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ABC Company

Claim Reserve Valuation Estimates as of December 31, 2016

Medical, Pharmacy and Dental

IV. FINAL MEDICAL, VISION, PHARMACY, & DENTAL RESERVE ESTIMATE at December 31, 2016:

1. Final Medical Claim IBNR Reserve Estimate

$2,491,563

2. Final Pharmacy Claim IBNR Reserve Estimate

$9,000

3. Final Dental Claim IBNR Reserve Estimate

$48,980

4. Medical Claims Processed But Not Cleared

$0

Bank Account

5. Pharmacy Claims Processed But Not Cleared

$0

Bank Account

6. Dental Claims Processed But Not Cleared

$0

Bank Account

7. Est. Administration Expenses on Medical

$146,900

Run-off Claims (Rounded)

8. Est. Administration Expenses on Pharmacy

$0

Run-off Claims (Rounded)

9. Est. Administration Expenses on Dental

$0

Run-off Claims (Rounded)

10. Final Reserve Estimate

$2,696,443