HomeMy WebLinkAbout11-01-2012 EMPLOYEE BENEFIT TRUSTEE MEETINGWbftd�
Now ALA M
;L�� I
7"
City of Caldwell Employee I leallh Trust
Financial Stalemems
September 30, 2012
BALANCE, SI lE,ET
As of September 30, 2012
Assets
Cash 619,060
Reccivnbles(Cobra reftuid) -
Total Assets 619,060
Lk9bilities
Accounts Payable -
Claims IBNR 181,933
Surplus 437,127
Total Liabilities 619,060
INCOME STATEMENT
October I, 2011 - September .30, 2012
Revenues
Plan Contributions 2,598,457
M i scel hmeous -
Total Revenues 2,598,457
Expenses
Claims Paid 1,965,725
Plan Charges 589,864
Total Expenses 2,555,592
Revenues Over expenses 42,964
*� Blue
® Cross of Idaho
An lr-depradmt Urnsw of 7de MA9 Cross and &ue 5haWdAsswahw
City of Caldwell
Group #: 10031719
Aggregate Settlement Calculation
Contract Period: 10 -01 -2011 Through 09 -30 -2012
Contract Basis: Paid in 12
Aggregate W 125%
LOB's: Medical, Rx
Aggregate Excess Loss Amount:
Aggregate Factor
Annual Exposure
Annual Limit
Minimum Aggregate Calculation:
Aggregate Factor
Enrollment on 10 -01 -11
Annualized Exposure
Annual Limit
Minimum Aggregate Percentage:
Minimum Aggregate Excess Loss Amount:
Final Aggregate Excess Loss Amount:
Claims:
Total Paid Claims
Less: Claims Over Specific Stop Loss
Net Claims
Aggregate Surplus or (Deficit):
Amount to be Refunded to Group:
$ 726.61
2,705
$ 726.61
226
2,712
$ 1,970, 566.32
90%
$ 1,965,480.05
$ 1,773,509.69
$ 1,965,4$0.05
$ 2,196,296.71
$ 447,040.21
$ 1,749,256,50
$ 216,22155
Prepared by Blue Cross of Idaho
10/23/2012