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- -- l 2015
<br />Renewal Expectation
<br />Orange County Government
<br />Subscribers
<br />Total
<br />Claims
<br />Stop Loss
<br />Credits
<br />Net
<br />Claims
<br />HSA
<br />April -13
<br />May -13
<br />June -13
<br />July -13
<br />988
<br />994
<br />996
<br />1,004
<br />$620,474.22
<br />$668,568.00
<br />$408,942.76
<br />$710,969.65
<br />$0
<br />$0
<br />$0
<br />$0
<br />$620,474.22
<br />$668,568.00
<br />$408,942.76
<br />$710,969.65
<br />$21,238.60
<br />$21,341.70
<br />$21,238.60
<br />$21,547.90
<br />August -13
<br />1,012
<br />$609,311.64
<br />$0
<br />$609,311.64
<br />$21,341.70
<br />September -13
<br />1,006
<br />$494,158.67
<br />$0
<br />$494,158.67
<br />$21,341.70
<br />October -13
<br />November -13
<br />December -13
<br />1,013
<br />1,016
<br />1,015
<br />$636,751.28
<br />$946,271.22
<br />$631,855.00
<br />$0
<br />$0
<br />$0
<br />$636,751.28
<br />$946,271.22
<br />$631,855.00
<br />$21,754.10
<br />$21,857.20
<br />$21,857.20
<br />January -14
<br />979
<br />$614,054.44
<br />$0
<br />$614,054.44
<br />$23,718.00
<br />February -14
<br />March -14
<br />Total
<br />Self- funded Calculation
<br />980
<br />974
<br />11,977
<br />$685,672.00
<br />$995,490.00 1
<br />$8,022,518.871
<br />$0
<br />$811075
<br />$81,074.81
<br />$685,672.00
<br />$914,415.19
<br />$7,941,444.06
<br />$24,072.00
<br />$23,364.00
<br />$264,672.70
<br />Current PPO Plan Design
<br />2014 Renewal
<br />Claims - Without Benefit Change
<br />$8,022,519
<br />Trend 2014 - 8%
<br />113.00%
<br />Trended 2014 Claims
<br />$9,065,446
<br />Administration
<br />$479,080
<br />Stop Loss Insurance
<br />$1,377,355
<br />PPACA - Fee for Comparative Effectiveness Research Agency
<br />$3,188.00
<br />PPACA - Transitional Reinsurance Fee - 2014 - 2016
<br />$72,621.96
<br />Copays Accumulate to Out of Pocket Maximum - 5%
<br />$453,272.32
<br />HSA Cost - $1,416
<br />$288,864.00
<br />2015 Cost
<br />$11,739,828
<br />Current Contribution
<br />$9,977,799
<br />HSA Contribution Budget - $1,416
<br />$288,864
<br />Total Contribution for 2014
<br />$10,266,663
<br />Percentage Change over 2014
<br />114.35%
<br />R
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