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Claim IBNR
Estimates
Claims Processed But
Not Cleared Bank
Account (Estimated)
Administration
Expenses on Run-off
(Rounded)
Total
Medical
$1,850,000
$169,100
$224,500
$2,243,600
Pharmacy
$360,000
$53,900
$800
$414,700
Final Reserve Estimate
$2,658,300
In making the estimation, CBIZ relied upon the following information:
}
Paid claim lag reports
}
Monthly enrollment reports
}
Large claim reports
}
Administrative and Stop Loss data
}
}
}
}
}
}
}
}
The conclusions drawn in this report are based on the assumptions outlined. There is no guarantee that ABC Company's
actual experience will match the estimates as provided.
Monthly backlog and lost workdays – None reported
Claims in the course of settlement – None reported
Large claimants – Claimants exceeding the stop loss deductible of $300,000 (plus $125,000 aggregating spec)
were considered. Claims of amount $859,260 were removed from the medical claim lag.
Contractual arrangements – Information regarding claim run-out processing costs were received.
Liability for legal fees or consulting fees related to claim investigation and settlement – None reported
Definition of incurral date – Date of service
Computer system conversion and/or other conversions – None reported
Claims processed but not cleared bank account – Accounts for the lag between when a claim is reported as
paid by the vendor versus actual physical withdrawl from ABC Company's checking account.
Other information pertinent to the claim valuation was requested from UnitedHealthcare, Express Scripts and Delta
Dental. Information of note is as follows:
ABC Company
Claim Reserve Valuation Estimates as of December 31, 2015
CBIZ Employee Services, Inc. prepared an estimate of the claims incurred but not yet paid for ABC Company's benefit
plan as of December 31, 2015. We recommend ABC Company hold the following IBNR reserve:
This information was provided from ABC Company's claim payers, UnitedHealthcare, Express Scripts and Delta Dental.
Full reliance on the accuracy of this data was placed on these parties.
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