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06) June 2003
CLAIMS PAID REPORT City of jeffersonville c-9486 Aggregate Factors: $332.65 $931.37 Single Family MDJ3~ ~ p_p_p_p_~an~ Ap~02 89 164 May-02 88 166 Jun-02 89 165 Jul-02 90 167 Aug-02 92 162 Sep-O2 80 163 Oct-02 84 162 Nov-02 87 158 De~02 80 167 Jan-03 75 171 Feb-03 77 171 MAP03 77 175 Eligible for Aggregate Stop-Loss Coverage Specific Stop-Loss ~m b[Op-LU~ ...... ~ ~eimbursements ~ Claims Paid Monthiy~ Affachment Point _YT.B T~aJ $182,350.53 366,231.15 549,513.05 734,990.34 916,476.08 1,094,901.39 1,273,725.93 1,449,822.94 1,631,973.73 1,816,186.75 2,001,065.07 2,189,668.87 ~¢TD Total CZsims Pi~¢_ Pa[d_ $171,496.34 $171,496.34 $0.00 356,007.10 184,510.76 0.00 441,024.17 85,017.07 0.00 791,643.96 350,619.79 72,971.85 990,905.11 199,261.15 3,389.34 1,191,350.68 200,445.57 883.21 1,317,500.25 126,149.57 0.00 1,453,687.43 136,187.18 7,326.37 1,596,291.39 142,603.96 3,021.94 1,795,064.81 198,773.42 0.00 1,931,465.07 136,400.26 2,995.42 2,302,797.70 371,332.63 32,703.75 :p¢nidiCJ~ $0.00 0.00 0.00 0.00 0.00 Gross Claims Pd. (Includes ALL Claims Pd) I B~vJ¢~¢_ Y_%D_Tota~ $171,496.34 $171,496.34 184,510.76 356,007.10 85,017.07 441,024.17 350,619.79 791,643.96 199,261.15 990,905.11 0.00 200,445.57 1,191,350.68 0.00 126,149.57 1,317,500.25 0.00 136,187.18 1,453,687.43 0.00 142,603.96 1,596,291.39 0.00 198,773.42 1,795,064.81 0.00 136,400.26 1,931,465.07 0.00 371,332.63 2,302,797.70 NET CLAIMS PAID - Toward Aggregate *ESTIMATED NET CLAIMS PAID - Toward Aggregate $2,179,505.82 $2,t79,505.82 (includes pending specific reimbursements) According to the Aggregate contract all Medical ancLPresC, dl~Dru(~ claims go toward the aggregate attachment point. All inquiries should be directed to the Administrator's Office. Stewart C. Miller & Co., Inc. Benefit Administrators Attn: Jufle Swathwood P.O. Box 5769 Lafayette, IN 47903-5769 (765) 447-8803 (800) 552-6550 Prepared by Stewart C. Miller & Co., Inc. Preliminary Report