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 16,445 299,134 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 75,500 134,500 Reserve for Unearned Premiums 216,993 532,357 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
Unaudited Statement of Operations Total Member Months: 3,015 4,655 Premium Income $ 2,199,553 $ 3,005,653 Pharmacy Rebate Income 100,659 444,694 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 232,234 244,961 Variable Admin Expense 97,731 78,676 Salary and Professional Expense 120,070 135,120 Prescription Admin Expense 17,226 27,086 Agent Commissions - 200 Other Expense 17,414 29,128 Total Operating 484,675 515,171 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
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
HIPIOWA Budgeted Cashflow 2016 Budget JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC July YTD YTD Membership 1) 524 498 498 498 498 498 498 498 498 498 498 498 3,512 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) 433,778 343,416 424,091 357,416 281,227 451,516 364,999 271,007 387,053 309,586 254,650 341,868 2,656,443 4,220,607 Assessment 2) - - - - - - 6,400,000 1,600,000 - - - - 6,400,000 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 75,812 135,621 Pharmacy Rebates - - 100,000 - - 100,000 - - 90,000 - - 90,000 200,000 380,000 Realized Gain - - - - - - - - - - - - - - Interest 121 110 97 87 73 57 46 160 175 162 145 127 591 1,360 Total 443,576 354,142 534,964 368,440 292,401 562,841 6,776,482 1,882,775 489,010 321,707 266,934 444,316 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) 733,995 707,754 718,371 729,146 740,084 751,185 762,453 773,889 785,498 797,280 809,239 821,378 5,142,988 9,130,272 Pharmacy Claim Expense 4) 262,200 252,826 256,619 260,468 264,375 268,341 272,366 276,451 280,598 284,807 289,079 293,415 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 34,010 238,284 408,335 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 17,000 119,000 204,000 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 492 444 428 422 413 409 407 3,015 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 439,658 264,371 378,933 287,648 238,300 408,454 301,378 2,318,742 Assessment - - - - - 7,868,500 1,066,597 8,935,097 Claim 2,072 95,071 9,101 21,012 2,829 25,408 1,275 156,769 Pharmacy Rebates - - - - 100,659 - - 100,659 Realized Gain (Loss) 708 472 186 4,416 58 158 76 6,073 Interest 90 89 123 91 101 56 625 1,175 Total 442,528 360,003 388,343 313,167 341,946 8,302,575 1,369,951 - - - - - 11,518,514 Assessment - - - - - - 73,235 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 73,235 - - - - - 101,271 Medical Claim Expense 655,123 663,677 894,935 523,882 756,097 813,637 878,761 5,186,113 Pharmacy Claim Expense 275,966 183,283 166,236 188,385 187,714 204,557 255,881 1,462,021 PMPM Admin Expense 33,421 32,826 33,083 33,019 32,930 32,995 32,930 231,204 Variable Admin Expense 12,092 12,395 12,285 21,976 22,185 20,933 7,957 109,824 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 9,045 124,474 Other 2,381 3,656 2,433 2,313 4,370 2,164 2,478 19,795 Total 997,027 922,106 1,152,207 781,012 1,024,826 1,084,973 1,189,368 - - - - - 7,151,520 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 2016. 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
HIPIOWA 2016 Cash Flow Forecast Actual Forecast JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL Membership 1) 492 444 428 422 413 413 407 407 407 407 407 407 5,054 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) 439,658 264,371 378,933 287,648 238,300 408,454 301,378 224,407 325,790 260,585 214,343 287,757 3,631,624 Assessment 2) - - - - - 7,868,500 1,066,597 - - - - - 8,935,097 Claim 2,072 95,071 9,101 21,012 2,829 25,408 1,275 10,251 9,626 9,770 9,917 10,066 206,399 Pharmacy Rebates - - - - 100,659 - - - 90,000 - - 90,000 280,659 Realized Gain # 708 472 186 4,416 58 158 76 - - - - - 6,073 Interest 90 89 123 91 101 56 625 206 191 181 167 153 2,074 Total 442,528 360,003 388,343 313,167 341,946 8,302,575 1,369,951 234,865 425,608 270,536 224,428 387,975 13,061,925 Assessment - - - - - - 73,235 - - - - - 73,235 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 5,323 125,559 Medical Claim 3) 655,123 663,677 894,935 523,882 756,097 813,637 878,761 683,429 641,731 651,357 661,127 671,044 8,494,803 Pharmacy Claim Expense 4) 275,966 183,283 166,236 188,385 187,714 204,557 255,881 236,837 229,241 232,680 236,170 239,713 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 33,276 397,585 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 8,000 149,824 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 17,000 209,474 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 997,027 922,106 1,152,207 781,012 1,024,826 1,084,973 1,189,368 984,122 934,729 947,838 961,144 974,650 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 2016. 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