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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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
$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
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
$800 $769
$860
$610
$259 $279 $260 $239
$674
$858
$658 $649
2015 2016 2017 2018
Total Net Paid PEPM
MMO CVS Anthem
Anthem SL Reimbursements
$0
($79,212)
$0
($127,957)($3,192)
($18,456)($58,816)($45,473)
($5,719)($259,612)
($25,320)
($4,078)($8,504)
$0
($220,970)($144,352)
($11,829)($4,320)
($381,470)
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
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
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
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
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
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
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
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