From
Lisa Norris, Human Resources Director
Title
Insurance Fund Monthly Review
Presenter
Lisa Norris, Human Resources Director
Recommended Action
Review Only
Analysis
This analysis covers the experience in the Employee Insurance Fund through May 2018:
Employee Insurance Fund (Attachment 1):
May closed and active claims (row 32) continue to fall well beneath both the Fiscal Year Monthly Claim Average (column 11) of $1,075,057 and the Running 12-month Claim Average (column 12) of $1,153,519. Active claims continue to slowly edge up in May (as expected and communicated in previous meetings) as employees on our new High Deductible Health Plan (HDHP) and Exclusive Provider Plan (EPO) begin to meet deductibles and the plan is paying out more of the cost for services. Even with costs beginning to edge up on active claims, the year-end projection for this cost in the blue column (15), still falls well beneath our budgeted amount of $14,596,717 - estimated to hit only $13,214,532 using the worst case projection for all four remaining months of claims. Retirees ran a little higher in May reaching $248,050 which is slightly higher than both the Fiscal Year and Running 12-Month averages shown in columns 11 and 12. However, retirees are also still projected to only reach about 75% of the budgeted amount, with a year-end projection at $2,864,091. The positive experience so far from both active and retiree claims allows us to predict a healthy operating balance of $3,759,892 (column 15, row 41) at fiscal year-end. As communicated previously, I have now reflected the increase to the "Reserves for Contingency" shown on row 47, in blue column 15, to reflect the bump back up to our preferred level o f $2,000,000, thereby reducing the Ending Resource Balance accordingly.
UHC Slides
Slide 3, "Number of Claims Based on Size," shows that we have only had 5 claims exceed $100,000 in PAID costs so far in 2018. Slides 4 and 5 show the amount of INCURRED, not paid, High Cost Claimants. One-third of these claimants incurred costs in May between $1,000-$49,999 (light blue boxes, last column). The remainder of them incurred less than $1,000 in claims during May.
Financial Consideration
The current budget is approved and no financial consideration is necessary at this time until additional claims data based on future months can be reviewed.