Financial Summary

Acme Manufacturing
Plan Year: January 1, 2005 - December 31, 2005
Month Enrollment Monthly Funding Medical Claims Dental Claims Vision Claims RX Claims Admin Fees PPO Access Fees Reinsurance Misc. Balance to Funding
Employee Employee
/Child		 Employee
/Spouse		 Family
January 10 6 10 32 29,657 8,458 2,932 272 4,389 2,016 232 10,918 0 1,431
February 10 6 10 32 29,657 1,879 2,967 262 4,262 5,385 232 6,240 0 8,242
March 9 7 10 33 30,482 38,905 2,527 272 6,098 2,907 236 7,447 0 (27,638)
April 9 7 10 33 30,482 13,085 2,098 672 3,642 2,754 236 7,094 0 1,574
May 9 7 10 34 31,114 53,991 553 263 2,908 3,104 240 8,128 0 (37,809)
June 9 5 10 32 28,975 10,--9 1,347 234 5,418 3,112 220 7,810 0 1,054
July 8 6 10 31 28,537 6,271 2,640 252 6,122 2,704 224 6,729 0 3,851
August 8 5 10 32 28,731 6,431 3,303 223 4,565 2,803 220 6,940 0 4,468
September 8 4 10 31 27,661 17,362 2,754 253 5,337 2,839 212 7,200 0 (8,042)
October 8 6 10 28 26,643 68,525 1,957 231 4,149 2,741 208 6,787 0 (57,724)
November 8 6 10 33 30,044 7,796 1,189 981 3,731 2,617 232 6,368 0 8,122
December 10 8 10 34 31,796 112,540 1,703 627 4,038 3,137 248 7,861 0 (97,731)
Totals 107 72 120 385 353,778 345,251 25,696 4,508 54,657 36,570 2,740 88,904 0 (200,213)
Funding
Premium Equivalent
Employee $243.94 $26,102
Employee/Child $403.83 $33,809
Employee/Spouse $506.45 $50,713
Family $631.57 $243,154
$353,778
Funding $353,778
Less: Reinsurance: $26,102
  Paid Claims: $33,809
  Fees/Expenses: $50,713
  Miscellaneous: $243,154
 
Add: Reinsurance Reimbursement: $26,102
  Pending Reimbursement: $33,809
 
Surplus / (Deficit) ($119,091)