services, facilities &
providers
Guarantees
Discount Guarantee
Trend Guarantee
Service Performance Guarantee
Implementation Guarantee
Other
Shared Savings recovery fees are built into the base admin
fee. These would otherwise be 30% of achieved savings.
98.76%
Discount Guarantee: up to 25% of Fees at risk
OR
Trend Guarantee: 20% of fees at risk guaranteeing a
target of 3% trend.
6% of fees at risk for implementation metrics
19% of Fees at risk for Service
2017
United Healthcare - Immature Fees
Flat 3 years
6 months of run out admin is included in fee
Add'l 6 months for $0.29 PEPM or a +1% adjustment to the
ASO fee.
@ 0.29 PEPM for 6 months: +$28,764
2017
Florida Blue 2017 Offer
Flat 3 years
Fee for processing
Run Off Claims
Waived
12 months included
Assumes no cancellation prior to end of 2018
13% of Fees at risk for service
N/A
2.5 x Monthly base ASO fee