Pre-Existing Condition Insurance Plan Washington State (PCIP-WA) June 2013 Financial Review

Transcription

1 Pre-Existing Condition Insurance Plan Washington State (PCIP-WA) June 2013 Financial Review 1. Financial Statements June 2013 U Sheet Due to the timing of the HHS reimbursement receipts, there is no available cash on hand at the end of June Cash position is discussed further in the Budgeted Cash Flow section below. As of June 2013, the receivable for unbilled HHS reimbursements is $10.1 M. This amount represents an offset of liabilities, including IBNR, which will be invoiced and funded by HHS before the end of the program. The total IBNR of $8.4 M increased $106 K or 1.3% as compared to the prior month. The medical portion decreased $228 K or 3.1% and pharmacy increased $334 K or 36.5% from May U Statement Total member months for June 2013 YTD are 1,723 member months higher or 37.4% higher than June 2012 YTD. months are measured as the cumulative monthly member count (PMPM) over a period of time. The total incurred claim loss for June 2013 YTD is $5.7 M or 30.4% higher than June 2012 YTD. Incurred claim loss represents the total medical and pharmacy claims expense in addition to the change in unpaid losses (IBNR) and accrued loss adjustment for the period. For June 2013 YTD, the medical claims portion is $2.3 M or 16.1% higher than June 2012 YTD. Also, for June 2013 YTD, the pharmacy claims portion is $3.4 M or 74.2% higher than June 2012 YTD. The total incurred claim loss PMPM for June 2013 YTD is $3,877 as compared to the budgeted amount of $4,314. June 2013 YTD administrative expenses are $182 K or 35.6% higher than June 2012 YTD. The ratio of administrative expenses as a percentage of total cost is 2.7% for June 2013 YTD as compared to 2.6% for June 2012 YTD. Total cost is calculated as total incurred claim loss less pharmacy rebates plus administrative expenses. June 2013 YTD HHS Reimbursement is $4.4 M or 27.0% higher than the June 2012 YTD amount. 07/30/2013 1

2 2. Budgeted Cash Flow June 2013 The Budgeted Cash Flow document contains the budget (upper portion) as revised in May 2013 and the actual (lower portion) cash flow results year-to-date. The Program Summary (discussed below) is a dynamic report and therefore changes as better financial information is obtained. At the end of June 2013 there is no available cash balance. Total net cash receipts for June 2013 are $2.6 M or 9.3% unfavorable to budget primarily due to lower than anticipated reimbursements from HHS. Total June YTD expenses are $478 K or 1.7% favorable to budget. Total medical and pharmacy claims expenses combined are $505 K or 1.9% favorable to budget, and administrative variances discussed further below are $27 K or 4.2% unfavorable to budget. 3. Administrative Expense Budget June 2013 For June 2013, administrative expenses are $27 K or 4.2% unfavorable to budget (cash basis). 4. PCIP-WA Program Summary June 2013 The program summary is a blended cash flow forecast tool that tracks the federally allotted funds throughout the life of the program. Actual claims, premiums and administrative expense data is input as incurred, while data for future months is based on the original budget. The summary shows the projected remaining balance at the end of each year as well as at the end of the program. The summary also compares the original budget figures to the blended forecast figures and calculates the blended administrative cost percentage (yearly and in total). PCIP-WA submitted a revised forecast in May 2013 and those re-forecasted figures were updated in the May packet. The re-forecast reflected reduced enrollment, premium and claims projections resulting from the suspension of new enrollment as mandated by HHS. Actual results are illustrated through July As of July 2013, membership was transitioned to the federally ran PCIP pool and therefore PCIP-WA no longer has any active membership. In July 2013, PCIP-WA began to process run-out for claims incurred prior to July 1, As of July 2013, PCIP-WA has used up 69.0% of the current funding and is projected to have enough funds to cover costs through the remainder of 2013 and beyond. PCIP-WA and HHS will continue to monitor available funds and projections on a quarterly basis with new funds to be awarded as necessary. Administrative costs as a percent of total costs is 3.6% since inception of the program and, by the end of the program, that percentage is projected to be 5.9%. 07/30/2013 2

3 PCIP-WA Unaudited Sheet as of June 30 Total Enrollment : 1,044 Assets: Cash $ - $ 16,401 Premiums Receivable 59,677 33,666 HHS Receivable - - Unbilled Payments from HHS 10,138,837 10,620,115 Prepaid Expense 12,650 15,350 Total Assets $ 10,211,165 $ 10,685,531 Liabilities and Unassigned Surplus: Reserve for Unpaid Losses - Medical $ 7,137,000 $ 8,620,000 Reserve for Unpaid Losses - Pharmacy 1,249, ,000 Accrued Loss Adjustment 219, ,000 Premiums Received in Advance 257, ,266 Checks Written in Excess of Cash (1) 1,244,158 - Due to WSHIP - - Abandoned Claim Reserve 4,440 - Accrued Expenses 100,290 94,266 Total Liabilities $ 10,211,165 $ 10,685,531 Unassigned Surplus - - Total Liabilities and Unassigned Surplus $ 10,211,165 $ 10,685,531 (1) Checks Written in Excess of Cash are claim checks written prior to the receipt of HHS reimbursements. These checks are not distributed until the proper funding is received. 07/30/2013 3

4 Total 6,330 4,607 Premium Earned $ 4,505,740 $ 3,028,374 Pharmacy Rebate 52,031 19,347 Incurred Claim Loss - Medical 16,506,524 14,212,036 Incurred Claim Loss - Pharmacy 8,037,417 4,612,709 Total Incurred Claim Loss 24,543,940 18,824,745 Operating Expenses: PCIP-WA Unaudited Statement of Operations January 1 to June 30 Administrative Expense $ 320,764 $ 263,535 Variable Administrative Expense 140,976 76,415 Salary and Benefit Expense 116,903 88,706 Contracted Outreach Fees 24,670 12,169 Miscellaneous Expense 18,139 24,914 Professional Fee Expense 71,037 44,768 Start-Up Expenses - - Total Operating Expenses $ 692,489 $ 510,507 Underwriting Gain (Loss) $ (20,678,658) $ (16,287,531) HHS Reimbursement 20,678,658 16,287,531 Investment - - Other - - Changes in Unassigned Surplus $ - $ - 07/30/2013 4

5 PCIP WA 2013 Budgeted Cash Flow Budget (revised May 2013) JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER JUNE YTD TOTAL Enrollment Count 976 1,035 1,106 1,058 1, ,157 6,157 Cash BEGINNING OF MONTH Receipts Premium Receipts 721, , , , , , ,551,881 4,551,881 HHS Reimbursement 4,850,640 2,865,656 3,186,202 3,952,612 4,044,587 4,278,689 4,592,118 1,500, , , , ,621 23,178,387 31,051,359 Pharmacy Rebate Claim Refunds Receipts Investment Abandoned Claims Other Total Receipts 5,572,399 3,629,943 4,006,624 4,734,210 4,792,576 4,994,515 4,592,118 1,500, , , , ,621 27,730,268 35,603,240 Refunds Premium Refunds Total Refunds Expenses Medical Claim Expense 5,470,163 3,526,235 3,890,769 4,628,558 4,684,251 4,887,616 4,421,260 1,398, , , , ,620 27,087,592 34,373,041 Pharmacy Claim Expense Administrative Expense 45,797 47,269 49,016 46,831 48,600 47, ,087 44,408 28,185 22,851 16,140 16, , ,090 Variable Administrative Expense 10,500 10,500 10,500 10,500 10,500 10, ,000 63,000 Salary and Benefits Expense 17,250 17,250 17,250 17,250 17,250 17,250 20,000 20,000 20,000 20,000 20,000 20, , ,500 Contracted Outreach Fees 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 24,870 49,740 Prescription Administrative Expense 1,333 1,333 1,333 1,333 1,333 1, ,000 8,000 Miscellaneous Expense 14,378 14,378 14,378 15,559 14,630 14,630 22,417 22,417 22,417 19,917 19,917 19,917 87, ,954 Professional Fees 8,833 8,833 19,233 10,033 11,867 11,867 11,208 11,208 11,208 11,208 18,208 11,208 70, ,915 Start-Up Expense Total Expense 5,572,399 3,629,943 4,006,624 4,734,210 4,792,576 4,994,515 4,592,118 1,500, , , , ,621 27,730,268 35,603,240 Cash Month End $ - $ - $ - - $ - $ - $ - $ - $ - $ - $ - $ - Actual JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER TOTAL YTD Enrollment Count 966 1,034 1,106 1,106 1,074 1,044 6,330 Cash BEGINNING OF MONTH 867,231 (190,378) (438,323) (437,307) (582,046) (1,642,883) Receipts Premium Receipts 622, , ,196 1,491, , ,509 3,729,762 HHS Reimbursement 3,424,018 3,019,262 3,361,862 2,604,689 4,245,292 4,644,385 21,299,508 Pharmacy Rebate ,455-29,576 52,031 Claim Refunds Receipts 12,719 74,020 8, ,391 3,681 66, ,816 Investment Abandoned Claims Other Total Receipts 4,059,321 3,441,549 4,040,971 4,257,154 4,563,561 5,022, ,385,116 Refunds Premium Refunds 39,210 38,704 14,854 36,095 15,876 99, ,992 Total Refunds 39,210 38,704 14,854 36,095 15,876 99, ,992 Expenses Medical Claim Expense 3,841,725 2,472,719 2,866,118 3,056,226 3,595,116 3,041,807 18,873,711 Pharmacy Claim Expense 1,149,981 1,064,532 1,042,516 1,157,100 1,920,175 1,374,742 7,709,045 Administrative Expense 49,951 52,913 50,179 55,419 61,311 48, ,585 Variable Administrative Expense 11,906 22,597 16,402 37,876 10,538 23, ,706 Salary and Benefits Expense 7,102 18,798 28,886 30,582 8,254 17, ,557 Contracted Outreach Fees - 4,145 4,145 4,145 4,145 8,290 24,870 Prescription Administrative Expense 10,621 1,264 2,285 1,372 1,406 4,237 21,185 Miscellaneous Expense 4,881 4,822 1,985 5,284 3,375 2,294 22,643 Professional Fees 1,554 9,001 12,585 17,793 4,201 3,077 48,212 Start-Up Expense Total Expense 5,077,720 3,650,790 4,025,101 4,365,798 5,608,522 4,524, ,252,514 Cash (190,378) (438,323) (437,307) (582,046) (1,642,883) (1,244,158) Checks written in excess of Cash 190, , , ,046 1,642,883 1,244,158 Inc(Dec) in Abandoned Property Reserve Available Cash /30/2013 5

6 PCIP WA 2013 Budgeted Cash Flow Variance to Original Budget Favorable/(Unfavorable) JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER TOTAL YTD Enrollment Count (10) (1) Receipts Premium Receipts (99,174) (416,020) (150,226) 710,020 (433,402) (433,317) (822,119) HHS Reimbursement (1,426,622) 153, ,660 (1,347,923) 200, ,695 (1,878,879) Pharmacy Rebate ,455-29,576 52,031 Claim Refunds Receipts 12,719 74,020 8, ,391 3,681 66, ,816 Investment Abandoned Claims Other Total Receipts (1,513,078) (188,394) 34,346 (477,056) (229,016) 28,045 (2,345,152) Refunds Premium Refunds (39,210) (38,704) (14,854) (36,095) (15,876) (99,253) (243,992) Total Refunds (39,210) (38,704) (14,854) (36,095) (15,876) (99,253) (243,992) Expenses Medical Claim Expense 1,628,438 1,053,516 1,024,651 1,572,332 1,089,135 1,845,809 8,213,881 Pharmacy Claim Expense (1,149,981) (1,064,532) (1,042,516) (1,157,100) (1,920,175) (1,374,742) (7,709,045) Administrative Expense (4,154) (5,643) (1,162) (8,588) (12,711) (1,639) (33,897) Variable Administrative Expense (1,406) (12,097) (5,902) (27,376) (38) (12,888) (59,706) Salary and Benefits Expense 10,148 (1,548) (11,636) (13,332) 8,996 (685) (8,057) Contracted Outreach Fees 4,145 - (0) (0) (0) (4,145) (0) Prescription Administrative Expense (9,288) 69 (952) (39) (73) (2,903) (13,185) Miscellaneous Expense 9,496 9,555 12,392 10,275 11,255 12,336 65,309 Professional Fees 7,280 (168) 6,649 (7,760) 7,666 8,790 22,456 Start-Up Expense Total Expense 494,678 (20,847) (18,476) 368,412 (815,946) 469, ,754 Inc(Dec) in Abandoned Property Reserve Cash (190,378) (438,323) (437,307) (582,046) (1,642,883) (1,244,158) Checks written in excess of Cash 190, , , ,046 1,642,883 1,244, Available Cash (1) Assumes an annual claims expense trend of 15%. (2) Assumes a premium rate level of 100% of the standard risk rate. (3) Assumes a 10% rate increase in January of each year. (4) Assumes increases in enrollment until March when HHS requires suspension of new enrollees. After March, assumes an enrollment attrition rate of 4% per month. 07/30/2013 6

7 PCIP-WA 2013 Administrative Expense Budget Variance Analysis Budget Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total ship (1) 976 1,035 1,106 1,058 1, ,157 Administrative Expense (2) 45,797 47,269 49,016 46,831 48,600 47, ,087 44,408 28,185 22,851 16,140 16, ,090 Variable Administrative Expense (3) 10,500 10,500 10,500 10,500 10,500 10, ,000 Salary and Benefits Expense (4) 17,250 17,250 17,250 17,250 17,250 17,250 20,000 20,000 20,000 20,000 20,000 20, ,500 Contracted Outreach Fees (5) 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 4,145 49,740 RX Benefit Management Fees (6) 1,333 1,333 1,333 1,333 1,333 1, ,000 Miscellaneous Expense (7) 14,378 14,378 14,378 15,559 14,630 14,630 22,417 22,417 22,417 19,917 19,917 19, ,954 Professional Fees (8) 8,833 8,833 19,233 10,033 11,867 11,867 11,208 11,208 11,208 11,208 18,208 11, ,915 Start Up Costs (9) Total Budget Operating Expenses 102, , , , , , , ,178 85,955 78,121 78,410 72,000 1,230,199 Actual Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec YTD Total ship (1) 966 1,034 1,106 1,106 1,074 1,044 6,330 Administrative Expense (2) 49,951 52,913 50,179 55,419 61,311 48, ,585 Variable Administrative Expense (3) 11,906 22,597 16,402 37,876 10,538 23, ,706 Salary and Benefits Expense (4) 7,102 18,798 28,886 30,582 8,254 17, ,557 Contracted Outreach Fees (5) - 4,145 4,145 4,145 4,145 8,290 24,870 RX Benefit Management Fees (6) 10,621 1,264 2,285 1,372 1,406 4,237 21,185 Miscellaneous Expense (7) 4,881 4,822 1,985 5,284 3,375 2,294 22,643 Professional Fees (8) 1,554 9,001 12,585 17,793 4,201 3,077 48,212 Start Up Costs (9) - Total Actual Operating Expenses 86, , , ,471 93, , ,758 Variance Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec YTD Total ship (1) (10) (1) Administrative Expense (2) (4,154) (5,643) (1,162) (8,588) (12,711) (1,639) (33,897) Variable Administrative Expense (3) (1,406) (12,097) (5,902) (27,376) (38) (12,888) (59,706) Salary and Benefits Expense (4) 10,148 (1,548) (11,636) (13,332) 8,996 (685) (8,057) Contracted Outreach Fees (5) 4,145 - (0) (0) (0) (4,145) (0) RX Benefit Management Fees (6) (9,288) 69 (952) (39) (73) (2,903) (13,185) Miscellaneous Expense (7) 9,496 9,555 12,392 10,275 11,255 12,336 65,309 Professional Fees (8) 7,280 (168) 6,649 (7,760) 7,666 8,790 22,456 Start Up Costs (9) Total Variance Expenses 16,221 (9,831) (612) (46,820) 15,095 (1,135) (27,082) Notes: (1) ship is projected to increase through March at which point new enrollment is suspended. Enrollment then decreases due to attrition. ship budget developed by Leif and Assoc in May of (2) Administrative Expense reflects fixed contractual TPA fees as well as contractual and performance bonuses per member for TPA, Utilization Management fees and Network services. (3) Variable Administrative Expense includes Case Management & Care Coaching, special mailings, and misc. system programming. (4) Salary and Benefits Expense reflect the combined amounts of the Executive Director, Deputy Executive Director, Executive Assistant and Program Coordinator. PCIP-WA reimburses WSHIP for 50% of salary and benefit costs and these figures reflect those reimbursements. (5) Contracted Outreach Fees is the outreach expenses billed from the Washington Office of Insurance Commissioner. (6) Prescription Administrative Expense is the administrative fees charged by the PBM. (7) Miscellaneous expense includes Board expenses, conference travel, insurance, agent commissions, phone/internet charges, and office expenses. PCIP-WA reimburses WSHIP for 50% of miscellaneous costs and these figures reflect those reimbursements. (8) Professional fees include legal fees, auditing fees, actuarial fees, and consulting. 07/30/2013 7

8 Pre existing Condition Insurance Pool PCIP WA Program Expense and Funding Summary (Highlighted cells represent actual data) Projected Budget Variance Claims less Refunds Claims PMPM Net Premiums Calculated Drawdowns 2010 Funding % of 2010 Funding Used Total Program 1,275,913 Federal Allotment 87,574, September % 17, , , ,848 1,075, % 87,373,427 October % 286,018 5,608 27, ,165 34, , , % 87,098,950 November % 260,978 3,070 66, ,682 91, , , % 86,812,577 December % 441,240 3, , ,458 77, , , % 86,415, Totals ,005,816 3, , , ,498 1,158,803 Contract Adjustment (246,028) Revised 2010 Budget (May 2013) 1,005,996 3, , , ,517 1,296, Budget Variance F/(U) , ,333 36,019 (108,676) Projected Remaining 86,415, Admin % of Total Costs 28.7% in October 2010 is reduced by $18,380 of excess premiums from September "Total Program " column is populated with the most current contract amount. (June 2013) 07/30/2013 8

9 Pre existing Condition Insurance Pool PCIP WA Program Expense and Funding Summary (Highlighted cells represent actual data) Projected Budget Variance Claims less Refunds Claims PMPM Net Premiums Calculated Drawdowns 2011 Funding % of 2011 Funding Used Total Program 29,218,573 Carry forward 86,415, January % 531,845 2, , ,588 70, ,870 28,754, % 85,951,602 February % 632,702 2, , ,949 66, ,470 28,220, % 85,417,132 March % 1,461,569 4, ,714 1,158, ,912 1,279,767 26,940, % 84,137,365 April % 1,341,681 3, ,556 1,156,125 79,114 1,235,239 25,705, % 82,902,126 May % 1,217,756 2, ,713 1,020,043 89,865 1,109,908 24,595, % 81,792,218 June % 1,795,218 4, ,411 1,299,807 81,719 1,381,526 23,213, % 80,410,692 July % 1,216,882 2, ,438 1,015,444 36,539 1,051,983 22,161, % 79,358,709 August % 1,730,552 3, ,019 1,528, ,275 1,672,808 20,489, % 77,685,901 September % 1,552,438 2, ,316 1,305,122 61,438 1,366,560 19,122, % 76,319,341 October % 2,287,994 3, ,699 1,634, ,656 1,742,951 17,379, % 74,576,390 November % 2,203,600 3, ,938 1,985,661 65,031 2,050,692 15,328, % 72,525,697 December % 2,105,353 2, ,471 1,298,882 88,898 1,387,780 13,941, % 71,137, Totals 5,439 5,513 18,077,590 3,279 3,813,285 14,264,304 1,013,249 15,277,554 Contract Adjustment 246,028 Revised 2011 Budget (May 2013) 18,065,567 3,321 3,152,411 14,913,156 1,061,052 15,974, Budget Variance F/(U) (12,023) 660, ,852 47, ,682 Projected Remaining 71,137, Admin % of Total Costs 5.3% Includes $29,101,463 available for 2011 plus $117,110 carryover from (Note: Even though the August 2011 reforecast reduced the 2011 contract amount, HHS had put $29,101,463 on the PMS based on the June 2011 reforecast. That amount remained on PMS and any excess will carry forward to "Total Program " column is populated with the most current projections which were submitted to HHS for approval in May /30/2013 9

10 Pre existing Condition Insurance Pool PCIP WA Program Expense and Funding Summary (Highlighted cells represent actual data) Projected Budget Variance Claims less Refunds Claims PMPM Net Premiums Calculated Drawdowns 2012 Funding % of 2012 Funding Used Total Program 75,137,918 Carry forward 71,137, January % 1,878,781 2, ,866 1,501,914 88,360 1,590,274 73,547, % 69,547,643 February % 1,985,778 2, ,966 1,748,812 79,859 1,828,671 71,718, % 67,718,972 March % 2,457,915 3, ,800 1,506, ,412 1,613,527 70,105, % 66,105,445 April % 3,270,512 4, ,274 2,949,238 94,225 3,043,463 67,061, % 63,061,982 May % 4,250,759 5, ,455 3,952,304 76,697 4,029,001 63,032, % 59,032,981 June % 2,782,652 3,305 1,046,198 1,736,454 78,658 1,815,112 61,217, % 57,217,869 July % 3,329,890 3, ,041 2,961,850 91,791 3,053,640 58,164, % 54,164,229 August % 3,327,890 3, ,264 3,030,626 80,460 3,111,087 55,053, % 51,053,142 September % 3,509,876 3,790 1,073,773 2,436,103 79,824 2,515,928 52,537, % 48,537,215 October % 3,547,164 3, ,780 3,061, ,114 3,167,497 49,369, % 45,369,718 November % 4,502,069 4, ,635 4,125, ,258 4,228,691 45,141, % 41,141,027 December 1,005 1, % 4,814,638 4,753 1,338,133 3,476, ,060 3,592,564 41,548, % 37,548, Totals 10,111 10,192 39,657,925 3,891 7,171,188 32,486,737 1,102,717 33,589,454 Revised 2012 Budget (May 2013) 39,438,847 3,901 6,725,302 32,713,545 1,102,719 33,816, Budget Variance F/(U) (219,078) 445, , ,810 Projected Remaining 37,548, Admin % of Total Costs 2.7% "Total Program " column is populated with the most current projections which were submitted to HHS for approval in February Includes $61,196,899 available for 2012 plus $13,941,019 carryover from $68,196,899 is the 2012 projected drawdowns based on the latest actuarial forecast submitted to HHS. HHS estimated a $7,000,000 carry forward from 2011, so the current contract admendment only shows $61,196,899 awarded for /30/

11 Pre existing Condition Insurance Pool PCIP WA Program Expense and Funding Summary (Highlighted cells represent actual data) Projected Budget Variance Claims less Refunds Claims PMPM Net Premiums Calculated Drawdowns 2013 Funding % of 2013 Funding Used Total Program 37,548,462 Carry forward 37,548, January % 4,978,987 5, ,374 4,395,612 86,015 4,481,627 33,066, % 33,066,835 February 1,035 1, % 3,463,230 3, ,563 3,153, ,540 3,267,206 29,799, % 29,799,629 March 1,106 1, % 3,899,721 3, ,342 3,244, ,467 3,360,846 26,438, % 26,438,783 April 1,058 1, % 4,052,480 3,664 1,455,523 2,596, ,471 2,749,428 23,689, % 23,689,354 May 1,013 1, % 5,511,610 5, ,712 5,212,899 93,230 5,306,129 18,383, % 18,383,225 June 969 1, % 4,320,882 4, ,255 4,137, ,034 4,245,660 14,137, % 14,137,565 July 2,395,114 13,584 2,381, ,793 2,489,323 11,648, % 11,648,242 August 3,807,307 3,807, ,178 3,909,485 7,738, % 7,738,757 September 683, ,856 85, ,811 6,968, % 6,968,946 October 449, ,051 78, ,172 6,441, % 6,441,773 November 153, ,651 78, ,062 6,209, % 6,209,712 December 179, ,620 72, ,621 5,958, % 5,958, Totals 6,157 6,330 33,895,509 4,143 3,499,353 30,396,155 1,194,216 31,590,372 Revised 2013 Budget (May 2013) 34,813,710 5,654 4,517,023 30,296,687 1,230,199 31,526, Budget Variance F/(U) 918,201 (1,017,670) (99,468) 35,983 (63,486) Projected Remaining 5,958,091 Inception to Date Actual Claims Claims PMPM Net Premiums 2013 Admin % of Total Costs 3.4% 2010 Totals 305 1,005,816 3, , , , Totals 5,513 18,077,590 3,279 3,813,285 14,264,304 1,013, Totals 10,192 39,657,925 3,891 7,171,188 32,486,737 1,102, YTD Totals 6,330 28,622,023 4,143 3,499,353 25,122, ,551 Inception to Date 22,340 87,363,353 3,911 14,735,338 72,628,016 3,298,014 ITD Admin % of Total Costs 3.6% This amount includes excess funds carried forward from 2012 in the amount of $41,548,464 minus $4,000,000 of funds which were deobligated in June of "Total Program " column is populated with the most current projections which were submitted to HHS for approval in May /30/

12 Pre existing Condition Insurance Pool PCIP WA Program Expense and Funding Summary (Highlighted cells represent actual data) Projected Budget Variance Claims less Refunds Claims PMPM Net Premiums Calculated Drawdowns 2014 Funding % of 2014 Funding Used Total Program 5,958,091 Carry forward 5,958, January 202, ,344 68, ,460 5,687, % 5,687,631 February 141, ,749 66, ,489 5,479, % 5,479,142 March 115, ,779 66, ,930 5,297, % 5,297,212 April 100, ,631 65, ,437 5,130, % 5,130,775 May 40,036 40,036 64, ,465 5,026, % 5,026,310 June 116, ,862 66, ,166 4,843, % 4,843,144 July 59,375 59,375 4,783, % 4,783,769 August 59,375 59,375 4,724, % 4,724,394 September 59,375 59,375 4,665, % 4,665,019 October 59,375 59,375 4,605, % 4,605,644 November 59,375 59,375 4,546, % 4,546,269 December 59,375 59,375 4,486, % 4,486, Totals 717, , ,797 1,471,197 Revised 2014 Budget (May 2013) 717, , ,797 1,471, Budget Variance F/(U) 0 0 (0) 0 Projected Remaining 4,486, Admin % of Total Costs 51.2% Projected s Actual s Budget Variance Claims Claims PMPM Net Premiums Calculated Drawdowns 2015 Funding % of 2015 Funding Used Total Program 2015 and Beyond 4,486,894 From 2014 Ending 4,486,894 Revised 2015 Budget (May 2013) 1,373,007 1,373,007 3,113, % Projected Remaining 3,113,887 Claims less Refunds Net Premiums 2010 Totals 1,005, , , , Totals 18,077,590 3,813,285 14,264,304 1,013, Totals 39,657,925 7,171,188 32,486,737 1,102, Totals 33,895,509 3,499,353 30,396,155 1,194, Totals 717, , , & Beyond 1,373,007 Summary Blended Summary (Includes Actual data with Forecasted Amounts) 93,354,239 14,735,338 78,618,901 5,841,484 Admin % of Total Costs 5.9% 07/30/