78 / 148
Enrollment
2,701
2,701
Administration Cost
$40.60
$41.80
3.0%
CBIZ Commission
$0.50
$0.50
0.0%
Individual Stop Loss
$20.32
$25.16
23.8%
Paid, $300,000 w/ $125,000 aggregating ISL
Aggregate Stop Loss
None
None
Total Fixed Costs
$61.42
$67.46
9.8%
Annual
$1,990,745
$2,186,514
9.8%
PMPY Fee
$2.25
Members
5,383
Annual
$12,112
PEPM
$0.00
PEPM
$0.37
1
Assume ERISA, thus PCORI fees have been excluded from premium equivalent rates
ABC Company
Not applicable after 2016
Estimated ACA Fees
Reinsurance Transfer Fee
PCORI Fee
1
Medical and Pharmacy Funding Rate Projection For a January 1, 2017 Effective Date
— Fixed Cost Summary —
Estimated Fixed Costs
2016
2017
Estimated
% Change
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