HomeMy WebLinkAboutDelta Dental-6/24/2013Experience Period Claims Paid 3/1/12 through 2/28/13
Claims Paid 3/1/12 through 2/28/13
Adjustment of Claims to Incurred Basis
Incurred Claims
Trend in Claims
Projected Claims Based on Current Experience
Claims and Enrollment Fluctuation Adjustment
Projected Annual Claims Based on Current Enrollment
Fixed Fees
Aggregate Stop Loss
Administrative Fees
Operating Costs
Network Access Fee
Broker Fee
Subtotal Fixed Fees
Projected Annual Expense
City of Waterloo
Group # 92179
Contract Period 7/1/13 through 6/30/14
Financial Exhibit
Per Contract
$0.00
$3.55
$0.25
$0.00
$415,107
$12,838
$427,945
$28,758
$456,703
($5,016)
$451,687
$o
$28,499
$2,007
$0
$3.80 $30,506
1< acknowledge acceptance of this renewal at the rates shown above.
Percent of Premium Contributed by Employer: Single
Total Employees Enrolled:
Signature of Gr up Administrator
Please sign and eturn to fax # 888-264-1433
$482,194
% Family
Total Employees Eligible:
E -Mail Ad61re s
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DELTA DENTAL OF IOWA
Delta Dental PPO"
Current Enrollment
Stn a Fami
155 514
Projected Claim Factors
Single, Family,
$22.32 $66.50
Attachment Points
Single Family,
N/A N/A
Fixed Fees
Cost Per Contract
Current Renewal
$3.70 $3.80
Suggested Rates
Single Family
$23.83 $70.99
Maximum Funding
Sinale Family
N/A N/A
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Date