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VI. MEDICAL, VISION, AND RX CLAIM RESERVE VALUATION -- METHODOLOGIES 1 - 6
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Approx
Approx
(MM)
12
Devel'd
Devel'd
12
Adj.
Adj.
ESTIMATED
#of
#of
Member
PaidOn
Mos.Harm Ultimate
Ult Inc
MoAvg Inc
CRED.
Ult. Inc
Ult Inc
RESERV@
RUNOFFAT ESTRES+
LAG(t)
MONTH and YEAR
Employees
Dependents
Months
Incurred
CF(t)
IncClms
Clms/MM Clms/MM
FACTOR
Clms/MM
Clms
12/1/2016
EACHMOS.
RUNOFF
0
Dec 16
1,535
1,151
2,686
602,300
0.2018
2,984,937
1111.19
695.36
0
695.36
1,867,918
1,265,618
NA
2,491,563
1
Nov16
1,537
1,153
2,690
1,319,486
0.6681
1,974,905
734.23
691.61
0.7
721.45
1,940,515
621,029
1,896,059
3,122,004
2
Oct 16
1,532
1,149
2,681
1,279,387
0.8319
1,537,987
573.66
687.89
1
573.66
1,537,987
258,600
2,031,864
2,636,781
3
Sep 16
1,535
1,151
2,686
1,644,542
0.9113
1,804,673
671.82
684.18
1
671.82
1,804,673
160,131
2,128,980
2,475,296
4
Aug 16
1,533
1,150
2,683
1,487,603
0.9457
1,573,087
586.37
680.49
1
586.37
1,573,087
85,483
2,709,070
2,895,256
5
Jul 16
1,474
1,106
2,580
1,859,099
0.9683
1,919,869
744.28
676.82
1
744.28
1,919,869
60,769
2,678,251
2,778,953
6
Jun 16
1,524
1,143
2,667
1,984,504
0.9865
2,011,628
754.27
673.18
1
754.27
2,011,628
27,124
2,755,240
2,795,172
7
May 16
1,547
1,160
2,707
1,686,128
0.9928
1,698,292
627.31
669.55
1
627.31
1,698,292
12,164
2,696,547
2,709,355
8
Apr 16
1,548
1,161
2,709
1,687,910
0.9964
1,694,069
625.35
665.94
1
625.35
1,694,069
6,159
2,590,519
2,591,164
9
Mar 16
1,548
1,161
2,709
2,533,575
0.9991
2,535,896
936.10
662.35
1
936.10
2,535,896
2,321
3,221,939
3,216,425
10
Feb 16
1,550
1,163
2,713
1,741,973
1.0006
1,741,012
641.85
658.78
1
641.85
1,741,012
-961
2,152,579
2,144,743
11
Jan 16
1,553
1,165
2,718
1,054,243
1.0029
1,051,158
386.77
655.23
1
386.77
1,051,158
-3,085
1,852,963
1,846,089
12
Dec 15
1,553
1,165
2,718
1,746,875
1.0005
1,745,972
642.43
651.70
1
642.43
1,745,972
-902
2,031,111
2,027,322
13
Nov15
1,555
1,166
2,721
1,852,641
1.0007
1,851,316
680.32
648.19
1
680.32
1,851,316
-1,324
2,007,417
2,004,530
14
Oct 15
1,546
1,160
2,706
1,763,737
1.0009
1,762,192
651.34
644.69
1
651.34
1,762,192
-1,545
1,906,241
1,904,678
15
Sep 15
1,545
1,159
2,704
1,256,068
1.0002
1,255,835
464.48
641.22
1
464.48
1,255,835
-233
1,237,565
1,237,548
16
Aug 15
1,523
1,142
2,665
1,307,496
0.9999
1,307,584
490.60
637.76
1
490.60
1,307,584
88
1,145,904
1,146,120
17
Jul 15
1,468
1,101
2,569
1,834,960
0.9999
1,835,088
714.32
634.32
1
714.32
1,835,088
128
1,520,707
1,520,834
18
Jun 15
1,516
1,137
2,653
2,187,091
1.0000
2,187,091
824.38
630.91
1
824.38
2,187,091
0
1,909,592
1,909,592
19
May 15
1,525
1,144
2,669
1,593,241
1.0000
1,593,241
597.00
627.51
1
597.00
1,593,241
0
1,811,923
1,811,923
20
Apr 15
1,528
1,146
2,674
1,605,052
1.0000
1,605,052
600.24
624.12
1
600.24
1,605,052
0
2,108,023
2,108,023
21
Mar 15
1,527
1,145
2,672
2,036,665
1.0000
2,036,665
762.15
620.76
1
762.15
2,036,665
0
2,513,258
2,513,258
22
Feb 15
1,529
1,147
2,676
2,125,582
1.0000
2,125,582
794.39
617.41
1
794.39
2,125,582
0
1,961,936
1,961,936
23
Jan 15
1,527
1,145
2,672
1,603,274
1.0000
1,603,274
599.97
614.09
1
599.97
1,603,274
0
953,410
953,410
TOTALRESERVEESTIMATE:
2,491,563
REINSURANCEADJUSTMENTFACTOR IS:
1.000
RESERVE ESTIMATE AT DECEMBER 31, 2016
PARAMETERS
RESERVE
REINS.
ULT
%OFCURRENT
A. USING A 12 MONTH HARMONIC AVERAGE CF(t):
HARM.
CLMAVG
ESTIMATE RECOVER.
RESERVE 12MosPdClms
1. MEDICAL, VISION, AND RX CLAIM RESERVE USING A 12 MONTH PMPM AVG CHARGE:
12
12
2,491,563
1.00
2,491,563
11.91%
2. MEDICAL, VISION, AND RX CLAIM RESERVE USING A 6 MONTH PMPM AVG CHARGE:
12
6
2,473,746
1.00
2,473,746
11.83%
B. USING A 6 MONTH HARMONIC AVERAGE CF(t):
1. MEDICAL, VISION, AND RX CLAIM RESERVE USING A 12 MONTH PMPM AVG CHARGE:
6
12
2,697,094
1.00
2,697,094
12.90%
2. MEDICAL, VISION, AND RX CLAIM RESERVE USING A 6 MONTH PMPM AVG CHARGE:
6
6
2,694,843
1.00
2,694,843
12.89%
C. USING A 3 MONTH HARMONIC AVERAGE CF(t):
1. MEDICAL, VISION, AND RX CLAIM RESERVE USING A 12 MONTH PMPM AVG CHARGE:
3
12
2,895,217
1.00
2,895,217
13.84%
2. MEDICAL, VISION, AND RX CLAIM RESERVE USING A 6 MONTH PMPM AVG CHARGE:
3
6
2,908,203
1.00
2,908,203
13.91%