T h is r e p o r t c o n t a in s p r o p r ie t a r y a n ... · T h is r e p o r t c o n t a in s...

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Page 1 of 2 Date: 04/06/2017 ADVICE Reporting System T h i s r e p o r t c o n t a i n s p r o p r i e t a r y a n d / o r c o n f i d e n t i a l i n f o r m a t i o n . D i s c l o s u r e i s s t r i c t l y p r o h i b i t e d e x c e p t t o t h e e x t e n t r e q u i r e d b y l a w . CITY OF CLEVELAND GC MONTHLY HEALTHCARE DETAIL EXPERIENCE REPORT April 2016 thru March 2017 FAT : TRADITIONAL RAT : FULLY INSURED NON-PARTICPATING Reported Premium: Billed Premium without fees YTD/MONTH ACCOUNT PRODUCT GROUP IN NETWORK OUT OF NETWORK TOTAL CLAIMS BILLED PREMIUM TOTAL SUBS TOTAL MBRS Apr-16 3329367-CITY OF CLEVELAND DENT $244,615 $64,513 $309,128 $321,218 6,068 15,123 ACCOUNT Total $244,615 $64,513 $309,128 $321,218 6,068 15,123 Apr-2016 Total $244,615 $64,513 $309,128 $321,218 6,068 15,123 May-16 3329367-CITY OF CLEVELAND DENT $236,854 $73,493 $310,347 $317,476 6,020 14,982 ACCOUNT Total $236,854 $73,493 $310,347 $317,476 6,020 14,982 May-2016 Total $236,854 $73,493 $310,347 $317,476 6,020 14,982 Jun-16 3329367-CITY OF CLEVELAND DENT $236,820 $67,462 $304,281 $319,357 6,012 14,960 ACCOUNT Total $236,820 $67,462 $304,281 $319,357 6,012 14,960 Jun-2016 Total $236,820 $67,462 $304,281 $319,357 6,012 14,960 Jul-16 3329367-CITY OF CLEVELAND DENT $211,966 $58,659 $270,625 $315,920 5,945 14,816 ACCOUNT Total $211,966 $58,659 $270,625 $315,920 5,945 14,816 Jul-2016 Total $211,966 $58,659 $270,625 $315,920 5,945 14,816 Aug-16 3329367-CITY OF CLEVELAND DENT $255,597 $71,269 $326,866 $313,591 5,920 14,761 ACCOUNT Total $255,597 $71,269 $326,866 $313,591 5,920 14,761 Aug-2016 Total $255,597 $71,269 $326,866 $313,591 5,920 14,761 Sep-16 3329367-CITY OF CLEVELAND DENT $221,141 $67,712 $288,853 $313,424 5,914 14,707 ACCOUNT Total $221,141 $67,712 $288,853 $313,424 5,914 14,707 Sep-2016 Total $221,141 $67,712 $288,853 $313,424 5,914 14,707 Oct-16 3329367-CITY OF CLEVELAND DENT $204,808 $57,598 $262,406 $314,442 5,939 14,709 ACCOUNT Total $204,808 $57,598 $262,406 $314,442 5,939 14,709 Oct-2016 Total $204,808 $57,598 $262,406 $314,442 5,939 14,709 Nov-16 3329367-CITY OF CLEVELAND DENT $214,716 $63,401 $278,116 $311,303 5,911 14,625 ACCOUNT Total $214,716 $63,401 $278,116 $311,303 5,911 14,625 Nov-2016 Total $214,716 $63,401 $278,116 $311,303 5,911 14,625

Transcript of T h is r e p o r t c o n t a in s p r o p r ie t a r y a n ... · T h is r e p o r t c o n t a in s...

Page 1: T h is r e p o r t c o n t a in s p r o p r ie t a r y a n ... · T h is r e p o r t c o n t a in s p r o p r ie t a r y a n d / o r c o n f id e n t ia l in f o r m a t io n . D

Page 1 of 2Date: 04/06/2017

ADVICE Reporting System

T h i s r e p o r t c o n t a i n s p r o p r i e t a r y a n d / o r c o n f i d e n t i a l i n f o r m a t i o n . D i s c l o s u r e i s s t r i c t l y p r o h i b i t e d e x c e p t t o t h e e x t e n t r e q u i r e d b y l a w .

CITY OF CLEVELANDGC MONTHLY HEALTHCARE DETAIL EXPERIENCE REPORT

April 2016 thru March 2017FAT : TRADITIONALRAT : FULLY INSURED NON-PARTICPATINGReported Premium: Billed Premium without fees

YTD/MONTH ACCOUNT PRODUCT GROUP IN NETWORK OUT OF NETWORK TOTAL CLAIMS BILLED PREMIUM TOTAL SUBS TOTAL MBRSApr-16 3329367-CITY OF CLEVELAND DENT $244,615 $64,513 $309,128 $321,218 6,068 15,123 ACCOUNT Total $244,615 $64,513 $309,128 $321,218 6,068 15,123

Apr-2016 Total $244,615 $64,513 $309,128 $321,218 6,068 15,123

May-16 3329367-CITY OF CLEVELAND DENT $236,854 $73,493 $310,347 $317,476 6,020 14,982 ACCOUNT Total $236,854 $73,493 $310,347 $317,476 6,020 14,982

May-2016 Total $236,854 $73,493 $310,347 $317,476 6,020 14,982

Jun-16 3329367-CITY OF CLEVELAND DENT $236,820 $67,462 $304,281 $319,357 6,012 14,960 ACCOUNT Total $236,820 $67,462 $304,281 $319,357 6,012 14,960

Jun-2016 Total $236,820 $67,462 $304,281 $319,357 6,012 14,960

Jul-16 3329367-CITY OF CLEVELAND DENT $211,966 $58,659 $270,625 $315,920 5,945 14,816 ACCOUNT Total $211,966 $58,659 $270,625 $315,920 5,945 14,816

Jul-2016 Total $211,966 $58,659 $270,625 $315,920 5,945 14,816

Aug-16 3329367-CITY OF CLEVELAND DENT $255,597 $71,269 $326,866 $313,591 5,920 14,761 ACCOUNT Total $255,597 $71,269 $326,866 $313,591 5,920 14,761

Aug-2016 Total $255,597 $71,269 $326,866 $313,591 5,920 14,761

Sep-16 3329367-CITY OF CLEVELAND DENT $221,141 $67,712 $288,853 $313,424 5,914 14,707 ACCOUNT Total $221,141 $67,712 $288,853 $313,424 5,914 14,707

Sep-2016 Total $221,141 $67,712 $288,853 $313,424 5,914 14,707

Oct-16 3329367-CITY OF CLEVELAND DENT $204,808 $57,598 $262,406 $314,442 5,939 14,709 ACCOUNT Total $204,808 $57,598 $262,406 $314,442 5,939 14,709

Oct-2016 Total $204,808 $57,598 $262,406 $314,442 5,939 14,709

Nov-16 3329367-CITY OF CLEVELAND DENT $214,716 $63,401 $278,116 $311,303 5,911 14,625 ACCOUNT Total $214,716 $63,401 $278,116 $311,303 5,911 14,625

Nov-2016 Total $214,716 $63,401 $278,116 $311,303 5,911 14,625

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Page 2 of 2Date: 04/06/2017

ADVICE Reporting System

T h i s r e p o r t c o n t a i n s p r o p r i e t a r y a n d / o r c o n f i d e n t i a l i n f o r m a t i o n . D i s c l o s u r e i s s t r i c t l y p r o h i b i t e d e x c e p t t o t h e e x t e n t r e q u i r e d b y l a w .

CITY OF CLEVELANDGC MONTHLY HEALTHCARE DETAIL EXPERIENCE REPORT

April 2016 thru March 2017FAT : TRADITIONALRAT : FULLY INSURED NON-PARTICPATINGReported Premium: Billed Premium without fees

YTD/MONTH ACCOUNT PRODUCT GROUP IN NETWORK OUT OF NETWORK TOTAL CLAIMS BILLED PREMIUM TOTAL SUBS TOTAL MBRSDec-16 3329367-CITY OF CLEVELAND DENT $216,770 $58,850 $275,621 $310,248 5,896 14,577 ACCOUNT Total $216,770 $58,850 $275,621 $310,248 5,896 14,577

Dec-2016 Total $216,770 $58,850 $275,621 $310,248 5,896 14,577

Jan-17 3329367-CITY OF CLEVELAND DENT $193,525 $49,964 $243,489 $309,412 5,880 14,536 ACCOUNT Total $193,525 $49,964 $243,489 $309,412 5,880 14,536

Jan-2017 Total $193,525 $49,964 $243,489 $309,412 5,880 14,536

Feb-17 3329367-CITY OF CLEVELAND DENT $181,819 $57,903 $239,723 $310,098 5,900 14,552 ACCOUNT Total $181,819 $57,903 $239,723 $310,098 5,900 14,552

Feb-2017 Total $181,819 $57,903 $239,723 $310,098 5,900 14,552

Mar-17 3329367-CITY OF CLEVELAND DENT $230,101 $71,111 $301,212 $309,306 5,887 14,507 ACCOUNT Total $230,101 $71,111 $301,212 $309,306 5,887 14,507

Mar-2017 Total $230,101 $71,111 $301,212 $309,306 5,887 14,507

Grand Total $2,648,731 $761,935 $3,410,667 $3,765,794 71,292 176,855

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Page 1 of 1Date: 10/04/2018

ADVICE Reporting System

T h i s r e p o r t c o n t a i n s p r o p r i e t a r y a n d / o r c o n f i d e n t i a l i n f o r m a t i o n . D i s c l o s u r e i s s t r i c t l y p r o h i b i t e d e x c e p t t o t h e e x t e n t r e q u i r e d b y l a w .

CITY OF CLEVELANDGC MONTHLY HEALTHCARE DETAIL EXPERIENCE REPORT

April 2018 thru September 2018FAT : TRADITIONALRAT : FULLY INSURED NON-PARTICPATINGReported Premium: Billed Premium without fees

YTD/MONTH ACCOUNT PRODUCT GROUP IN NETWORK OUT OF NETWORK TOTAL CLAIMS BILLED PREMIUM TOTAL SUBS TOTAL MBRSApr-18 3329367-CITY OF CLEVELAND DENT $258,506 $64,075 $322,581 $321,761 6,230 14,949 ACCOUNT Total $258,506 $64,075 $322,581 $321,761 6,230 14,949

Apr-2018 Total $258,506 $64,075 $322,581 $321,761 6,230 14,949

May-18 3329367-CITY OF CLEVELAND DENT $260,360 $84,051 $344,411 $320,871 6,221 14,926 ACCOUNT Total $260,360 $84,051 $344,411 $320,871 6,221 14,926

May-2018 Total $260,360 $84,051 $344,411 $320,871 6,221 14,926

Jun-18 3329367-CITY OF CLEVELAND DENT $251,082 $68,006 $319,088 $320,235 6,215 14,887 ACCOUNT Total $251,082 $68,006 $319,088 $320,235 6,215 14,887

Jun-2018 Total $251,082 $68,006 $319,088 $320,235 6,215 14,887

Jul-18 3329367-CITY OF CLEVELAND DENT $260,787 $59,299 $320,086 $319,063 6,189 14,798 ACCOUNT Total $260,787 $59,299 $320,086 $319,063 6,189 14,798

Jul-2018 Total $260,787 $59,299 $320,086 $319,063 6,189 14,798

Aug-18 3329367-CITY OF CLEVELAND DENT $257,353 $69,396 $326,748 $319,604 6,227 14,811 ACCOUNT Total $257,353 $69,396 $326,748 $319,604 6,227 14,811

Aug-2018 Total $257,353 $69,396 $326,748 $319,604 6,227 14,811

Sep-18 3329367-CITY OF CLEVELAND DENT $200,155 $48,614 $248,769 $318,344 6,213 14,746 ACCOUNT Total $200,155 $48,614 $248,769 $318,344 6,213 14,746

Sep-2018 Total $200,155 $48,614 $248,769 $318,344 6,213 14,746

Grand Total $1,488,241 $393,441 $1,881,682 $1,919,878 37,295 89,117

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Loss Ratio Report Combined

Date Executed: 9/12/17Reporting Period: 2016/01 thru 2016/12

City of Cleveland

Month

Number ofSubscribers

Number ofMembers

Gross BilledPremium

Gross PaidPremium

Billed vsPaid %Change

Fees onBilled

Premium

Broker Feeson BilledPremium

Net BilledPremium

Total ClaimDollars

Claims toNet BilledPremium

Claims toNet PaidPremium

201601 5,384 13,755 $26,195 $26,465 1.0% $2,162 $0 $24,034 $31,672 131.8% 130.4%

201602 5,357 13,678 $26,514 $26,411 -0.4% $2,188 $0 $24,326 $23,659 97.3% 97.6%

201603 5,361 13,664 $26,048 $26,348 1.1% $2,150 $0 $23,899 $18,299 76.6% 75.7%

201604 5,403 13,763 $30,031 $30,376 1.1% $2,478 $0 $27,552 $47,532 172.5% 170.6%

201605 5,364 13,657 $30,537 $30,211 -1.1% $2,520 $0 $28,017 $29,707 106.0% 107.2%

201606 5,351 13,613 $29,807 $30,103 1.0% $2,460 $0 $27,347 $26,055 95.3% 94.3%

201607 5,335 13,555 $29,744 $30,135 1.3% $2,455 $0 $27,290 $27,450 100.6% 99.3%

201608 5,310 13,492 $29,856 $29,990 0.4% $2,464 $0 $27,392 $31,409 114.7% 114.1%

201609 5,291 13,431 $29,605 $29,772 0.6% $2,443 $0 $27,162 $28,477 104.8% 104.3%

201610 5,310 13,423 $29,476 $29,805 1.1% $2,432 $0 $27,044 $23,302 86.2% 85.2%

201611 5,286 13,337 $29,627 $29,844 0.7% $2,445 $0 $27,182 $19,785 72.8% 72.3%

201612 5,265 13,280 $29,526 $29,827 1.0% $2,437 $0 $27,090 $20,844 76.9% 76.2%

Totals: 5,335 13,554 $346,967 $349,286 0.7% $28,633 $0 $318,334 $328,191 103.1% 102.4%

IBNR Estimate 0.75 Months $20,512

Total Adjusted Claims & Percentage $348,703 109.5% 108.8%

Group(s) Used: 9812959;9852161

Fees on Premium represents the underwriter expense, taxes and other fees & assessments. Maximum Broker Fee during Reporting Period = 0%. Note: IBNR estimate represents accrual for claims incurred by members but not yet paid.

Note: Claims to Net Paid Premium calculation is based on premium dollars paid as of the report execution date.

LR :1/1

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Loss Ratio Report By Group

Date Executed: 9/12/17Reporting Period: 2016/01 thru 2016/12

City of Cleveland

9812959 1001 - City of Cleveland

MonthNumber ofSubscribers

Number ofMembers

Gross BilledPremium

Gross PaidPremium

Billed vsPaid %Change

Fees onBilled

Premium

Broker Feeson BilledPremium

Net BilledPremium

Total ClaimDollars

Claims toNet BilledPremium

Claims toNet PaidPremium

201601 5,380 13,742 $26,176 $26,445 1.0% $2,160 $0 $24,016 $31,672 131.9% 130.5%

201602 5,353 13,665 $26,494 $26,391 -0.4% $2,186 $0 $24,308 $23,575 97.0% 97.4%

201603 5,357 13,651 $26,029 $26,328 1.1% $2,148 $0 $23,881 $18,299 76.6% 75.8%

201604 5,399 13,750 $30,008 $30,353 1.1% $2,476 $0 $27,532 $47,532 172.6% 170.7%

201605 5,360 13,644 $30,515 $30,188 -1.1% $2,518 $0 $27,997 $29,707 106.1% 107.3%

201606 5,347 13,600 $29,784 $30,081 1.0% $2,458 $0 $27,326 $26,055 95.3% 94.4%

201607 5,331 13,542 $29,722 $30,113 1.3% $2,453 $0 $27,269 $27,206 99.8% 98.5%

201608 5,306 13,479 $29,834 $29,968 0.4% $2,462 $0 $27,372 $31,325 114.4% 113.9%

201609 5,287 13,418 $29,582 $29,750 0.6% $2,441 $0 $27,141 $28,437 104.8% 104.2%

201610 5,306 13,410 $29,454 $29,782 1.1% $2,431 $0 $27,023 $23,108 85.5% 84.6%

201611 5,282 13,324 $29,605 $29,821 0.7% $2,443 $0 $27,162 $19,721 72.6% 72.1%

201612 5,261 13,267 $29,504 $29,827 1.1% $2,435 $0 $27,069 $20,764 76.7% 75.9%

Totals: 5,331 13,541 $346,707 $349,048 0.7% $28,612 $0 $318,095 $327,401 102.9% 102.2%

IBNR Estimate 0.75 Months $20,463

Total Adjusted Claims & Percentage $347,864 109.4% 108.6%

Group:

Fees on Premium represents the underwriter expense, taxes and other fees & assessments. Maximum Broker Fee during Reporting Period = 0%. Note: IBNR estimate represents accrual for claims incurred by members but not yet paid.

Note: Claims to Net Paid Premiums calculation is based on premiums paid as of the report execution date.

LR_Grp:1/2

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Loss Ratio Report By Group

Date Executed: 9/12/17Reporting Period: 2016/01 thru 2016/12

City of Cleveland

9852161 1001 - City of Cleveland

MonthNumber ofSubscribers

Number ofMembers

Gross BilledPremium

Gross PaidPremium

Billed vsPaid %Change

Fees onBilled

Premium

Broker Feeson BilledPremium

Net BilledPremium

Total ClaimDollars

Claims toNet BilledPremium

Claims toNet PaidPremium

201601 4 13 $20 $20 0.0% $2 $0 $18 $0 0.0% 0.0%

201602 4 13 $20 $20 0.0% $2 $0 $18 $84 467.1% 467.1%

201603 4 13 $20 $20 0.0% $2 $0 $18 $0 0.0% 0.0%

201604 4 13 $22 $22 0.0% $2 $0 $21 $0 0.0% 0.0%

201605 4 13 $22 $22 0.0% $2 $0 $21 $0 0.0% 0.0%

201606 4 13 $22 $22 0.0% $2 $0 $21 $0 0.0% 0.0%

201607 4 13 $22 $22 0.0% $2 $0 $21 $244 1,189.4% 1,189.4%

201608 4 13 $22 $22 0.0% $2 $0 $21 $84 409.5% 409.5%

201609 4 13 $22 $22 0.0% $2 $0 $21 $40 195.0% 195.0%

201610 4 13 $22 $22 0.0% $2 $0 $21 $194 944.9% 944.9%

201611 4 13 $22 $22 0.0% $2 $0 $21 $64 311.4% 311.4%

201612 4 13 $22 $0 -100.0% $2 $0 $21 $80 390.0% 0.0%

Totals: 4 13 $260 $238 -8.6% $21 $0 $239 $790 331.0% 362.2%

IBNR Estimate 0.75 Months $49

Total Adjusted Claims & Percentage $839 351.7% 384.8%

Group:

Fees on Premium represents the underwriter expense, taxes and other fees & assessments. Maximum Broker Fee during Reporting Period = 0%. Note: IBNR estimate represents accrual for claims incurred by members but not yet paid.

Note: Claims to Net Paid Premiums calculation is based on premiums paid as of the report execution date.

LR_Grp:2/2

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Member Counts by Rate Tier

Date Executed: 9/12/17

City of Cleveland

Group ID Month Rate DescriptionRate perMonth

EmployeeCount

98129591001 201612 Per Subscriber Per Period $5.59 5,278

5,278

98521611001 201612 Per Subscriber Per Period $5.59 4

4

Total 5,282

LR_Mbr :1/1

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Loss Ratio Report Combined

Date Executed: 1/26/18Reporting Period: 2017/01 thru 2017/12

City of Cleveland

Month

Number ofSubscribers

Number ofMembers

Gross BilledPremium

Gross PaidPremium

Billed vsPaid %Change

Fees onBilled

Premium

Broker Feeson BilledPremium

Net BilledPremium

Total ClaimDollars

Claims toNet BilledPremium

Claims toNet PaidPremium

201701 5,248 13,237 $29,454 $29,554 0.3% $2,431 $0 $27,023 $21,414 79.2% 79.0%

201702 5,268 13,266 $29,236 $29,716 1.6% $2,413 $0 $26,823 $18,539 69.1% 68.0%

201703 5,257 13,245 $29,448 $29,638 0.6% $2,430 $0 $27,018 $24,370 90.2% 89.6%

201704 5,341 13,377 $29,359 $30,018 2.2% $2,423 $0 $26,936 $49,589 184.1% 180.1%

201705 5,323 13,313 $30,247 $29,918 -1.1% $2,496 $0 $27,751 $32,912 118.6% 119.9%

201706 5,316 13,288 $29,677 $29,828 0.5% $2,449 $0 $27,228 $34,567 127.0% 126.3%

201707 5,306 13,244 $29,655 $29,616 -0.1% $2,447 $0 $27,208 $33,507 123.2% 123.3%

201708 5,295 13,207 $38,966 $29,454 -24.4% $2,956 $0 $36,009 $28,113 78.1% 104.0%

201709 5,320 13,248 $62,630 $29,907 -52.2% $4,265 $0 $58,364 $34,147 58.5% 124.5%

201710 5,333 13,244 $58,619 $29,856 -49.1% $4,040 $0 $54,579 $29,682 54.4% 108.4%

201711 5,349 13,250 $58,154 $29,951 -48.5% $4,025 $0 $54,129 $28,364 52.4% 103.2%

201712 5,357 13,238 $55,337 $0 -100.0% $3,868 $0 $51,469 $25,471 49.5% 0.0%

Totals: 5,309 13,263 $480,781 $327,457 -31.9% $36,243 $0 $444,538 $360,675 81.1% 120.1%

IBNR Estimate 0.75 Months $22,542

Total Adjusted Claims & Percentage $383,217 86.2% 127.6%

Group(s) Used: 9812959;9852161

Fees on Premium represents the underwriter expense, taxes and other fees & assessments. Maximum Broker Fee during Reporting Period = 0%. Note: IBNR estimate represents accrual for claims incurred by members but not yet paid.

Note: Claims to Net Paid Premium calculation is based on premium dollars paid as of the report execution date.

LR :1/1

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Loss Ratio Report By Group

Date Executed: 1/26/18Reporting Period: 2017/01 thru 2017/12

City of Cleveland

9812959 1001 - City of Cleveland

MonthNumber ofSubscribers

Number ofMembers

Gross BilledPremium

Gross PaidPremium

Billed vsPaid %Change

Fees onBilled

Premium

Broker Feeson BilledPremium

Net BilledPremium

Total ClaimDollars

Claims toNet BilledPremium

Claims toNet PaidPremium

201701 5,244 13,224 $29,431 $29,554 0.4% $2,429 $0 $27,003 $21,414 79.3% 79.0%

201702 5,264 13,253 $29,213 $29,694 1.6% $2,411 $0 $26,803 $18,539 69.2% 68.0%

201703 5,253 13,232 $29,426 $29,616 0.6% $2,428 $0 $26,997 $24,370 90.3% 89.7%

201704 5,337 13,364 $29,336 $29,996 2.2% $2,421 $0 $26,915 $49,589 184.2% 180.2%

201705 5,320 13,304 $30,225 $29,895 -1.1% $2,494 $0 $27,731 $32,912 118.7% 120.0%

201706 5,313 13,279 $29,677 $29,828 0.5% $2,449 $0 $27,228 $34,567 127.0% 126.3%

201707 5,303 13,235 $29,638 $29,599 -0.1% $2,446 $0 $27,192 $33,179 122.0% 122.2%

201708 5,292 13,198 $38,949 $29,437 -24.4% $2,955 $0 $35,994 $28,113 78.1% 104.1%

201709 5,317 13,239 $62,613 $29,890 -52.3% $4,264 $0 $58,349 $34,147 58.5% 124.5%

201710 5,330 13,235 $58,602 $29,839 -49.1% $4,039 $0 $54,564 $29,682 54.4% 108.4%

201711 5,346 13,241 $58,137 $29,934 -48.5% $4,023 $0 $54,113 $28,364 52.4% 103.3%

201712 5,354 13,229 $55,240 $0 -100.0% $3,862 $0 $51,378 $25,391 49.4% 0.0%

Totals: 5,306 13,253 $480,488 $327,283 -31.9% $36,221 $0 $444,267 $360,267 81.1% 120.0%

IBNR Estimate 0.75 Months $22,517

Total Adjusted Claims & Percentage $382,783 86.2% 127.5%

Group:

Fees on Premium represents the underwriter expense, taxes and other fees & assessments. Maximum Broker Fee during Reporting Period = 0%. Note: IBNR estimate represents accrual for claims incurred by members but not yet paid.

Note: Claims to Net Paid Premiums calculation is based on premiums paid as of the report execution date.

LR_Grp:1/2

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Loss Ratio Report By Group

Date Executed: 1/26/18Reporting Period: 2017/01 thru 2017/12

City of Cleveland

9852161 1001 - City of Cleveland

MonthNumber ofSubscribers

Number ofMembers

Gross BilledPremium

Gross PaidPremium

Billed vsPaid %Change

Fees onBilled

Premium

Broker Feeson BilledPremium

Net BilledPremium

Total ClaimDollars

Claims toNet BilledPremium

Claims toNet PaidPremium

201701 4 13 $22 $0 -100.0% $2 $0 $21 $0 0.0% 0.0%

201702 4 13 $22 $22 0.0% $2 $0 $21 $0 0.0% 0.0%

201703 4 13 $22 $22 0.0% $2 $0 $21 $0 0.0% 0.0%

201704 4 13 $22 $22 0.0% $2 $0 $21 $0 0.0% 0.0%

201705 3 9 $22 $22 0.0% $2 $0 $21 $0 0.0% 0.0%

201706 3 9 $0 $0 0.0% $0 $0 $0 $0 0.0% 0.0%

201707 3 9 $17 $17 0.0% $1 $0 $15 $328 2,131.8% 2,131.8%

201708 3 9 $17 $17 0.0% $1 $0 $15 $0 0.0% 0.0%

201709 3 9 $17 $17 0.0% $1 $0 $15 $0 0.0% 0.0%

201710 3 9 $17 $17 0.0% $1 $0 $15 $0 0.0% 0.0%

201711 3 9 $17 $17 0.0% $1 $0 $15 $0 0.0% 0.0%

201712 3 9 $97 $0 -100.0% $6 $0 $91 $80 87.9% 0.0%

Totals: 3 10 $292 $173 -40.7% $22 $0 $270 $408 150.8% 256.6%

IBNR Estimate 0.75 Months $26

Total Adjusted Claims & Percentage $434 160.3% 272.7%

Group:

Fees on Premium represents the underwriter expense, taxes and other fees & assessments. Maximum Broker Fee during Reporting Period = 0%. Note: IBNR estimate represents accrual for claims incurred by members but not yet paid.

Note: Claims to Net Paid Premiums calculation is based on premiums paid as of the report execution date.

LR_Grp:2/2

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Member Counts by Rate Tier

Date Executed: 1/26/18

City of Cleveland

Group ID MonthRate

Description Rate per Month Employee Count

9812959 1001 201712 PSPM 5.59 5,354

Group ID: 5,354

9852161 1001 201712 PSPM 5.59 3

Group ID: 3

LR_Mbr :1/1

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Loss Ratio Report Combined

Date Executed: 10/12/18Reporting Period: 2018/01 thru 2018/09

City of Cleveland

Month

Number ofSubscribers

Number ofMembers

Gross BilledPremium

Gross PaidPremium

Billed vsPaid %Change

Fees onBilled

Premium

Broker Feeson BilledPremium

Net BilledPremium

Total ClaimDollars

Claims toNet BilledPremium

Claims toNet PaidPremium

201801 5,345 13,228 $57,836 $29,923 -48.3% $4,004 $0 $53,832 $48,815 90.7% 177.8%

201802 5,347 13,225 $29,879 $29,918 0.1% $2,466 $0 $27,413 $33,626 122.7% 122.5%

201803 5,390 13,261 $29,946 $30,007 0.2% $2,471 $0 $27,474 $39,557 144.0% 143.7%

201804 5,474 13,486 $30,264 $30,426 0.5% $2,498 $0 $27,767 $39,506 142.3% 141.5%

201805 5,454 13,401 $30,974 $30,756 -0.7% $2,556 $0 $28,418 $34,665 122.0% 122.8%

201806 5,455 13,387 $30,410 $30,460 0.2% $2,510 $0 $27,900 $27,358 98.1% 97.9%

201807 5,465 13,369 $30,689 $30,451 -0.8% $2,533 $0 $28,157 $30,624 108.8% 109.6%

201808 5,494 13,366 $30,633 $30,684 0.2% $2,528 $0 $28,105 $33,612 119.6% 119.4%

201809 5,448 13,251 $30,510 $30,382 -0.4% $2,518 $0 $27,992 $26,621 95.1% 95.5%

Totals: 5,430 13,330 $301,140 $273,006 -9.3% $24,082 $0 $277,058 $314,383 113.5% 125.5%

IBNR Estimate 0.75 Months $26,199

Total Adjusted Claims & Percentage $340,582 122.9% 136.0%

Group(s) Used: 9812959;9852161

Fees on Premium represents the underwriter expense, taxes and other fees & assessments. Maximum Broker Fee during Reporting Period = 0%. Note: IBNR estimate represents accrual for claims incurred by members but not yet paid.

Note: Claims to Net Paid Premium calculation is based on premium dollars paid as of the report execution date.

LR :1/1

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Loss Ratio Report By Group

Date Executed: 10/12/18Reporting Period: 2018/01 thru 2018/09

City of Cleveland

9812959 1001 - City of Cleveland

MonthNumber ofSubscribers

Number ofMembers

Gross BilledPremium

Gross PaidPremium

Billed vsPaid %Change

Fees onBilled

Premium

Broker Feeson BilledPremium

Net BilledPremium

Total ClaimDollars

Claims toNet BilledPremium

Claims toNet PaidPremium

201801 5,342 13,219 $57,557 $29,907 -48.0% $3,988 $0 $53,569 $48,553 90.6% 177.0%

201802 5,344 13,216 $29,862 $29,901 0.1% $2,464 $0 $27,397 $33,543 122.4% 122.3%

201803 5,387 13,252 $29,929 $29,929 0.0% $2,470 $0 $27,459 $39,477 143.8% 143.8%

201804 5,471 13,477 $30,247 $30,410 0.5% $2,496 $0 $27,751 $39,506 142.4% 141.6%

201805 5,451 13,392 $30,957 $30,756 -0.7% $2,555 $0 $28,403 $34,665 122.0% 122.8%

201806 5,452 13,378 $30,393 $30,443 0.2% $2,508 $0 $27,885 $27,358 98.1% 97.9%

201807 5,462 13,360 $30,672 $30,434 -0.8% $2,531 $0 $28,141 $30,624 108.8% 109.7%

201808 5,491 13,357 $30,616 $30,667 0.2% $2,527 $0 $28,090 $33,448 119.1% 118.9%

201809 5,445 13,242 $30,493 $30,493 0.0% $2,516 $0 $27,977 $26,621 95.2% 95.2%

Totals: 5,427 13,321 $300,728 $272,940 -9.2% $24,055 $0 $276,673 $313,795 113.4% 125.3%

IBNR Estimate 0.75 Months $26,150

Total Adjusted Claims & Percentage $339,944 122.9% 135.8%

Group:

Fees on Premium represents the underwriter expense, taxes and other fees & assessments. Maximum Broker Fee during Reporting Period = 0%. Note: IBNR estimate represents accrual for claims incurred by members but not yet paid.

Note: Claims to Net Paid Premiums calculation is based on premiums paid as of the report execution date.

LR_Grp:1/2

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Loss Ratio Report By Group

Date Executed: 10/12/18Reporting Period: 2018/01 thru 2018/09

City of Cleveland

9852161 1001 - City of Cleveland

MonthNumber ofSubscribers

Number ofMembers

Gross BilledPremium

Gross PaidPremium

Billed vsPaid %Change

Fees onBilled

Premium

Broker Feeson BilledPremium

Net BilledPremium

Total ClaimDollars

Claims toNet BilledPremium

Claims toNet PaidPremium

201801 3 9 $279 $17 -94.0% $16 $0 $263 $262 99.6% 1,701.9%

201802 3 9 $17 $17 0.0% $1 $0 $15 $83 538.5% 538.5%

201803 3 9 $17 $78 364.0% $1 $0 $15 $80 520.0% 112.0%

201804 3 9 $17 $17 0.0% $1 $0 $15 $0 0.0% 0.0%

201805 3 9 $17 $0 -100.0% $1 $0 $15 $0 0.0% 0.0%

201806 3 9 $17 $17 0.0% $1 $0 $15 $0 0.0% 0.0%

201807 3 9 $17 $17 0.0% $1 $0 $15 $0 0.0% 0.0%

201808 3 9 $17 $17 0.0% $1 $0 $15 $164 1,065.9% 1,065.9%

201809 3 9 $17 ($112) -767.3% $1 $0 $15 $0 0.0% 0.0%

Totals: 3 9 $413 $67 -83.9% $27 $0 $386 $589 152.5% 964.5%

IBNR Estimate 0.75 Months $49

Total Adjusted Claims & Percentage $638 165.3% 1,044.8%

Group:

Fees on Premium represents the underwriter expense, taxes and other fees & assessments. Maximum Broker Fee during Reporting Period = 0%. Note: IBNR estimate represents accrual for claims incurred by members but not yet paid.

Note: Claims to Net Paid Premiums calculation is based on premiums paid as of the report execution date.

LR_Grp:2/2

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Member Counts by Rate Tier

Date Executed: 10/12/18

City of Cleveland

Group ID MonthRate

Description Rate per Month Employee Count

9812959 1001 201809 PSPM 5.59 5,454

Group ID: 5,454

9852161 1001 201809 PSPM 5.59 3

Group ID: 3

LR_Mbr :1/1

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MonthMedical

SubscribersMedical

Members

Total Gross Paid Amount

(ReportLink)

Total Net Paid Amount

MMO SL Reimbursements

Jan-14 5,612 15,111 $4,151,768 $4,151,768Feb-14 5,593 15,061 $3,508,808 $3,508,808Mar-14 5,576 15,015 $4,540,920 $4,540,920Apr-14 4,474 11,922 $876,106 $876,106

May-14 4,450 11,874 $2,664,927 $2,664,927Jun-14 4,431 11,833 $2,782,824 $2,782,824Jul-14 4,337 11,648 $3,694,768 $3,404,986 ($289,782)

Aug-14 4,329 11,612 $3,345,603 $3,342,907 ($2,696)Sep-14 4,359 11,635 $3,176,450 $3,171,330 ($5,120)Oct-14 4,339 11,581 $3,263,927 $3,261,453 ($2,474)Nov-14 4,313 11,511 $2,937,822 $2,905,562 ($32,260)Dec-14 4,296 11,474 $4,162,135 $4,155,260 ($6,875)

Total/Average 4,676 12,523 $39,106,057 $38,766,850 ($339,207)PEPM $697 $691

YOY % Change

Jan-15 4,284 11,432 $2,782,365 $2,782,361 ($4)Feb-15 4,276 11,403 $2,995,574 $2,995,214 ($360)Mar-15 4,257 11,362 $4,801,924 $4,346,573 ($455,351)Apr-15 4,243 11,293 $3,157,878 $3,157,878

May-15 4,235 11,266 $3,263,184 $3,262,611 ($573)Jun-15 4,221 11,212 $3,177,446 $3,177,446Jul-15 4,143 11,063 $3,320,381 $3,320,381

Aug-15 4,125 11,038 $3,405,585 $3,405,585Sep-15 4,150 11,070 $3,381,362 $3,381,362Oct-15 4,140 11,042 $3,643,756 $3,606,063 ($37,692)Nov-15 4,133 11,004 $3,281,205 $3,273,206 ($8,000)Dec-15 4,115 10,961 $3,652,586 $3,536,021 ($116,565)

Total/Average 4,194 11,179 $40,863,246 $40,244,702 ($618,544)PEPM $812 $800

YOY % Change 17% 16%

Jan-16 4,115 10,932 $2,736,653 $2,692,496 ($44,158)Feb-16 4,088 10,852 $2,984,548 $2,960,458 ($24,090)Mar-16 4,087 10,823 $3,594,628 $3,384,423 ($210,205)Apr-16 4,138 10,899 $3,131,157 $3,131,157

May-16 4,107 10,835 $3,043,763 $3,043,763Jun-16 4,089 10,804 $2,715,793 $2,715,793Jul-16 4,034 10,699 $2,777,081 $2,710,787 ($66,295)

Aug-16 4,018 10,671 $3,281,609 $3,252,748 ($28,861)Sep-16 4,032 10,678 $3,221,009 $3,201,166 ($19,843)Oct-16 4,045 10,690 $3,787,874 $3,758,764 ($29,109)Nov-16 4,019 10,638 $3,406,421 $3,371,769 ($34,652)Dec-16 4,010 10,623 $3,326,558 $3,296,501 ($30,057)

Total/Average 4,065 10,762 $38,007,095 $37,519,826 ($487,269)PEPM $779 $769

YOY % Change -4% -4%

Jan-17 3,998 10,594 $3,245,728 $3,176,818 ($68,910)

MMO

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Feb-17 4,007 10,599 $3,558,618 $3,512,900 ($45,717)Mar-17 4,001 10,591 $4,809,395 $4,759,069 ($50,325)Apr-17 4,490 11,405 $3,511,142 $3,511,142

May-17 4,472 11,319 $4,081,238 $4,081,238Jun-17 4,457 11,293 $3,767,494 $3,767,494Jul-17 4,407 11,183 $3,963,240 $3,901,753 ($61,487)

Aug-17 4,396 11,153 $3,522,254 $3,509,287 ($12,967)Sep-17 4,459 11,258 $4,111,647 $4,076,388 ($35,259)Oct-17 4,451 11,219 $3,731,654 $3,687,293 ($44,361)Nov-17 4,456 11,195 $3,772,675 $3,545,797 ($226,878)Dec-17 4,447 11,137 $3,338,372 $3,236,915 ($101,457)

Total/Average 4,337 11,079 $45,413,456 $44,766,094 ($647,362)PEPM $873 $860

YOY % Change 12% 12%

Jan-18 4,444 11,130 $3,764,321 $3,705,526 ($58,796)Feb-18 4,458 11,172 $4,507,201 $4,238,585 ($268,616)Mar-18 4,472 11,167 $4,622,211 $4,415,564 ($206,647)Apr-18 4,443 11,002 $3,638,869 $3,638,869

May-18 4,430 10,971 $4,341,917 $4,341,917Jun-18 4,416 10,928 $4,068,824 $3,976,643 ($92,181)Jul-18 4,367 10,810 $3,996,709 $3,907,759 ($88,951)

Aug-18 4,376 10,791 $4,510,790 $4,145,446 ($365,344)Total/Average 4,426 10,996 $33,450,844 $32,370,308 ($1,080,535)

PEPM $630 $610YOY % Change -28% -29%

MMO Average Medical Subscribers & Members by YearYear Avg Subscribers Avg Members

2014 4,676 12,5232015 4,194 11,1792016 4,065 10,7622017 4,337 11,0792018 4,426 10,996

Anthem Average Medical Subscribers & Members by Year

4,676 4,194

12,523

11,179

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

2014 2015

Avg Su

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Year Avg Subscribers Avg Members2014 1,223 3,3712015 1,371 3,6922016 2,096 5,5602017 2,037 5,3552018 2,129 5,443

Year MMO CVS Anthem2014 38,766,850 12,210,196 7,202,2162015 40,244,702 13,011,361 11,086,8822016 37,519,826 13,630,099 21,590,1892017 44,766,094 13,545,993 16,088,3912018 32,370,308 12,679,065 16,566,709

Total Net Paid

1,223 1,371

3,371 3,692

0

1,000

2,000

3,000

4,000

5,000

6,000

2014 2015

Avg Su

38,766,850

12,210,196

7,202,216

0

5,000,000

10,000,000

15,000,000

20,000,000

25,000,000

30,000,000

35,000,000

40,000,000

45,000,000

50,000,000

2014

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Year MMO CVS Anthem2014 $691 $218 $4912015 $800 $259 $6742016 $769 $279 $8582017 $860 $260 $6582018 $610 $239 $649

Total Net Paid PEPM

$691

$218

$491

$0

$100

$200

$300

$400

$500

$600

$700

$800

$900

$1,000

2014

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CVS

MMO FI Premium

Total Net Pharmacy Paid

Amount

Medical Subscribers

Medical Members

Total Gross Paid Amount With

PaymentInnovation

Total Net Paid Amount With

PaymentInnovation

$4,618,058 $941,215$4,615,176 $846,170$4,606,192 $960,061

$960,546 1,193 3,293 $0 $0$974,570 1,196 3,308 $0 $0

$1,035,039 1,198 3,315 $56 $56$971,949 1,206 3,349 $767,846 $767,846

$1,080,465 1,240 3,407 $2,769,915 $2,769,915$1,084,285 1,240 3,406 $963,017 $963,017$1,010,496 1,245 3,417 $931,633 $931,633$1,019,698 1,242 3,414 $790,495 $790,495$1,325,702 1,247 3,427 $979,254 $979,254

$13,839,426 $12,210,196 1,223 3,371 $7,202,216 $7,202,216$218 $491 $491

$1,203,139 1,252 3,428 $1,055,200 $1,055,200$1,009,711 1,255 3,427 $793,645 $793,645$1,328,640 1,252 3,421 $1,399,143 $1,319,931$1,254,006 1,376 3,709 $952,997 $952,997

$891,701 1,390 3,726 $1,034,504 $1,034,504$1,081,673 1,394 3,744 $1,390,719 $1,390,719$1,007,164 1,399 3,761 $1,395,118 $1,395,118

$930,368 1,418 3,796 $1,127,866 $1,127,866$1,073,260 1,417 3,792 $1,020,030 $1,020,030$1,092,990 1,423 3,810 $1,382,504 $1,382,504$1,062,831 1,444 3,861 $1,366,182 $1,366,182$1,075,877 1,436 3,833 $1,416,961 $1,416,961

$13,011,361 1,371 3,692 $11,086,882 $11,086,882$259 $674 $67419% 37% 37%

$987,688 1,458 3,876 $1,095,352 $1,095,352$993,977 1,449 3,858 $1,255,624 $1,255,624

$1,072,612 1,468 3,903 $1,338,031 $1,338,031$1,268,576 2,329 6,172 $959,412 $959,412$1,144,498 2,317 6,132 $2,213,091 $2,213,091$1,104,406 2,319 6,131 $2,105,761 $2,105,761$1,219,834 2,311 6,123 $2,303,424 $2,175,467$1,180,763 2,308 6,126 $1,864,111 $1,860,919$1,177,876 2,294 6,096 $2,137,950 $2,119,494$1,163,038 2,307 6,110 $2,164,901 $2,106,085$1,139,287 2,302 6,101 $2,314,008 $2,268,536$1,177,545 2,294 6,089 $2,098,136 $2,092,417

$0 $13,630,099 2,096 5,560 $21,849,801 $21,590,189$279 $869 $858

8% 29% 27%

$1,163,325 2,294 6,100 $1,928,192 $1,902,873

Anthem

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$1,009,112 2,309 6,148 $1,893,239 $1,889,161$1,218,811 2,302 6,123 $2,896,953 $2,888,449$1,123,317 1,915 5,051 $2,255,448 $2,255,448$1,245,101 1,924 5,070 $2,063,237 $2,063,237$1,135,307 1,925 5,067 $1,733,418 $1,733,418$1,150,289 1,929 5,081 $1,632,846 $1,632,846$1,246,510 1,934 5,078 $2,087,783 $2,087,783

$980,623 1,954 5,096 $1,551,804 $1,551,804$1,092,184 1,974 5,118 $1,659,516 $1,659,516$1,111,336 1,980 5,135 $1,563,521 $1,563,521$1,070,078 2,001 5,188 $1,540,817 $1,540,817

$0 $13,545,993 2,037 5,355 $16,088,391 $16,088,391$260 $658 $658

-7% -24% -23%

$1,268,777 1,996 5,189 $1,743,932 $1,743,932$1,092,277 1,994 5,163 $2,078,374 $2,078,374$1,064,734 2,023 5,204 $2,314,070 $2,314,070$1,199,980 2,186 5,582 $1,596,454 $1,596,454$1,225,199 2,183 5,579 $2,863,292 $2,642,322$4,386,297 2,187 5,581 $2,110,500 $1,966,148$1,275,351 2,212 5,601 $1,653,572 $1,641,743$1,166,451 2,248 5,641 $2,587,986 $2,583,666

$0 $12,679,065 2,129 5,443 $16,948,179 $16,566,709$239 $664 $649

-8% 1% -1%

4,065 4,337 4,426

10,762 11,079 10,996

2016 2017 2018

MMO

ubscribers Avg Members

Anthem

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2,096 2,037 2,129

5,560 5,355 5,443

2016 2017 2018

Anthem

ubscribers Avg Members

40,244,702

37,519,826

44,766,094

32,370,308

13,011,361 13,630,099 13,545,993 12,679,065 11,086,882

21,590,189

16,088,391 16,566,709

2015 2016 2017 2018

Total Net Paid

MMO CVS Anthem

Total Net Paid PEPM

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$800 $769

$860

$610

$259 $279 $260 $239

$674

$858

$658 $649

2015 2016 2017 2018

Total Net Paid PEPM

MMO CVS Anthem

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Anthem SL Reimbursements

$0

($79,212)

$0

($127,957)($3,192)

($18,456)($58,816)($45,473)

($5,719)($259,612)

($25,320)

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($4,078)($8,504)

$0

($220,970)($144,352)

($11,829)($4,320)

($381,470)

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Proc Month Coverage Code Description Sex Employee Age Date Reported Date Incurred Date Paid Claim Amount2016/01 Basic Life M 45 11/30/2015 11/20/2015 01/05/2016 15,000.002016/02 Basic Life M 54 01/08/2016 12/28/2015 02/16/2016 11,746.442016/02 Basic Life M 56 11/12/2014 01/26/2014 02/24/2016 2,500.002016/03 Basic Life M 54 01/08/2016 12/28/2015 03/01/2016 1,626.782016/03 Basic Life M 54 01/08/2016 12/28/2015 03/09/2016 1,626.782016/03 Basic Life M 48 02/09/2016 02/02/2016 03/08/2016 8,460.142016/04 Basic Life M 56 03/18/2016 02/10/2016 04/06/2016 15,000.002016/04 Basic Life F 69 04/07/2016 03/09/2016 04/14/2016 15,000.002016/04 Basic Life M 64 04/14/2016 03/05/2016 04/22/2016 15,000.002016/04 Basic Life M 48 02/09/2016 02/02/2016 04/01/2016 6,539.862016/05 Basic Life M 56 05/03/2016 04/09/2016 05/11/2016 15,000.002016/06 Basic Life M 44 06/10/2016 04/03/2016 06/16/2016 15,000.002016/06 Basic Life M 44 06/20/2016 05/17/2016 06/24/2016 15,000.002016/08 Basic Life M 65 08/02/2016 07/11/2016 08/09/2016 15,000.002016/08 Basic Life M 43 05/03/2016 04/01/2016 08/22/2016 15,000.002016/09 Basic Life F 57 08/11/2016 08/09/2016 09/13/2016 7,500.002016/09 Basic Life F 57 08/11/2016 08/09/2016 09/16/2016 7,500.002016/09 Basic Life M 42 08/22/2016 08/15/2016 09/26/2016 15,000.002016/10 Basic Life M 69 10/13/2016 09/26/2016 10/20/2016 15,000.002016/10 Basic Life M 55 09/26/2016 09/02/2016 10/03/2016 15,000.002016/10 Basic Life M 52 08/29/2016 08/06/2016 10/26/2016 15,000.002016/11 Basic Life M 37 10/27/2016 03/13/2016 11/01/2016 15,000.002016/11 Basic Life M 60 11/16/2016 10/28/2016 11/25/2016 15,000.002017/01 Basic Life F 56 12/27/2016 12/26/2016 01/23/2017 15,000.002017/02 Basic Life M 59 01/30/2017 01/03/2017 02/03/2017 15,000.002017/02 Basic Life F 51 01/25/2017 12/16/2016 02/06/2017 15,000.002017/02 Basic Life M 70 01/30/2017 12/12/2016 02/03/2017 15,000.002017/03 Basic Life M 39 03/08/2017 01/24/2017 03/15/2017 15,000.002017/05 Basic Life M 60 05/10/2017 03/16/2017 05/17/2017 15,000.002017/05 Basic Life M 52 05/09/2017 04/05/2017 05/15/2017 15,000.002017/05 Basic Life M 55 05/22/2017 01/21/2017 05/25/2017 15,000.002017/06 Basic Life F 63 06/13/2017 05/30/2017 06/22/2017 15,000.002017/06 Basic Life M 58 06/05/2017 05/16/2017 06/08/2017 15,000.002017/07 Basic Life M 67 07/14/2017 07/07/2017 07/25/2017 15,000.002017/08 Basic Life M 51 08/14/2017 07/26/2017 08/18/2017 15,000.002017/08 Basic Life M 72 08/25/2017 07/21/2017 08/31/2017 15,000.002017/11 Basic Life F 66 11/07/2017 10/05/2017 11/10/2017 15,000.002017/12 Basic Life M 55 06/26/2017 05/15/2017 12/04/2017 15,000.002017/12 Basic Life M 63 12/12/2017 11/27/2017 12/21/2017 15,000.002018/01 Basic Life F 62 01/08/2018 12/13/2017 01/26/2018 15,000.002018/04 Basic Life M 52 03/30/2018 02/14/2018 04/05/2018 15,000.002018/04 Basic Life F 70 04/20/2018 03/15/2018 04/27/2018 15,000.002018/07 Basic Life M 54 07/05/2018 04/09/2018 07/11/2018 15,000.002018/08 Basic Life M 63 08/07/2018 07/11/2018 08/10/2018 15,000.002018/09 Basic Life M 50 09/20/2018 07/06/2018 09/27/2018 15,000.002018/10 Basic Life F 64 10/22/2018 08/11/2018 10/25/2018 15,000.002018/10 Basic Life M 61 09/25/2018 09/07/2018 10/02/2018 15,000.002016/01 Basic Life Interest M 45 11/30/2015 11/20/2015 01/05/2016 9.452016/02 Basic Life Interest M 54 01/08/2016 12/28/2015 02/16/2016 9.022016/03 Basic Life Interest M 54 01/08/2016 12/28/2015 03/01/2016 1.60

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2016/03 Basic Life Interest M 54 01/08/2016 12/28/2015 03/09/2016 1.802016/03 Basic Life Interest M 48 02/09/2016 02/02/2016 03/08/2016 6.572016/04 Basic Life Interest M 56 03/18/2016 02/10/2016 04/06/2016 18.642016/04 Basic Life Interest F 69 04/07/2016 03/09/2016 04/14/2016 9.622016/04 Basic Life Interest M 64 04/14/2016 03/05/2016 04/22/2016 12.822016/04 Basic Life Interest M 48 02/09/2016 02/02/2016 04/01/2016 8.562016/05 Basic Life Interest M 56 05/03/2016 04/09/2016 05/11/2016 9.212016/06 Basic Life Interest M 44 06/10/2016 04/03/2016 06/16/2016 21.292016/06 Basic Life Interest M 44 06/20/2016 05/17/2016 06/24/2016 10.462016/08 Basic Life Interest M 65 08/02/2016 07/11/2016 08/09/2016 8.462016/08 Basic Life Interest M 43 05/03/2016 04/01/2016 08/22/2016 41.422016/09 Basic Life Interest F 57 08/11/2016 08/09/2016 09/13/2016 4.032016/09 Basic Life Interest F 57 08/11/2016 08/09/2016 09/16/2016 4.372016/09 Basic Life Interest M 42 08/22/2016 08/15/2016 09/26/2016 9.672016/10 Basic Life Interest M 69 10/13/2016 09/26/2016 10/20/2016 6.022016/10 Basic Life Interest M 55 09/26/2016 09/02/2016 10/03/2016 7.772016/10 Basic Life Interest M 52 08/29/2016 08/06/2016 10/26/2016 18.642016/11 Basic Life Interest M 37 10/27/2016 03/13/2016 11/01/2016 62.242016/11 Basic Life Interest M 60 11/16/2016 10/28/2016 11/25/2016 7.592017/01 Basic Life Interest F 56 12/27/2016 12/26/2016 01/23/2017 8.512017/02 Basic Life Interest M 59 01/30/2017 01/03/2017 02/03/2017 12.232017/02 Basic Life Interest F 51 01/25/2017 12/16/2016 02/06/2017 15.812017/02 Basic Life Interest M 70 01/30/2017 12/12/2016 02/03/2017 16.122017/03 Basic Life Interest M 39 03/08/2017 01/24/2017 03/15/2017 19.732017/05 Basic Life Interest M 60 05/10/2017 03/16/2017 05/17/2017 25.742017/05 Basic Life Interest M 52 05/09/2017 04/05/2017 05/15/2017 18.242017/05 Basic Life Interest M 55 05/22/2017 01/21/2017 05/25/2017 48.922017/06 Basic Life Interest F 63 06/13/2017 05/30/2017 06/22/2017 10.872017/06 Basic Life Interest M 58 06/05/2017 05/16/2017 06/08/2017 10.872017/07 Basic Life Interest M 67 07/14/2017 07/07/2017 07/25/2017 9.032017/08 Basic Life Interest M 51 08/14/2017 07/26/2017 08/18/2017 11.532017/08 Basic Life Interest M 72 08/25/2017 07/21/2017 08/31/2017 20.562017/11 Basic Life Interest F 66 11/07/2017 10/05/2017 11/10/2017 18.792017/12 Basic Life Interest M 55 06/26/2017 05/15/2017 12/04/2017 95.942017/12 Basic Life Interest M 63 12/12/2017 11/27/2017 12/21/2017 13.612018/01 Basic Life Interest F 62 01/08/2018 12/13/2017 01/26/2018 27.482018/04 Basic Life Interest M 52 03/30/2018 02/14/2018 04/05/2018 37.192018/04 Basic Life Interest F 70 04/20/2018 03/15/2018 04/27/2018 34.642018/07 Basic Life Interest M 54 07/05/2018 04/09/2018 07/11/2018 81.022018/08 Basic Life Interest M 63 08/07/2018 07/11/2018 08/10/2018 29.342018/09 Basic Life Interest M 50 09/20/2018 07/06/2018 09/27/2018 81.182018/10 Basic Life Interest F 64 10/22/2018 08/11/2018 10/25/2018 74.602018/10 Basic Life Interest M 61 09/25/2018 09/07/2018 10/02/2018 25.792016/02 Conversion Basic Life M 64 01/21/2016 01/21/2016 3,300.002017/09 Conversion Basic Life M 60 08/01/2016 08/01/2016 1,100.002017/09 Conversion Basic Life M 66 01/01/2017 01/01/2017 2,300.002017/09 Conversion Basic Life M 59 10/02/2016 10/02/2016 3,150.002018/01 Conversion Basic Life F 58 06/01/2017 06/01/2017 3,150.002018/01 Conversion Basic Life M 65 08/01/2017 08/01/2017 3,450.002018/09 Conversion Basic Life M 56 06/17/2018 06/17/2018 2,100.002018/09 Conversion Basic Life M 55 02/01/2018 02/01/2018 3,150.002018/09 Conversion Basic Life M 65 03/04/2018 03/04/2018 3,450.00

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2016/05 Dependent Life F 61 05/11/2016 03/24/2016 05/17/2016 10,000.002017/06 Dependent Life F 44 06/26/2017 11/23/2016 06/30/2017 5,000.002017/06 Dependent Life M 50 05/31/2017 05/19/2016 06/07/2017 5,000.002017/06 Dependent Life M 60 06/13/2017 06/02/2017 06/19/2017 10,000.002018/01 Dependent Life F 62 01/08/2018 12/23/2017 01/11/2018 10,000.002018/01 Dependent Life F 64 01/08/2018 12/19/2017 01/11/2018 10,000.002016/05 Dependent Life Interest F 61 05/11/2016 03/24/2016 05/17/2016 9.622017/06 Dependent Life Interest F 44 06/26/2017 11/23/2016 06/30/2017 20.402017/06 Dependent Life Interest M 50 05/31/2017 05/19/2016 06/07/2017 35.242017/06 Dependent Life Interest M 60 06/13/2017 06/02/2017 06/19/2017 5.362018/01 Dependent Life Interest F 62 01/08/2018 12/23/2017 01/11/2018 7.912018/01 Dependent Life Interest F 64 01/08/2018 12/19/2017 01/11/2018 9.582017/05 OADD M 39 03/08/2017 01/24/2017 05/26/2017 50,000.002017/12 OADD M 72 08/25/2017 07/21/2017 12/01/2017 150,000.002017/05 OADD Interest M 39 03/08/2017 01/24/2017 05/26/2017 160.442017/12 OADD Interest M 72 08/25/2017 07/21/2017 12/01/2017 666.822016/01 Optional Life M 45 11/30/2015 11/20/2015 01/26/2016 300,000.002016/03 Optional Life M 54 01/08/2016 12/28/2015 03/01/2016 10,000.002016/03 Optional Life M 54 01/08/2016 12/28/2015 03/09/2016 10,000.002016/04 Optional Life M 56 03/18/2016 02/10/2016 04/06/2016 50,000.002016/04 Optional Life F 69 04/07/2016 03/09/2016 04/14/2016 50,000.002016/06 Optional Life M 43 05/03/2016 04/01/2016 06/29/2016 100,000.002016/11 Optional Life M 60 11/16/2016 10/28/2016 11/25/2016 100,000.002017/02 Optional Life M 59 01/30/2017 01/03/2017 02/03/2017 50,000.002017/03 Optional Life M 39 03/08/2017 01/24/2017 03/15/2017 50,000.002017/05 Optional Life M 52 05/09/2017 04/05/2017 05/15/2017 50,000.002017/08 Optional Life M 72 08/25/2017 07/21/2017 08/31/2017 150,000.002017/11 Optional Life F 66 11/07/2017 10/05/2017 11/10/2017 40,000.002018/10 Optional Life F 64 10/22/2018 08/11/2018 10/25/2018 30,000.002018/10 Optional Life M 61 09/25/2018 09/07/2018 10/02/2018 20,000.002016/01 Optional Life Interest M 45 11/30/2015 11/20/2015 01/26/2016 275.342016/03 Optional Life Interest M 54 01/08/2016 12/28/2015 03/01/2016 9.822016/03 Optional Life Interest M 54 01/08/2016 12/28/2015 03/09/2016 11.052016/04 Optional Life Interest M 56 03/18/2016 02/10/2016 04/06/2016 62.122016/04 Optional Life Interest F 69 04/07/2016 03/09/2016 04/14/2016 32.052016/06 Optional Life Interest M 43 05/03/2016 04/01/2016 06/29/2016 170.682016/11 Optional Life Interest M 60 11/16/2016 10/28/2016 11/25/2016 50.632017/02 Optional Life Interest M 59 01/30/2017 01/03/2017 02/03/2017 40.772017/03 Optional Life Interest M 39 03/08/2017 01/24/2017 03/15/2017 65.752017/05 Optional Life Interest M 52 05/09/2017 04/05/2017 05/15/2017 60.822017/08 Optional Life Interest M 72 08/25/2017 07/21/2017 08/31/2017 205.562017/11 Optional Life Interest F 66 11/07/2017 10/05/2017 11/10/2017 50.102018/10 Optional Life Interest F 64 10/22/2018 08/11/2018 10/25/2018 149.182018/10 Optional Life Interest M 61 09/25/2018 09/07/2018 10/02/2018 34.382016/03 Portability Optional Life M 60 03/03/2016 03/03/2016 1,600.002016/04 Portability Optional Life M 61 04/01/2016 04/01/2016 4,000.002016/09 Portability Optional Life M 63 09/01/2016 09/01/2016 4,000.002016/12 Portability Optional Life F 65 12/02/2016 12/02/2016 6,000.002016/12 Portability Optional Life F 54 11/01/2016 11/01/2016 1,000.002017/01 Portability Optional Life F 58 01/01/2017 01/01/2017 1,750.002017/01 Portability Optional Life M 54 01/01/2017 01/01/2017 3,000.002017/01 Portability Optional Life F 35 01/17/2017 01/17/2017 1,000.00

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2017/06 Portability Optional Life M 56 06/01/2017 06/01/2017 1,750.002017/07 Portability Optional Life M 63 07/02/2017 07/02/2017 4,000.002017/08 Portability Optional Life M 45 08/01/2017 08/01/2017 3,000.002017/08 Portability Optional Life M 63 08/01/2017 08/01/2017 2,400.002017/08 Portability Optional Life M 50 08/01/2017 08/01/2017 1,000.002017/12 Portability Optional Life M 52 12/02/2017 12/02/2017 2,000.002018/02 Portability Optional Life M 43 01/01/2018 01/01/2018 500.002018/03 Portability Optional Life F 53 03/04/2018 03/04/2018 1,000.002018/03 Portability Optional Life M 45 03/04/2018 03/04/2018 1,000.002018/04 Portability Optional Life M 59 04/01/2018 04/01/2018 700.002018/04 Portability Optional Life M 59 04/19/2018 04/19/2018 700.002018/06 Portability Optional Life M 52 05/04/2018 05/04/2018 1,400.002018/07 Portability Optional Life F 51 07/02/2018 07/02/2018 1,000.00

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Claim Count Conv Amount1 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.000 0.000 0.000 0.00

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0 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.001 15,000.001 5,000.001 10,000.001 15,000.001 15,000.001 15,000.001 10,000.001 15,000.001 15,000.00

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1 0.001 0.001 0.001 0.001 0.001 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.001 0.000 0.000 0.000 0.000 0.001 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.001 20,000.001 50,000.001 50,000.001 50,000.001 50,000.001 50,000.001 150,000.001 100,000.00

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1 50,000.001 50,000.001 150,000.001 30,000.001 50,000.001 100,000.001 50,000.001 50,000.001 50,000.001 20,000.001 20,000.001 70,000.001 50,000.00