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2013 Renewal Estimate
<br />Orange County Government
<br />Subscribers
<br />Premium
<br />Total
<br />Claims
<br />Loss
<br />Ratio
<br />Stop -Loss
<br />Credit
<br />Net
<br />Claims
<br />January-12
<br />950
<br />$743,443.38
<br />$604,308.68
<br />81.29%
<br />$0.00
<br />$604,308.68
<br />February -12
<br />946
<br />$744,199.26
<br />$569,144.77
<br />76.48%
<br />$0.00
<br />$569,144.77
<br />March -12
<br />937
<br />$738,815.00
<br />$578,773.00
<br />78.34%
<br />$0.00
<br />$578,773.00
<br />April -12
<br />936
<br />$733,883.00
<br />$737,301.78
<br />100.47%
<br />$0.00
<br />$737,301.78
<br />May -12
<br />945
<br />$737,267.00
<br />$567,845.00
<br />77.02%
<br />$0.00
<br />$567,845.00
<br />June -12
<br />948
<br />$736,226.18
<br />$445,234.87
<br />60.48%
<br />$0.00
<br />$445,234.87
<br />July -12
<br />995
<br />$763,570.85
<br />$522,122.29
<br />68.38%
<br />$0.00
<br />$522,122.29
<br />August -12
<br />991
<br />$760,770.00
<br />$648,641.00
<br />85.26%
<br />$0.00
<br />$648,641.00
<br />September -12
<br />983
<br />$754,703.00
<br />$611,959.00
<br />81.09%
<br />$0.00
<br />$611,959.00
<br />October -12
<br />987
<br />$753,274.00
<br />$505,413.00
<br />67.10%
<br />$0.00
<br />$505,413.00
<br />November -12
<br />994
<br />$758,491.00
<br />$607,188.00
<br />80.05%
<br />$0.00
<br />$607,188.00
<br />December -12
<br />995
<br />$757,024.00
<br />$621,695.00
<br />82.12%
<br />$0.00
<br />$621,695.00
<br />Total
<br />11,607
<br />$8,981,666.67
<br />$7,019,626.38
<br />78.16%
<br />$0.00
<br />$6,397,931.38
<br />Fully Insured Calculation
<br />Current PPO Plan Design
<br />2014 Renewal
<br />Premium - 1/13 - 12/13
<br />$9,729,197
<br />Claims
<br />$6,397,931
<br />Claims - With Benefit Change
<br />$6,397,931
<br />Trend 2014- 8 % -24 Months
<br />116.00%
<br />Trended 2014 Claims
<br />$7,421,600
<br />PPACA - Fee for Comparative Effectiveness Research Agency
<br />$1,649.00
<br />PPACA - Transitional Reinsurance Fee - 2014- 2016
<br />$103,887.00
<br />PPACA - Health Insurance Industry Fee
<br />$243,229.93
<br />2014 Expected Cost
<br />$7,770,366
<br />Premium - 1/13 - 12/13
<br />$9,729,197
<br />Loss Ratio
<br />79.87%
<br />Target Loss Ratio
<br />85.00%
<br />Rate Action
<br />93.96%
<br />Self- funded Calculation
<br />Current PPO Plan Design
<br />2014 Renewal
<br />Claims - Without Benefit Change
<br />$6,397,931
<br />Trend 2014- 8 % -25 Months
<br />116.67%
<br />Trended 2014 Claims
<br />$7,464,467
<br />Administration
<br />$1,448,321
<br />PPACA - Fee for Comparative Effectiveness Research Agency
<br />$1,649.00
<br />PPACA - Transitional Reinsurance Fee - 2014 - 2016
<br />$103,887.00
<br />Total Cost
<br />$9,018,324
<br />Current Contribution
<br />$9,729,197
<br />Percentage Change over 2014
<br />92.69%
<br />11
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