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Executive Summary
Medical & Rx
UMR administrative costs remain the same for 2017
Stop Loss rates will be finalized in mid November (estimated increase is 15% - $65k)
Claims are -28% to budget year to date
Full 2016 year claims are projected to be -21.9% versus current budget rates
2017 claims are projected to -14.6% versus current budget rates
There are 3 large claimants over $50k, two of which are over $100k
OPTUM RX Prescription Drug
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Claims decreased 20.5% implementing OPTUM RX
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2016 rebates to date is $10k and estimated to be $30k for the year
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2017 rebates estimated to double
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Removing the $50 deductible from the low PPO plan would estimate and annual cost of
$11,212
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Adopting premium formulary could mean an additional estimated savings of $71k
Current plan enrollment:
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PPO – 53% of employees
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QDHP – 47% of employees
97% of claims are paid at in network level with average discount of 54.61% (savings of $1.3k)
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