Year to Date, Monthly Aggregate Report

Acme Manufacturing
Plan Year: January 1, 2016 - December 31, 2016
Carrier: HCC Life Insurance Company Aggregate Contract Type: 15/12 Specific Contract Type: 15/12 Effective: 12/01/2016
Group: Acme Manufacturing     Specific Deductible $30,000 Covered: Medical / Dental / Vision / RX
Policy Number : T0718001 Aggregate Factors: Employee: $169.40        
      Employee/Child: $368.53        
      Employee/Spouse: $439.62        
      Family: $527.85        
Month Enrollment Loss Fund Paid Claims Out of Contract Subtotal Subject to Loss Funding Extra Contractual Payments Voids & Refunds Specific Reimbursements Specific Pending Net Claims Aggregate (Under) / Over Aggregate Filed Monthly % of Aggregate
Employee Employee
/Child
Employee
/Spouse
Family Month YTD Medical Dental Vision RX
January 10 6 10 32 24,481 24,481 8,458 2,932 272 4,389 20 15,759 0 0 0 0 15,759 (8,722) 0 64%
February 10 6 10 32 24,481 48,963 1,879 2,967 262 4,262 0 9,107 0 0 0 0 9,107 (15,374) 0 37%
March 9 7 10 33 25,208 74,172 38,905 2,527 272 6,098 (2,328) 49,858 0 0 0 0 49,858 24,649 0 198%
April 9 7 10 33 25,208 99,380 13,085 2,098 672 3,642 0 18,824 0 0 0 0 18,824 (6,383) 0 74%
May 9 7 10 34 25,736 125,117 53,991 553 263 2,908 0 57,450 0 126 31,291 0 26,033 296 0 101%
June 9 5 10 32 23,943 149,060 10,--9 1,347 234 5,418 0 16,774 0 0 0 0 16,774 (7,169) 0 70%
July 8 6 10 31 23,615 172,675 6,271 2,640 252 6,122 0 15,033 0 0 88 0 14,945 (8,669) 0 63%
August 8 5 10 32 23,774 196,450 6,431 3,303 223 4,565 (267) 14,566 0 67 0 0 14,499 (9,274) 0 61%
September 8 4 10 31 22,877 219,318 17,362 2,754 253 5,337 0 25,451 0 0 0 0 25,451 2,573 0 111%
October 8 6 10 28 22,031 241,359 68,525 1,957 231 4,149 0 74,630 0 0 14,715 80 59,835 37,804 0 271%
November 8 6 10 33 24,840 266,199 7,796 1,189 981 3,731 0 12,715 0 0 0 0 12,715 (12,124) 0 51%
December 10 8 10 34 26,274 292,474 112,540 1,703 627 4,038 (4,143) 122,423 0 0 910 34,037 87,476 61,202 0 332%
Totals 107 72 120 385   292,474 345,251 25,696 4,508 54,657 (6,719) 432,597 0 193 47,004 34,117 34,117 58,808 0 120%
YTD Claims
Total Claims Paid $425,877
Less Out of Contract (1) ($6,719)
Less Extra Contractual Payments $0
Less Voids & Refunds $193
Less Specific Reimbursements $47,004
Less Pending Specific Reimbursements $34,117
Subtotal $351,282
Less Aggregate Deductible $292,474
* YTD Aggregate Claim $58,808
YTD Loss Ratio 120%
  • (1) Out of Contract - claims incurred before 3/01/2004
  • * (Negative) number indicates net claim amount less than deductible (no aggregate claims)
  • * Positive number indicates the Aggregate Attachment Point has been exceeded (possible aggregate claim)