20110829PAC to Staff Attach 178-2.pdf

PacifiCorp
Flex Plan - Electric Operations
7120/2010
Claimsl Net CostjEnrollm,eJll Premiums ExpeJises Iç;ital Cost Contributions Net Cost per EnrolleeMedical
No Coverage 292 $0 $0 $0 ($525,600)$525,600 $1,800
EPO 373 $4,182,421 $249,671 $4,432,092 $1,202,508 $3,229,584 $8,658PPO3304,056,107 183,229 4,239,336 980,100 3,259,236 9,876Deductible Plan 918 14,138,978 509,710 14,648,688 2,966,952 11,681,736 12,725Definity HSA _--..1A1~13,987,162 __~B38 ~,86,000 2.105,484 12,780,516 9,045UHC/UBH Subtotal 3,034 $36,364,668 $1,841,448 $38,206, 16 $7,255,044 $30,951,072 $10,201
Kaiser 218 $2,520,130 $2,171 $2,522,302 $705,252 $1,817,050 $8,335
Total Medical 3,544 $313,884,798 $1,843,620 $40,728,418 $7,434,696 $33,293,722 $9,394
Dental
No Coverage 245 $0 $0 $0 ($14,700)$14,700 $60$50 Deductible with orthodontic 1,503 2,076,777 67,635 2,144,412 860,268 1,284,144 854$~jO Deductible wlo orthodontic:__--.12§::!, ___1,670,274 __~?30 ----1.!.51,O,04 701,328 1,049,676 585Total Dental 3,542 $3,747,051 $148,365 $3,1995,416 $1,546,896 $2,348,520 $663
Vision
No Coverage 399 $0 $0 $0 $0 $0 $0VSP3,143 520,251 0 520,251 258,720 261,531 83_.----Total Vision 3,542 $520,251 $0 $520,251 $258,720 $261,531 $74
I Totai Electric Operations $43,152,101 $1 ,991 ,J85 $45,t44,085 --W,240,312 $35,90:3,773 $1O:TITI
Hewitt A~:)ocia¡es 10
Active Budgd Fot\X::iist 7 20 20JO_"b R/9120io
ID PAC-E-11-12
IPUC 178 Attachment IPUC 178 -2
Attach IPUC 178 -2.pdf Page 1 of 1