HIPIOWA - IOWA COMPREHENSIVE HEALTH ASSOCIATION Unaudited Balance Sheet As of July 31
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1 Unaudited Balance Sheet As of July 31 Total Enrollment: 407 Assets: Cash $ 9,541,661 $ 1,237,950 Invested Cash 781,689 8,630,624 Premiums Receivable 16, ,134 Prepaid 32,930 34,403 Assessments Receivable 138,138 - Total Assets $ 10,510,863 $ 10,202,111 Liabilities and Members' Equity: Reserve for Unpaid Losses $ 1,700,000 $ 3,000,000 Accrued Loss Adjustment 75, ,500 Reserve for Unearned Premiums 216, ,357 Accrued Expense 10,226 19,108 Assessments Payable - - Abandoned Claim Reserve 1,096 10,218 Total Liabilities 2,003,815 3,696,184 Unassigned Surplus 8,507,048 6,505,928 Total Liabilities and Unassigned Surplus $ 10,510,863 $ 10,202,111 09/07/2016 1
2 Unaudited Statement of Operations Total Member Months: 3,015 4,655 Premium Income $ 2,199,553 $ 3,005,653 Pharmacy Rebate Income 100, ,694 Incurred Claim Loss - Medical 5,029,345 5,821,378 Incurred Claim Loss - Pharmacy 1,462,021 1,999,824 Total Incurred Claim Loss 6,491,365 7,821,202 Operating : PMPM Administrative Expense 232, ,961 Variable Admin Expense 97,731 78,676 Salary and Professional Expense 120, ,120 Prescription Admin Expense 17,226 27,086 Agent Commissions Other Expense 17,414 29,128 Total Operating 484, ,171 Underwriting Loss (4,675,830) (4,886,026) Realized Gain (Loss) 5,971 (1,076) Interest Income 1,277 1,894 Other Income - - Changes to Unassigned Surplus $ (4,668,582) $ (4,885,209) HIPIOWA - IOWA COMPREHENSIVE HEALTH ASSOCIATION Statement of Changes in Unassigned Surplus Unassigned Surplus at Beginning of Year $ 4,175,630 $ 4,395,918 Changes to Unassigned Surplus (4,668,582) (4,885,209) Member Assessments 9,000,000 6,995,219 Unassigned Surplus $ 8,507,048 $ 6,505,928 09/07/2016 2
3 Statement of Cash Flows Funds Provided (Used) from Operations: Changes to Unassigned Surplus $ (4,668,582) $ (4,885,209) Add (Deduct) Items Not Requiring Cash Funds: (Inc) Dec in Premiums Receivable (10,237) 520,109 (Inc) Dec in Prepaid 1,030 2,471 (Inc) Dec in Assessment Receivable (138,138) 4,855 Inc (Dec) in Reserve for Unpaid Losses - - Inc (Dec) in Accrued Loss Adjustment - - Inc (Dec) in Reserve for Unearned Premiums 99,754 (523,600) Inc (Dec) in Accrued Expense (18,103) (36,928) Inc (Dec) in Assessments Payable - (30,722) Inc (Dec) in Abandoned Claim Reserve (11,581) (2,174) Total from Operations (4,745,858) (4,951,198) Other Sources of Funds: Member Assessments 9,000,000 6,995,219 Change in Cash and Invested Cash 4,254,142 2,044,021 Beginning of Period Cash 6,069,208 7,824,553 End of Period Cash and Invested Cash $ 10,323,350 $ 9,868,574 09/07/2016 3
4 HIPIOWA Budgeted Cashflow 2016 Budget JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC July YTD YTD Membership 1) ,512 6,002 BEGINNING OF MONTH $ 6,069,208 $5,442,255 $4,763,666 $4,250,948 $3,558,265 $2,776,057 $2,246,020 $7,905,880 $8,668,196 $8,018,792 $7,187,473 $6,286,110 Premium 5) 433, , , , , , , , , , , ,868 2,656,443 4,220,607 Assessment 2) ,400,000 1,600, ,400,000 8,000,000 Claim 9,677 10,616 10,776 10,937 11,101 11,268 11,437 11,608 11,782 11,959 12,139 12,321 75, ,621 Pharmacy Rebates , , , , , ,000 Realized Gain Interest ,360 Total 443, , , , , ,841 6,776,482 1,882, , , , ,316 9,332,846 12,737,588 Assessment Premium 8,025 6,353 7,846 6,612 5,203 8,353 6,752 5,014 7,160 5,727 4,711 6,325 49,144 78,081 Total 8,025 6,353 7,846 6,612 5,203 8,353 6,752 5,014 7,160 5,727 4,711 6,325 49,144 78,081 Medical Claim 3) 733, , , , , , , , , , , ,378 5,142,988 9,130,272 Pharmacy Claim Expense 4) 262, , , , , , , , , , , ,415 1,837,195 3,261,545 PMPM Admin Expense 34,221 34,011 34,010 34,011 34,010 34,011 34,010 34,011 34,010 34,010 34,010 34, , ,335 Variable Admin Expense 9,000 9,000 8,000 8,000 8,000 8,000 8,000 8,000 8,000 8,000 8,000 8,000 58,000 98,000 Pharmacy Admin Expense 3,588 3,287 3,336 3,386 3,437 3,488 3,541 3,594 3,648 3,702 3,758 3,814 24,063 42,579 Salary and Professional Expense 17,000 17,000 17,000 17,000 17,000 17,000 17,000 17,000 17,000 17,000 17,000 17, , ,000 Other 2,500 2,500 2,500 2,500 2,500 2,500 12,500 2,500 2,500 2,500 2,500 2,500 27,500 40,000 Total 1,062,504 1,026,378 1,039,836 1,054,511 1,069,406 1,084,525 1,109,870 1,115,445 1,131,254 1,147,299 1,163,586 1,180,117 7,447,030 13,184,731 END OF MONTH $5,442,255 $4,763,666 $4,250,948 $3,558,265 $2,776,057 $2,246,020 $7,905,880 $8,668,196 $8,018,792 $7,187,473 $6,286,110 $5,543,984 Actual JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC YTD TOTAL Membership ,015 BEGINNING OF MONTH $ 6,069,208 5,511,284 4,945,749 4,170,170 3,696,589 3,008,616 10,216,002 10,323,350 10,323,350 10,323,350 10,323,350 10,323,350 Premium 439, , , , , , ,378 2,318,742 Assessment ,868,500 1,066,597 8,935,097 Claim 2,072 95,071 9,101 21,012 2,829 25,408 1, ,769 Pharmacy Rebates , ,659 Realized Gain (Loss) , ,073 Interest ,175 Total 442, , , , ,946 8,302,575 1,369, ,518,514 Assessment ,235 73,235 Premium 3,424 3,433 11,715 2,801 5,382 1,281-28,036 Total 3,424 3,433 11,715 2,801 5,382 1,281 73, ,271 Medical Claim Expense 655, , , , , , ,761 5,186,113 Pharmacy Claim Expense 275, , , , , , ,881 1,462,021 PMPM Admin Expense 33,421 32,826 33,083 33,019 32,930 32,995 32, ,204 Variable Admin Expense 12,092 12,395 12,285 21,976 22,185 20,933 7, ,824 Pharmacy Admin Expense 3,162 3,492 1,956 2,424 2,388 2,352 2,316 18,090 Salary and Professional Expense 14,882 22,777 41,279 9,014 19,142 8,335 9, ,474 Other 2,381 3,656 2,433 2,313 4,370 2,164 2,478 19,795 Total 997, ,106 1,152, ,012 1,024,826 1,084,973 1,189, ,151,520 Available 5,511,284 4,945,749 4,170,170 3,699,523 3,008,328 10,224,937 10,323,350 10,323,350 10,323,350 10,323,350 10,323,350 10,323,350 Inc(Dec) in Escheat Check Reserve (2,934) 288 (8,935) Month Ending $ 5,511,284 $ 4,945,749 4,170,170 $ 3,696,589 $ 3,008,616 $ 10,216,002 $ 10,323,350 $ 10,323,350 $ 10,323,350 $ 10,323,350 $ 10,323,350 $ 10,323,350 Claims PMPM 1,888 1,693 2,458 1,638 2,278 2,427 2,785 2,153 (1) Projected 5% enrollment drop in January 2016 and another 5% drop in February Enrollment trended flat thereafter. (2) Forecasted assessment in June ($8,000,000). (3) Assumes annual medical claims expense trended with a 18% PMPM increase. (4) Assumes annual pharmacy claims expense trended with a 18% PMPM increase. (5) Assumes Premiums trended with 13.3% rate increase. 09/07/2016 4
5 HIPIOWA 2016 Cash Flow Forecast Actual Forecast JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL Membership 1) ,054 Beginning Cash 6,069,208 5,511,284 4,945,749 4,170,170 3,696,589 3,008,616 10,216,002 10,323,350 9,569,941 9,054,793 8,372,670 7,631,989 Premium 5) 439, , , , , , , , , , , ,757 3,631,624 Assessment 2) ,868,500 1,066, ,935,097 Claim 2,072 95,071 9,101 21,012 2,829 25,408 1,275 10,251 9,626 9,770 9,917 10, ,399 Pharmacy Rebates , , , ,659 Realized Gain # , ,073 Interest ,074 Total 442, , , , ,946 8,302,575 1,369, , , , , ,975 13,061,925 Assessment , ,235 Premium 3,424 3,433 11,715 2,801 5,382 1,281-4,152 6,027 4,821 3,965 5,323 52,324 Total 3,424 3,433 11,715 2,801 5,382 1,281 73,235 4,152 6,027 4,821 3,965 5, ,559 Medical Claim 3) 655, , , , , , , , , , , ,044 8,494,803 Pharmacy Claim Expense 4) 275, , , , , , , , , , , ,713 2,636,662 PMPM Admin Expense 33,421 32,826 33,083 33,019 32,930 32,995 32,930 33,276 33,276 33,276 33,276 33, ,585 Variable Admin Expense 12,092 12,395 12,285 21,976 22,185 20,933 7,957 8,000 8,000 8,000 8,000 8, ,824 Pharmacy Admin Expense 3,162 3,492 1,956 2,424 2,388 2,352 2,316 3,079 2,980 3,025 3,070 3,116 33,360 Salary and Professional Expense 14,882 22,777 41,279 9,014 19,142 8,335 9,045 17,000 17,000 17,000 17,000 17, ,474 Other 2,381 3,656 2,433 2,313 4,370 2,164 2,478 2,500 2,500 2,500 2,500 2,500 32,295 Total 997, ,106 1,152, ,012 1,024,826 1,084,973 1,189, , , , , ,650 11,954,003 Inc(Dec) in Escheat Check Reserve (2,934) 288 (8,935) Ending Cash 5,511,284 4,945,749 4,170,170 3,696,589 3,008,616 10,216,002 10,323,350 9,569,941 9,054,793 8,372,670 7,631,989 7,039,991 (1) Projected 5% enrollment drop in January 2016 and another 5% drop in February Enrollment trended flat thereafter. (2) Forecasted assessment in May ($9,000,000). (3) Assumes annual medical claims expense trended with a 18% PMPM increase. (4) Assumes annual pharmacy claims expense trended with a 18% PMPM increase. (5) Assumes Premiums trended with 13.3% rate increase. 09/07/2016 5
HIPIOWA - IOWA COMPREHENSIVE HEALTH ASSOCIATION Unaudited Balance Sheet As of January 31
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