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2012 Plan Experience
<br /> HSA Plan
<br /> Claims Per
<br /> Date Combined Active/Retiree
<br /> Subs Mbrs Premium Medical Pharmacy Capitation Medical Claims Per Month Loss Ratio
<br /> January-12 195 375 $142,357 $12,038 $2
<br /> $3,845.63 $15,884.91 $81.46 11.16%
<br /> February-12 196 373
<br /> $141,406 $21,599 $699 $3,814.70 $26,113.07 $133.23 18.47%
<br /> March-12 191 362 139,684 $30,321.00 $1,091.00 $3,732.00- $35,144.00 $184.00 25.16%
<br /> Total 582 1,110 $423,446.44
<br /> $63,958.26 $1,791.39 $11,392.33 $77,141.98 -, o
<br /> PPO Plan : 18.22/
<br /> Claims Per
<br /> Date Combined Active/Retiree
<br /> Subs Mbrs Premium Medical Pharmacy Capitation Medical Claims Per Month Loss Ratio
<br /> January 12 755 1,258 $601,087 $503,372 $72,164
<br /> $12,887.50 $588,423.77 $779.37 97.89%
<br /> February-12 750 1,254
<br /> $602,794 $443,530 $86,572.58 $12,928.74 $543,031.69 $724.04 90.09%
<br /> March-12 746 1,246 $599,131.00 $424,785.00 $105,977.00 $12,867.00 $543,629.00 0
<br /> Total 2,251 3,758 $1,803,011.20 $1,371,687.47 $264,713.75 $728 73 92.90/
<br /> $38,683.24 $1,675,084.46 .rn" .; '' '5;.: :' 92.90%
<br /> Orange County
<br /> Claims Per
<br /> Combined Date Subs Mbrs Premium Medical Pharmacy Capitation Medical Claims Active
<br /> Per eMonth/Retiree Loss Ratio
<br /> January-12 950 1,633 $743,443.38 $515,409.87 $72,165.67 $16,733.13
<br /> $604,308.68 $636.11 81.29%
<br /> February-12 946 1,627
<br /> $744,199.26 $465,129.86 $87,271.47 $16,743.44 $569,144.77 $601.63 76.48%
<br /> March-12 937 1,608 $738,815.00 $455,106.00 $107,068.00 $16,599.00 $578,773.00 0
<br /> Total 2,833 4,868 $2,226,457.64 $1,435,645.73 $266,505.14 $617 69 78.70/
<br /> $50,075.57 $1,752,226.44 �q� s —°
<br /> _" , 78.70%
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