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Health Plan Projection
•
2016 Paid claims (Feb 2016
– July 2016)
•
Assumes 7.5% medical
trend and 11.5% Rx trend
being applied for an 18
months of projected claims
•
Assumes 15% Stop Loss
reinsurance increases
•
Projection excludes Rx
rebates
•
No change in employee
contributions
•
Net result for 2016 is a
total projection cost that is
22.3% less than current rate
equivalents
Medical/Rx
2016
2017
1 Paid Claims (Feb 2016 - July 2016)
$1,257,500
$2,466,432
2 Average Enrollment
302
302
3 Annual Trend
7.8%
7.8%
4 Current Enrollment
302
302
5 Projected Claims
$2,261,881
$2,466,432
6 Claims Per Employee Per Year
$7,490
$8,167
7 Pharmacy Rebates
$0
$0
8 Administration
111734
111384
9 Stop Loss
$457,868
$526,332
10 PPACA Fees
$14,468
$1,076
11 Total Projected Cost
$2,845,952
$3,105,224
12 Premium Equivalent
$3,643,700
$3,636,672
13 Increase ($)
-$797,748
-$531,448
14 Increase (%)
-21.9%
-14.6%
15 Employee Contributions
$797,006
$797,006
16 Total Projected Cost (net employee contribution)
$2,048,945
$2,308,218
17
Premium Equivalent (net employee contributions)
$2,846,694
$2,839,666
12