DRAFT Posted October 3, 2018 MINUTES Board of Directors Meeting September 26, :00am Presiding Officer: Susan Tenney, Chair

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1 DRAFT Posted October 3, 2018 MINUTES Board of Directors Meeting September 26, :00am Presiding Officer: Susan Tenney, Chair A meeting of the of the Board of Directors of the New Hampshire Vaccine Association (NHVA) was held in person at the offices of Helms & Company, Inc. in Concord, NH with a quorum present. The meeting was called to order by Susan Tenney at 10:00am. I. Welcome and Introductions Attendance The following individuals attended the meeting, including by phone (P) as indicated: Committee Members: Susan Tenney, HPHC, Chair Laura Condon, Public Member Elizabeth Daly, NH DHHS Patricia Edwards, MD, Healthcare Provider Sean Lyons, Cigna Edward Moran, Public Member, absent Jason Margus, Anthem David Sky, NHID Other Attendees: Patrick Miller, Helms & Company, Inc. John Hastings, Helms & Company, Inc. Mike Degnan, Helms & Company, Inc. Erin Meagher, Helms & Company, Inc. Keith Nix, Helms & Company, Inc. Karen Carew, Carew & Wells Colleen Haggerty, NH DHHS Mark McCue, Esq., Hinckley Allen Fred Potter, KidsVax, (P), Executive Session Only Cheryl Rounds, Derry, NH, Member of the Public Ms. Tenney acknowledged this was the first meeting with the new Administrative Team of Helms & Company, Inc. She thanked everyone for all of the hard work through the transition process and the development of the new rate setting process. She also thanked and acknowledged all the work KidsVax did historically. They were instrumental in getting the organization up and running years ago when the assessment process was first implemented. They were also instrumental in getting us through a revision in the covered lives to include the self-insured lives as well as refining the assessment to include only pediatric lives. KidsVax has done a lot of work over the years in regards to the national forums. The NHVA would like to publicly thank KidsVax for all the work they have done. II. Review of May 22 and June 20, 2018 Minutes Ms. Tenney asked if there were any updates to the May 22, 2018 minutes. No changes were presented. VOTE RECORDED: On a motion by Mr. Sky, seconded by Ms. Condon, it was unanimously VOTED: To accept the May 22, 2018 minutes as presented. Ms. Tenney asked if there were any updates to the June 20, 2018 minutes. Changes include: DHHS Update Ms. Daly indicated on page 3 that 2021 should read FY This will be corrected on lines 3, 5, and 7. 1

2 Executive Session Ms. Condon indicated on page 3 regarding the vote to continue negotiating the TRICARE proposal that she had requested a roll call vote. She was the single dissenter on this vote and would like it reflected in the minutes. This will be corrected on line 41. Secretary pro tem Mark indicated on page 3 he was the Secretary pro tem for the Executive Session only. The minutes should be signed by KidsVax. This will be corrected on lines 63 and 65. VOTE RECORDED: On a motion by Mr. Sky, seconded by Dr. Edwards, it was unanimously VOTED: To accept the June 20, 2018 minutes with amendments as outlined above. Ms. Daly abstained from the vote as she was not present at the June 20, 2018 meeting. III. Report of the Audit Committee Mr. Sky explained that the Audit Committee met earlier in the day and Ms. Karen Carew from Carew & Wells was present. Ms. Carew reported there was nothing remarkable in the audit; there were no significant changes in the financial numbers from last year to this year, the controls and systems in place made it very easy to complete the audit, and KidsVax was very cooperatives during the audit process. Ms. Carew did draw attention to the Notes section. Section A Nature of Activities & Summary of Significant Accounting Policies; Upcoming Accounting Pronouncements Page 8: Ms. Carew stated that given the FASB changes in upcoming accounting pronouncements there were no material issues at this time. In the future, the temporary net assets will be presented in a different format. This is the only area that Ms. Carew is still working on understanding how this will affect NHVA. Section E Commitments and Contingencies: TRICARE Page 10: Ms. Carew mentioned that this section is new this year, and she asked if there were any questions. There was brief discussion about the following sentence in Paragraph 2: The DHA subsequently hired Kennel and Associates, Inc. to assist the DHA with implementation of Section 719 Mr. Sky questioned this sentence and advised that the Washington Vaccine Association hired Kennell and Associates on behalf of several state vaccine associations to negotiate/develop a process with the DHA for TRICARE to participate in the vaccine assessment process. After discussion, the Committee believes this should be reworded. Ms. Carew agreed to go back and review the documentation she has, and she will make appropriate changes. Ms. Tenney asked if Martin s Point was the only agent currently paying into NHVA. As of June 2018, Humana is also acting as an agent for TRICARE and it was confirmed they did submit an assessment in August. Section E Commitments and Contingencies: Minuteman Health, Inc. : This is a new section that reflects the uncertainty of the assessment payment and reflects the claim NHVA has filed. Section C Related Party Transactions: State of New Hampshire; Paragraph 2 Page 9: Ms. Tenney questioned the term providing vaccines in this sentence: The Association transfers monies to the State of New Hampshire to fund a specified portion of the cost of providing vaccines for children in the State of New Hampshire. The Committee agreed to change the word providing to purchasing. Mr. Sky advised the Board that the Audit Committee voted unanimously to recommend the full Board accept the report. 2

3 VOTE RECORDED: On a motion by Mr. Sky, seconded by Ms. Daly, it was unanimously VOTED: To accept the Financial Statements for the Fiscal Years Ended June 30, 3018 and 2017 with the two amendments outlined above. IV. CY2019 Payer Process and Proposed FY2019 Administrative Budget Mr. Sky reviewed the proposed FY2019 administrative budget (July 1, 2018 through June 30, 2019) included in the meeting packet (next to last page of enclosed slide deck). The first column reflects the FY2018 budget as a comparison point for the proposed budget. Items highlighted in green are additional expenses that had not been accounted for in the prior year s budget as the Administrator transition had not been anticipated as well as the additional dollars for the TRICARE work that the Washington Vaccine Association/KidsVax are doing on behalf of NHVA. The next to last column list the totals for the proposed FY2019 budget, again with the additional expenses highlighted in green. The final column reflects the proposed budget without the unanticipated one-time costs. This allows comparison of FY2018 s budget to FY2019 s budget to show there would be a reduction in the FY2019 budget amount if not for these additional expenses. The Audit Committee has also questioned the July 2018 Administrator Contract fee of $10,660 as it does not appear to be the actual monthly administrator fee NHVA had been paying KidsVax. Mr. Miller stated in the Audit Committee meeting that he would reconcile the numbers from the G/L and report back to the Audit Committee. Mr. Sky advised the Board that the Audit Committee voted unanimously to recommend the full Board accept the proposed budget with the amendment of Administrator Contract correction. VOTE RECORDED: On a motion by Mr. Sky, seconded by Ms. Daly, it was unanimously VOTED: To accept the Proposed FY2019 Administrative Budget with the amended Administrator Contract amount as outlined above. Mr. Miller and Mr. Hastings provided a presentation which outlined proposed changes to the rate setting process and the proposed assessment rate for CY2019. Mr. Miller started with a brief history of what the Administrator s focus has been since June The Administrator met with key stakeholders and was charged with examining the assessment rate setting process and making recommendations to simplify the process. Mr. Miller walked the group through the historical data outlining the shrinking assessed lives, variability in assessed rate, increasing state vaccine expenditures, and stability in the proportion of the vaccine expenditures paid by the payers. Assumptions used in the rate setting process included: retrieval of the $9.9M advance payment from DHHS; increasing cash reserves to $5M; reducing variability in the payer assessment in future years; membership declines of 1.3% per year; and the approximate $3M CDC credit announced at the beginning of October of each federal fiscal year. Mr. Hastings walked the group through the redesigned assessment model details. A side by side comparison was provided reflecting both the prior model and the proposed model. Historically, assessed entities contributed approximately 60% of the requested funds by DHHS with 40% falling under the Vaccines for Children (VFC) program and state general funds. The Administrator recommended an assessment rate of $5.78 pcpm for CY There was then discussion regarding the DHHS carry forward balance and how it has grown significantly in recent years, largely due to the annual CDC credit. The question was raised regarding if NHVA can simply reimburse the state less funds in June 2019 to offset the large, existing balance at the state. Attorney McCue provided insight into 3

4 the statute. NHVA sets an assessment rate taking into consideration NHVA s cost and reserves, and the primary obligation is to collect the assessment while keeping needed reserves and depositing the balance with the state. Attorney McCue stated it is reasonable to use the unexpended amount as a credit towards future funding instead of requesting funds back from the state. This historically has not occurred. Part of the assessment model estimated the upcoming CDC credit at $3M. During the discussion Ms. Daly indicated they are anticipating the credit amount to be closer to $2M. This change would result in the anticipated payment to DHHS in FY2020 increasing from $10.2M to $11.2M. Mr. Hastings walked the group though the model reducing the anticipated credit amount by $1M, increasing the anticipated payment by $1M and as a result, the Board members agreed to a proposed assessment rate for CY2019 of $6.47 pcpm $0.69 greater than the assessment rate initially recommended by the Administrator. Other, general discussion included: verification that NHVA cannot pick and choose which vaccines to fund; that DHHS will contact NHVA in the event there be any shortfall, and the $5M reserve fund proposal should cover shortfalls; and the fact that the NHVA is part of a federal program that allows the bulk purchasing of vaccines which enables a lower purchase price and results in a lower cost overall to supply vaccines to NH providers. Several of the spreadsheets contained in the presentation documents were edited in real time during the meeting, and the presentation will be updated and included as part of the minutes for reference. VOTE RECORDED: On a motion by Dr. Edwards, seconded by Ms. Daly, it was unanimously VOTED: To approve the estimated payment to DHHS at $9,234,656 on June 30, Ms. Condon abstained from the vote. VOTE RECORDED: On a motion by Mr. Lyons, seconded by Dr. Edwards, it was unanimously VOTED: To set the CY2019 assessment rate at $6.47pcpm. V. Board Governance. Due to time limitations, this item was tabled. VI. DHHS Update. Due to time limitations, this item was tabled. VII. Executive Director Report. Due to time limitations, this item was tabled. VIII. Executive Session Notes to be included shortly. By unanimous roll call vote, the Board voted to end the executive session at 12:35 p.m., and then the Board voted to close the meeting. Executive Session minutes without Administrator present respectfully submitted, Mark S. McCue Secretary pro tem Draft Board minutes respectfully submitted by Patrick Miller, Helms & Company, Inc. October 2, 2018 # # # 4

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20 CY 2019 Process and Rate Discussion NHVA Board Meeting September 26, 2018 Slide presentation updated on October 2, 2018 to Reflect Board Meeting Discussion Held September 26, 2018: - Slide 3 - Slide 8 - Slide 9 handout during the meeting - Slide 10 - Slide 11 NOTES in red text in a box explain changes. Copyright New Hampshire Vaccine Association 1

21 Charge to the new Administrator As the new Administrator, Helms was charged with reviewing the prior assessment process and making recommendations for assessment process simplification and mechanism improvement JUNE-AUGUST - Interviewed Board members and stakeholders - Reviewed historical data - Received DHHS annual file AUGUST-SEPTEMBER SEPTEMBER - Developed model drafts with - Finalized model input from NHID, DHHS, and Chair - Prepared and launched new payer website - Audit Committee and Board meetings held - Model approval OCTOBER* - Payer rate notification - collection Q3 CY2018 begins * future Copyright New Hampshire Vaccine Association 2

22 JAN FEB MAR APR MAY JUN JULY AUG SEP OCT NOV DEC CY 2015 Set CY $9.95 DHHS payment $19,653,132 due 6/30/ CY 2016 Set CY $10.30 CY 2016 CY 2016 CY 17 DHHS payment Collected $0.14 $18,819,145 due 6/30/18 Collected $9.95 Collected $ CY 2017 Set CY $6.70 CY 2016 CY 2017 CY 2016 CY 2017 CY2018 DHHS payment Paid to DHHS $19,149,829 - $9,915,173 Collected $9.95 Collected $10.30 $19,653,132 Collected $10.30 due 6/30/ DHHS rpts Bal FWD $9,915, CY 2018 Set CY $6.47 CY 2017 Collected $10.30 CY2018 Collected $6.70 CY 2017 Assmmt Paid to DHHS $18,819,145 CY2018 Collected $6.70 CY 2019 DHHS payment $16,270,000 - $5,064,170 due 6/30/ DHHS rpts Bal FWD $12,979, CY 2019 Set CY 2020 $7.20 CY2018 Collected $6.70 CY 2019 Collected $6.47 CY 2018 to be Paid to DHHS $9,234,656 CY 2019 Collected $6.47 CY 2019 DHHS expects $16,700,00 -$3,000,000 due 6/30/ DHHS rpts Bal FWD $3,000, CY 2020 Set CY 2021 $7.55 CY 2019 Collected $6.47 CY 2020 Collected $7.20 CY 2019 Paid to DHHS $11,205,830 CY 2020 Collected $7.20 DHHS payment $17,140,000 -$3,000,000 due 6/30/21 20 Timeline Summary red text=placeholder estimates DHHS rpts Bal FWD $3,000, CY 2016 Collected $ CY 2017 Collected $ CY2018 Collected $ CY 2019 Collected $ CY 2020 Collected $

23 Mechanism Re-Design Goals 1. Simplification of the prior assessment process 2. Work to keep the payer assessment aligned with annual vaccine costs in future years Address trend reduction in covered lives Address trend increase in state vaccine expenditures Reduce payer burden 3. Ensure process alignment with RSA 126-Q:4-II and Operations Manual Establish funded reserves 4. Reduce financial risk/exposure to NHVA Establish a level cash balance Invest reserves to offset administrative budget Create allowances for TRICARE and Minuteman 5. One time assessment allowance for unbudgeted FY2019 administrative expenses Copyright New Hampshire Vaccine Association 4

24 Historical Trends Shrinking Assessed Lives and Variability in Assessed Rate Source: NHVA KidsVax reconciliation spreadsheet, Copyright New Hampshire Vaccine Association 5

25 Historical Trends Increasing State Vaccine Expenditures and Stability in Payer Proportion Source: NH DHHS spreadsheet, Copyright New Hampshire Vaccine Association 6

26 CY2019 Core Rate Assumptions rate to reflect DHHS return of $9.9M advanced payments and the establishment of target funded cash reserves of $5.0M at FY end Time lag discussion re: $9.9M $9.9M from DHHS prevents ($3.027M) cash overdrawn Total cash at FY end not to exceed $5M + Q1 assessments collected in May Work to keep the payer assessment aligned with annual vaccine costs in future years DHHS request for Administrative expenses of $327K not included per Attorney memo of September 5, 2018 Membership declining 1.3% per year Percentage paid by carriers = 60% Annual CDC credit assumed Risk Discussion Carrying two years of liabilities to DHHS (approximately $35M) at the end DHHS holds significant NHVA funds paid in advance NHVA holds only $250K of funded reserves Need to have significantly greater, funded cash reserves Copyright New Hampshire Vaccine Association 7

27 CY2019 Rate Model Description Final 18 Actual 18 CY19 Annual Draft 19 Old Row Adjustment for CY19 # Calculation Calculation Factors Rate 4 Prior Year ACTUAL Avg Total Expenditure + Increase from Act $ 28,383, % $ 27,073,959 Provision for Vaccine Utilization Increase + Vaccine Cost Increase $ 1,135,359 DHHS Projection Subtotal None $ 29,519,310 $ 26,377,918 Less: Estimated VFC and Estimated NH General Fund $ 10,369,479 $ 10,622,944 4 Prior Year ACTUAL Average % Paid by Insurers None 67.5% 59.7% 0.64% 60.11% Amount NHVA to pay DHHS (projected) Before Offsetting DHHS Surplus 08. $ 19,149,829 $ 15,754,974 $ 16,270,000 Normalized Administrative Expenses 12. $ 169, % $ 144,727 Provision for One-Time Expenditures 14. $ 3,936 $ 174,359 Admin % of Total Vaccine Costs None 0.61% 1.18% Total to be Raised - Before "Cushion" $ 19,322,859 $ 16,589,086 Apply Cushion ("Reserve") 10% per RSA 126-Q:4 II.(c) 16. $ 885, % $ 1,658,909 Actual Cushion ("reserve") None 4.62% Investment Earnings.17 $ (21,157) $ (7,984) Grand Total to be Raised - Before DHHS Offset 22. $ 20,187,291 $ 18,247,995 DHHS Offset 23. $ (4,995,232) Final to be Raised 24. $ 15,192,059 Less: Q1 s Collected in May 25. $ (5,147,290) 26. $ 10,044,769 Estimated Assessable Lives , % 161,500 9 mos Lives (old row #09. x 9 mos.) None 1,499,940 Rate Calculated Based on Prior Year Methodology 28. $ 6.70 $ 9.42 Rate Based on Proposed Model Changes $ 6.47 NOTE: The CY2019 assessment rate was updated during the board meeting and the Normalized Administrative Expenses are updated to reflect change in slide 11. Copyright New Hampshire Vaccine Association 8

28 NOTE: This was a handout provided during the Board meeting and is being added to the record. NHVA Board Meeting NHVA Board Meeting 9/26/2018 9/26/2018 Illustration 1 Illustration 2 Cash Outlook Cash Outlook Cash Balance at 6/30/18 - per Audit $ 3,697,000 Cash Balance at 6/30/18 - per Audit $ 3,697,000 Estimated collections FY 2019 Estimated Asseesment collections FY 2019 Rate Monthly lives Rate Monthly lives Aug-18 $ ,667 $ 3,350,000 Aug-18 $ ,667 $ 3,350,000 Nov-18 $ ,000 $ 3,256,200 Nov-18 $ ,000 $ 3,256,200 Feb-19 $ ,000 $ 3,256,200 Feb-19 $ ,000 $ 3,256,200 May-19????? 162,000 <====== May ,000 $ 2,809,080 <====== $ 9,862,400 $ 12,671,480 DHHS Promised payment by 6/30/19 $ (19,149,829) DHHS Promised payment by 6/30/19 $ (19,149,829) Expenses per proposed budget $ (320,133) Less - Offset Bal FWD $ 9,915,173 <====== Net Payment $ (9,234,656) Estimated Cash Balance 6/30/19 $ (5,910,562) Expenses per proposed budget $ (320,133) Estimated Cash Balance 6/30/19 $ 6,813,691 State of NH EOY Bal Fwd 6/30/18 State of NH EOY Bal Fwd 6/30/18 From 2016 $ 3,267,371 From 2016 $ 3,267,371 Added 2017 $ 6,647,802 Added 2017 $ 6,647,802 Added 2018 $ 3,064,170 Added 2018 $ 3,064,170 Total as reported 6/30/18 $ 12,979,343 Total as reported 6/30/18 $ 12,979,343 Also noted - Approx $3.0M credit likely added yearly after 9/30 Federal FYE Also noted - Approx $3.0M credit likely added yearly after 9/30 Federal FYE Copyright New Hampshire Vaccine Association 9

29 Cash Flow Reconciliation Fiscal YR 2018 Fiscal YR 2019 Fiscal YR 2020 Fiscal YR 2021 Fiscal YR 2022 Fiscal YR 2023 Actual Proposed Projected Projected Projected Projected Assumptions s ( 3 qtrs / 1 qtr ) 3 Quarters $ $ 6.70 $ 6.47 $ 7.20 $ 7.55 $ Quarter $ 6.70 $ 6.47 $ 7.20 $ 7.55 $ 7.99 $ 8.00 DHHS Surplus Offset $ - $ 9,915,173 $ 5,064,170 $ 3,000,000 $ 3,000,000 $ 3,000,000 Membership declines 1.30% per year Vaccine cost increases 2.64% per year Administration increases 3.00% per year RSA 126-Q:4 II.(c) reserve 10.00% per year Cash Receipts and Disbursements Cash Receipts Actual Proposed Projected Projected Projected Projected Collections $ 18,588,579 $ 13,080,778 $ 12,847,196 $ 13,892,638 $ 14,412,592 $ 14,844,747 Interst Earned $ 18,168 $ 7,984 $ 79,823 $ 109,099 $ 112,215 $ 116,686 Interest on W/C Reserve Total Cash Receipts $ 18,606,747 $ 13,088,762 $ 12,927,019 $ 14,001,738 $ 14,524,806 $ 14,961,433 Cash Disbursements Actual Proposed Projected Projected Projected Projected Payments to DHHS $ 18,819,145 $ 9,234,656 $ 11,205,830 $ 13,700,000 $ 14,140,000 $ 14,600,000 Administrative Expenses $ 177,158 $ 329,173 $ 164,800 $ 169,744 $ 174,836 $ 180,081 Total Cash Disbursements $ 18,996,303 $ 9,563,829 $ 11,370,630 $ 13,869,744 $ 14,314,836 $ 14,780,081 Net Cash Receipts (Disbursements) $ (389,556) $ 3,524,932 $ 1,556,389 $ 131,994 $ 209,970 $ 181,352 Cash Balance - Beginning $ 4,087,040 $ 3,697,484 $ 7,222,416 $ 8,778,804 $ 8,910,798 $ 9,120,768 Cash Balance - Ending $ 3,697,484 $ 7,222,416 $ 8,778,804 $ 8,910,798 $ 9,120,768 $ 9,302,120 Year End Targeted Cash Balance using Selected Rates Projected Q1 s Collected in May $ 3,134,715 $ 3,443,051 $ 3,563,486 $ 3,722,134 $ 3,678,344 Projected Cash Reserves - Target $5.0 M $ 4,087,701 $ 5,335,754 $ 5,347,312 $ 5,398,634 $ 5,623,775 Target 6/30 Cash Balance $ 7,222,416 $ 8,778,804 $ 8,910,798 $ 9,120,768 $ 9,302,120 NOTE: The CY2019 assessment rate was updated during the board meeting and the DHHS Surplus Offset for Projected FY2020 was reduced per NH DHHS estimate revisions. Copyright New Hampshire Vaccine 10 Association

30 Proposed Expense Budget Fiscal Year 2019 ( ) Administrative Expense Budget 2018/2019 Description COST, EXPENSE AND OTHER DEDCUTIONS 2017/18 FY Proposed FY Less One Time Budget July August September October November December January February March April May June Budget Expenses / /2019 Administrative & Professional Services Annual Administrator Contract 127,924 9,614-8,333 8,333 8,333 8,333 8,333 8,333 8,333 8,333 8,333 8,333 92,947 92,947 Transition ($10K) + Development ($5K) (Helms) - 15, ,000 TRICARE Washington (Fred) 20,000 20,000 20,000 20,000 20,000 20, ,000 Incentive + Transition (Kidsvax) 12,447 10,976 10, ,398 Special Projects (approved by board in advance) Accounting Expense 9, , ,000 10,500 Legal Fees 16,500 2,125 2,125 2,125 2,125 2,125 2,125 2,125 2,125 2,125 2,125 2,125 2,125 25,500 25,500 Total Administrative & Professional Services 153,424 45,061 48,976 42,309 32,833 31,333 31,333 11,333 11,333 11,333 11,333 11,333 11, , ,947 Office & Other Expenses & Costs Bank Fee & Service Charges 3, ,320 4,320 Public Information (Website)/Hosting Fee 1,000 1,710 1, , (Website) Maintenance ,250 1,250 Publications Bad Debt Expense (Done on analysis) Postage & Shipping Telephone (Conference line) - Printing Total Office & Other Expenses & Costs 5,580 2,070 2, ,341 6,880 Board Insurance (D&O) 8, ,400 8,400 Board Meetings Total Board 8, ,900 8,900 Contingency TOTAL COST, EXPENSE AND OTHER DEDUCTIONS 167,117 47,831 51,787 43,770 34,119 32,619 32,894 12,619 12,619 12,794 12,619 12,619 12, , ,727 NOTE: Green=one time expenses NOTE: The $10,660 for July 2018 Annual Administrator Contract was Changed to $9,

31 DHHS Vaccine Forecast for 19 New Hampshire Immunization Program 18 VACCINE 2017 Price per Doses Cost 1st Qtr Totals Total 2nd qtr totals Total 3rd qtr totals Total 4th qtr totals 2018 Price Per Doses Cost Total Total ordered in Total Cost.05% wastage % Roundings 2019 Price Per Doses Cost 19 Total Projected Cost Private Price* DT $ $ 1, $ $ $ $ $ 3, $ $ 5, $ $ 5, ACTHIB $ $ 63, $ 64, $ 62, $ 9.23 $ 53, $ 243, $ 9.23 $ 238, $ $ 414, HIBERIX $ $ - 0 $ $ 1, $ 9.65 $ 2, $ 3, $ 9.65 $ 3, $ $ 4, DAPTACEL $ $ 5, $ 4, $ 2, $ $ 3, $ 15, $ $ 15, $ $ 27, INFANRIX $ $ 37, $ 37, $ 40, $ $ 35, $ 150, $ $ 154, $ $ 204, ENGERIX B $ $ 43, $ 63, $ 55, $ $ 51, $ 215, $ $ 239, $ $ 394, RECOMBIVAX HB $ $ 11, $ - 0 $ $ $ 10, $ 22, $ $ 22, $ $ 43, HAVRIX $ $ 171, $ 162, $ 140, $ $ 143, $ 618, $ $ 644, $ $ 1,051, VAQTA $ $ 12, $ 10, $ 10, $ $ 10, $ 44, $ $ 46, $ $ 76, IPOL $ $ 8, $ 11, $ 5, $ $ 7, $ 33, $ $ 34, $ $ 83, KINRIX $ $ 127, $ 105, $ 104, $ $ 104, $ 441, $ $ 451, $ $ 562, QUADRACEL $ $ $ 14, $ 4, $ $ 19, $ 38, $ $ 39, $ $ 51, M-M-R II $ $ 80, $ 70, $ 60, $ $ 63, $ 274, $ $ 279, $ $ 943, PROQUAD $ $ 391, $ 384, $ 309, $ $ 401, $ 1,487, $ $ 1,551, $ $ 2,509, PEDIARIX $ $ 230, $ 260, $ 274, $ $ 230, $ 996, $ $ 1,020, $ $ 1,354, PENTACEL $ $ 280, $ 259, $ 329, $ $ 268, $ 1,137, $ $ 1,166, $ $ 1,851, PNEUMOVAX 23 $ $ 3, $ 4, $ $ $ $ 9, $ $ 10, $ $ 18, PREVNAR 13 TM $ $ 1,387, $ 1,434, $ 1,584, $ $ 1,351, $ 5,759, $ $ 5,956, $ $ 8,138, ROTARIX $ $ 111, $ 136, $ 138, $ $ 124, $ 511, $ $ 519, $ $ 657, ROTATEQ $ $ 406, $ 407, $ 467, $ $ 363, $ 1,645, $ $ 1,677, $ $ 1,972, VARIVAX $ $ 340, $ 313, $ 931, $ $ 303, $ 1,889, $ $ 1,994, $ $ 2,477, $ - $ - $ - Adolescent $ - $ - $ - ADACEL $ $ 26, $ 21, $ 15, $ $ 27, $ 91, $ $ 92, $ 133, BEXSERO $ $ 362, $ 111, $ 165, $ $ 305, $ 943, $ $ 1,148, $ 1,475, BOOSTRIX $ $ 116, $ 95, $ 69, $ $ 77, $ 358, $ $ 364, $ 456, GARDASIL9 $ $ 1,639, $ 1,189, $ 995, $ $ 1,230, $ 5,055, $ $ 5,429, $ 6,617, MENACTRA $ $ 696, $ 514, $ 388, $ $ 455, $ 2,054, $ $ 2,111, $ 2,674, MENVEO $ $ 74, $ 55, $ 39, $ $ 66, $ 235, $ $ 285, $ 393, TENIVAC $ $ 1, $ 2, $ 1, $ $ 1, $ 7, $ $ 8, $ 13, TRUMENBA $ $ 69, $ 18, $ 30, $ $ 36, $ 154, $ $ 157, $ 200, $ 6,703, $ 5,754, $ 6,229, $ 5,754, $ 24,442, $ 25,669, Commited State Doses to Purchase Influenza Influenza Vaccine 1st Qtr Totals 2nd qtr totals 3rd qtr totals 4th qtr totals Spent this Season ordered for Next Season 2018 Price per Dose SANOFI.25 Baby f $ $ 326, $ 163, $ 58, $ $ $ 548, $ $ 287, $ $ 365, SANOFI.5 Kid flu $ $ 375, $ 102, $ 2, $ $ $ 480, $ $ 438, $ $ 521, GSK.5 Kid flu $ $ 197, $ 620, $ 163, $ $ 1, $ 933, $ $ 486, $ $ 567, $ 899, $ 886, $ 224, $ 1, $ 1,961, $ $ 193, $ $ 240, Pediatric vaccine plus influenza equals $ 1,404, $ 7,602, $ 6,640, $ 6,453, $ 5,755, $ 26,403, $ 27,073, $ 36,260, VFC Estimated Vaccine Funds $ (9,848,810.00) This amount is for FFY18. Amount is State Funds $ (274,000.00) subject to change. Final amount will be available in October NHVA Estimated Cost $ 16,951, Unspent NHVA Revenue from 18 $ (3,064,171.00) Replacement credit $ (3,000,000.00) We will know exact amount on Oct 1st Last Updated: 8/8/2018 Program Administrative Costs $ 327, See worksheet e for detail NHVA Funds Requested for 19 $ 11,214, Note that the 19 NHVA payment was already set in Sept # CDC Online price list April 2017 : * CDC Online price list April 2018 : Actual TOTAL doses distributed taken from monthly Spend Plan Report Doses are based on order date and may not match state financial accounting system, which is based on payment date. Note: 2017 Total cost does not exactly match actual expenditures because this spreadsheet is based on actual doses. The actual cost may differ because vaccine pricing changess throughout the year and this spreadsheet assumes a static price. Copyright New Hampshire Vaccine Association 12

32 Contact Us Patrick Miller, MPH Executive Director, NHVA (m) John Hastings Financial Consultant to Helms & Company, Inc (m) Copyright New Hampshire Vaccine Association 13