Monthly Operations Report

June 2013

ACHIA Operations Report

Alaska Comprehensive Health Insurance AssociationLevels of Service

July 2012 - June 2013

Levels of Service

Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13Enrollment Standards1. 14-day Clean Application Process 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%2. 14-day ID Card Issuance 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%3. Accuracy 99% 100% 100% 100% 100% 100% 99% 100% 100% 100% 100% 99% 100%Billing Standards4. 14-day Paid-to Status Update 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%5. Accuracy 99% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%Claims Standards6. 30-day Clean Claim Process 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%7. Clerical Accuracy 97% 100% 99.95% 99.83% 99.96% 100% 99.94% 99.95% 99.94% 100% 99.94% 99.95% 99.96%8. Financial Accuracy 98% 100% 100% 99.99% 100% 100% 100% 99.99% 100% 100% 99.99% 99.99% 100%Customer Service Standards9. 45 Sec. Speed of Answer* 45 sec avg 47 39 33 39 53 50 18 59 51 41 44 3610. 5% Abandonment Rate* < 5% 2.6% 3.5% 4.2% 1.5% 4.7% 4.1% 0.8% 3.1% 2.7% 2.5% 3.9% 2.0%* Reporting began January 1, 2007

Measurement of StandardsStandard 1 - If the date received compared to the date approved for all clean applications approved during the reporting month is less than 14-days.Standard 2 - If the date received compared to the date mailed for all applications approved during the reporting month is less than 14-days from receipt of eligible application to issuance of identification card.Standard 3 - 99% or greater accuracy rate for enrollment coding of premium, plan and age rate categories for all approved applications during the reporting month.Standard 4 - 100% scoring of (10) member audit of 14-calendar days or less from premium receipt to update of eligibility file paid-to-statusStandard 5 - 99% scoring of (10) member audit of accuracy for posting of correct payment, implementation of rate changes and premium account reconciliations during the reporting month.Standard 6 - 100% of clean claims processed within 30-calendar days during the reporting month.Standard 7 - 97% or greater accuracy of a (20) claim audit for proper clerical coding of claims during the reporting month. Standard 8 - 98% or greater accuracy of a (20) claim audit for proper clerical coding of claims during the reporting month. Standard 9 - 45 second or less average speed of answer for all telephone inquiries received during the reporting month.Standard10 - 5% or less call abandonment rate.

1

Alaska Comprehensive Health Insurance AssociationNumber of Claims Received

July 2012 - June 2013(as compared to Previous Year)

0

500

1,000

1,500

2,000

2,500

3,000

Jul-11

Jul-12

Aug-11

Aug-12

Sep-11

Sep-12

Oct-11

Oct-12

Nov-11

Nov-12

Dec-11

Dec-12

Jan-12

Jan-13

Feb-12

Feb-13

Mar-12

Mar-13

Apr-12

Apr-13

May-12

May-13

Jun-12

Jun-13

2

Alaska Comprehensive Health Insurance AssociationService Code Analysis*

For the Month of June 2013

* Represents claims adjudicated in the month. May not tie to the financials depending on the timing of voids and adjustments.

Submitted PPO or Other Deductible Coinsurance Total Claim Code Description Charge Discount Ineligible Amounts Amounts Paid Lines

ANCILLARY CHARGES 337,015.94$ 53,411.95$ 34,027.66$ 6,397.24$ 4,520.25$ 238,658.84$ 343

AMBULANCE 1,009.00$ -$ 861.01$ -$ 29.60$ 118.39$ 2

ANESTHESIA 11,114.46$ 686.11$ 1,995.43$ 2,508.00$ 268.36$ 5,656.56$ 8

ASSISTANT SURGEON 3,007.64$ -$ 1,285.66$ 1,682.64$ 7.87$ 31.47$ 2

PART B CO-INSURANCE 879,083.15$ -$ 854,101.51$ -$ -$ 24,981.64$ 211

CANCER THERAPIES 4,364.00$ -$ 3,557.50$ -$ 70.50$ 736.00$ 8

CHIROPRACTIC 3,874.00$ -$ 65.59$ 718.41$ 28.00$ 3,062.00$ 58

D/A OUTPATIENT 154.00$ 7.70$ -$ 146.30$ -$ -$ 1

DIAGNOSTIC TESTING 206,114.15$ 8,091.07$ 129,479.43$ 20,967.05$ 3,517.62$ 44,058.98$ 488

ER PHYSICIAN 7,137.46$ 139.37$ 693.60$ 2,216.91$ 398.56$ 3,689.02$ 12

EQUIPMENT 7,535.50$ 1,025.70$ -$ 4,145.14$ 460.19$ 1,904.47$ 9

EMERGENCY ROOM 7,727.85$ 1,541.88$ -$ 1,104.85$ 644.46$ 4,436.66$ 19

HOME HEALTH MISC. 1,110.00$ 55.50$ -$ -$ 78.85$ 975.65$ 5

HOSPITAL INPT VISIT 4,890.20$ 534.55$ 2,004.82$ 807.45$ 308.68$ 1,234.70$ 13

INJECTIONS 49,876.55$ 24,731.90$ 14,986.04$ 43.41$ 430.07$ 9,685.13$ 54

IMMUNIZATIONS 414.49$ 15.04$ -$ 39.98$ -$ 359.47$ 6

MISC CHARGES 178,904.02$ 1,442.28$ 25,384.47$ 3,393.32$ 2,502.13$ 146,181.82$ 134

MAMMOGRAM 1,104.20$ 68.24$ -$ 344.96$ -$ 691.00$ 6

M/N OUTPATIENT 6,792.95$ 72.39$ 575.20$ 1,612.55$ 2,266.39$ 2,266.42$ 33

MULTIPLE SURGERY 15,697.16$ 2,460.13$ 1,481.06$ 903.67$ 879.55$ 9,972.75$ 11

M/N IP VISIT 1,461.00$ -$ -$ 1,461.00$ -$ -$ 4

MASSAGE THERAPY 176.00$ -$ -$ -$ 35.20$ 140.80$ 1

OCCUPATIONAL THERAPY 179.00$ -$ -$ -$ 35.80$ 143.20$ 1

OFFICE VISIT 35,222.87$ 1,719.13$ 5,704.17$ 11,217.73$ 1,603.70$ 14,978.14$ 179

PHYSICAL THERAPY 11,302.00$ 428.40$ -$ 2,057.47$ 1,166.17$ 7,649.96$ 72

PRESCRIPTION DRUGS 220,422.69$ -$ -$ 21,323.21$ 22,670.90$ 176,246.71$ 1,008

SURGERY 92,266.22$ 2,450.02$ 27,253.63$ 24,643.93$ 2,866.75$ 35,051.89$ 55

SEMI-PRIVATE ROOM 56,901.73$ 33,477.73$ -$ -$ -$ 23,424.00$ 1

UB ANESTHESIA 2,316.98$ 417.90$ -$ 375.32$ -$ 1,523.76$ 3

UB DIAG TESTING 36,253.34$ 5,510.83$ -$ 8,734.19$ 2,438.27$ 19,570.05$ 184

UB SPEECH THERAPY 829.00$ 207.25$ -$ -$ -$ 621.75$ 2

UB PHYSICAL THERAPY 2,164.00$ 101.50$ -$ 1,758.00$ -$ 304.50$ 17

UB SURGERY 39,803.25$ 6,537.56$ -$ -$ 1,779.23$ 31,486.46$ 10

UB CANCER THERAPIES 1,191.24$ 119.12$ -$ -$ -$ 1,072.12$ 2

WELLNESS EXAM 2,050.00$ 93.75$ -$ 285.00$ -$ 1,671.25$ 8

WELLNESS TESTING 6,048.30$ 237.00$ 54.78$ 1,061.82$ 244.91$ 4,449.79$ 46

EXCEPTIONS 6,518.05$ 325.90$ -$ -$ -$ 6,192.15$ 1

TOTALS 2,242,032.39$ 145,909.90$ 1,103,511.56$ 119,949.55$ 49,252.01$ 823,227.50$ 3,017

3

Alaska Comprehensive Health Insurance AssociationService Code Analysis Year to Date

January 2013 - December 2013

Submitted PPO or Other Deductible Coinsurance Total Claim Code Description Charge Discount Ineligible Amounts Amounts Paid Lines

ANCILLARY CHARGES 4,915,672.13$ 528,454.17$ 2,268,141.39$ 50,613.80$ 45,914.91$ 2,022,547.86$ 2,566 ALLERGY INJECTIONS 364.00$ -$ 7.11$ 27.21$ 65.92$ 263.76$ 13 AMBULANCE 207,382.79$ 9,040.44$ 34,945.93$ 420.47$ 861.45$ 162,114.50$ 40 ANESTHESIA 90,252.25$ 8,911.39$ 20,067.16$ 4,555.19$ 2,729.98$ 53,988.53$ 58 ASSISTANT SURGEON 19,707.55$ 135.00$ 1,285.66$ 2,589.09$ 730.17$ 14,967.63$ 10 PART B CO-INSURANCE 5,533,061.44$ -$ 5,385,001.34$ -$ -$ 148,060.10$ 1,092 CANCER THERAPIES 354,936.82$ 18,979.92$ 22,213.81$ 2,434.00$ 1,771.35$ 309,537.74$ 240 CHIROPRACTIC 30,209.00$ 301.02$ 620.32$ 6,303.78$ 1,154.73$ 21,829.15$ 426 CARDIAC REHAB 1,750.00$ 437.50$ -$ -$ -$ 1,312.50$ 5 D/A OUTPATIENT 787.00$ 70.35$ -$ 681.40$ -$ 35.25$ 5 DIAGNOSTIC TESTING 1,791,031.23$ 71,427.83$ 1,245,804.90$ 114,955.86$ 24,453.48$ 334,389.16$ 2,859 ER PHYSICIAN 43,195.79$ 970.31$ 15,124.53$ 8,851.12$ 1,904.30$ 16,345.53$ 71 EQUIPMENT 41,332.18$ 5,726.66$ 8,407.71$ 14,717.05$ 1,316.69$ 11,164.07$ 104 EMERGENCY ROOM 52,469.93$ 9,912.77$ 3,059.91$ 12,342.32$ 1,825.38$ 25,329.55$ 64 HOME HEALTH CARE 1,100.00$ 55.00$ -$ -$ -$ 1,045.00$ 4 HOME HEALTH MISC. 6,475.00$ 159.75$ 120.00$ -$ 582.95$ 5,612.30$ 49 HOSPITAL INPT VISIT 90,539.57$ 803.33$ 71,127.86$ 2,718.37$ 1,273.15$ 14,616.86$ 274 INTENSIVE CARE UNIT 885,459.98$ 25,800.84$ 808,707.98$ 1,000.00$ 2,806.35$ 47,144.81$ 9 INJECTIONS 617,019.77$ 314,249.33$ 155,263.87$ 4,840.53$ 3,217.52$ 139,448.52$ 349 IMMUNIZATIONS 4,809.54$ 374.07$ -$ 741.18$ -$ 3,694.29$ 86 M/N ANCILLARY 4,387.00$ 1,623.19$ -$ -$ 1,381.90$ 1,381.91$ 2 M/N ROOM & BOARD 9,484.00$ 3,509.08$ -$ 472.75$ 2,751.08$ 2,751.09$ 1 MISC CHARGES 327,678.24$ 6,442.93$ 91,402.61$ 19,307.91$ 5,103.94$ 205,420.85$ 516 MAMMOGRAM 7,855.20$ 494.05$ (42.41)$ 392.80$ 85.53$ 6,925.23$ 55 M/N OUTPATIENT 43,997.95$ 1,748.59$ 9,871.86$ 15,742.73$ 8,317.27$ 8,317.50$ 207 MULTIPLE SURGERY 43,489.01$ 8,142.37$ 13,902.48$ 3,195.24$ 1,479.92$ 16,769.00$ 36 M/N IP VISIT 4,396.53$ -$ -$ 1,461.00$ 1,467.76$ 1,467.77$ 16 MASSAGE THERAPY 2,620.00$ 90.00$ -$ -$ 124.00$ 2,406.00$ 21 OCCUPATIONAL THERAPY 1,913.00$ 49.15$ 617.60$ 570.85$ 70.00$ 605.40$ 10 OFFICE VISIT 230,813.08$ 8,944.94$ 36,843.75$ 84,839.41$ 9,770.08$ 90,414.90$ 1,104 PRIVATE ROOM 26,104.58$ 763.67$ 17,283.90$ 767.24$ 1,457.95$ 5,831.82$ 3 PHYSICAL THERAPY 43,183.50$ 2,399.05$ 3,162.72$ 5,132.52$ 2,582.48$ 29,906.73$ 295 PRESCRIPTION DRUGS 1,570,890.70$ -$ -$ 330,040.39$ 106,356.29$ 1,132,652.21$ 6,048 SURGERY 503,613.27$ 27,556.71$ 136,282.32$ 76,174.16$ 23,114.27$ 240,485.81$ 302 SEMI-PRIVATE ROOM 148,623.29$ 42,806.13$ 42,826.50$ 866.38$ 4,760.27$ 57,364.01$ 16 SPEECH THERAPY 541.00$ 35.36$ 79.22$ 141.42$ 57.00$ 228.00$ 3 UB ANESTHESIA 44,675.23$ 12,304.68$ -$ 3,130.11$ 674.50$ 28,565.94$ 23 UB DIAG TESTING 269,775.49$ 46,155.70$ -$ 52,040.30$ 16,408.91$ 155,170.58$ 1,027 UB SPEECH THERAPY 1,607.00$ 401.75$ -$ -$ 116.70$ 1,088.55$ 4 UB OCCUP THERAPY 5,254.75$ 1,627.82$ -$ -$ 99.79$ 3,527.14$ 13 UB PHYSICAL THERAPY 9,937.14$ 1,556.97$ -$ 2,699.59$ 151.53$ 5,529.05$ 52 UB SURGERY 285,639.43$ 71,408.80$ -$ 4,600.46$ 9,025.80$ 200,604.37$ 37 UB CANCER THERAPIES 20,226.87$ 3,399.60$ -$ 1,363.43$ 1,201.28$ 14,262.56$ 15 UB PULMONARY REHAB 3,120.00$ 579.15$ -$ 1,541.30$ 56.96$ 942.59$ 7 UB PAP SMEAR 274.80$ 5.50$ -$ -$ 26.93$ 242.37$ 2 UB RESP THERAPY 9,673.00$ 3,379.33$ -$ -$ -$ 6,293.67$ 2 WELLNESS EXAM 18,274.47$ 691.49$ -$ 1,874.65$ 66.00$ 15,642.33$ 64 WELLNESS TESTING 42,297.73$ 2,702.75$ 54.78$ 9,688.46$ 244.91$ 29,606.83$ 260 EXCEPTIONS 6,518.05$ 325.90$ -$ -$ -$ 6,192.15$ 1

TOTALS 18,374,420.28$ 1,244,954.34$ 10,392,184.81$ 843,834.47$ 287,561.38$ 5,604,043.47$ 18,466

4

Alaska Comprehensive Health Insurance AssociationTop Provider Report For the Month of

June 2013

RANK DESCRIPTION# OF

CLAIMS SUBMITTED

CHARGES PAID BY PLAN 1 AMERICAN HYPERBARIC CENTER 24 $ 134,706.00 133,323.34$ 2 RENAL CARE GROUP ALASKA INC 28 $ 343,285.97 123,360.35$ 3 LIBERTY DIALYSIS ALSASKA 5 $ 319,493.99 50,371.73$ 4 UNIVERSITY OF WASHINGTON 5 $ 77,492.55 39,391.88$ 5 GALEN HOSPITAL ALASKA INC 8 $ 51,535.02 34,072.18$ 6 PROVIDENCE HEALTH & SERV WASH 53 $ 368,296.08 25,942.97$ 7 CENTRAL PENINSULA HOSP PROV 35 $ 36,586.25 25,133.80$ 8 FAIRBANKS MEMORIAL HOSP 13 $ 24,663.42 21,178.29$ 9 ALASKA HEART INSTITUTE LLC 43 $ 35,914.00 14,264.66$

10 SOUTH PENINSULA HOSPITAL INC 24 $ 26,635.31 11,318.26$ 11 DRS ELLERBE AND KALLMAN INC 2 $ 8,129.00 8,129.00$ 12 MAT-SU VALLEY MEDICAL CTR LLC 16 $ 19,610.32 7,483.42$ 13 IVY HOME INFUSIONS LLC 3 $ 14,281.90 7,271.01$ 14 ALASKA ONCOLOGY & HEMATOLOGY 19 $ 30,716.00 6,258.15$ 15 MIDNIGHT SUN ONCOLOGY INC 7 $ 55,696.70 5,909.46$ 16 ALASKA SURGERY CENTER A HEAL 2 $ 17,755.00 5,782.01$ 17 CHUGACH ANESTHSIA LLC 4 $ 6,210.00 5,267.00$ 18 REHABILITATION MEDICINE ASSOC 5 $ 5,732.00 5,001.43$ 19 ALASKA RETINAL CONSULTANTS 2 $ 5,793.00 4,730.64$ 20 DIALYSIS ASSOCIATES OF ALASKA 25 $ 34,232.00 4,730.02$ 21 SLEEP CENTERS OF ALASKA 13 $ 6,635.00 4,588.79$ 22 MAT-SU SURGICAL ASSOCIATES APC 6 $ 9,620.00 4,428.00$ 23 ANDRZEJ MACIEJEWSKI MD 7 $ 11,935.00 3,998.21$ 24 ANCHORAGE NEIGHBORHOOD HEALTH 35 $ 6,959.00 3,473.30$ 25 RHYNEER CLINIC PC 1 $ 12,000.00 3,446.00$ 26 PROVIDENCE IMAGING CENTER 8 $ 10,494.00 3,298.87$ 27 MINIMED DISTRIBUTION CORP 4 $ 9,168.07 3,124.52$ 28 WICKLER W LAURENCE DO 1 $ 9,900.00 3,035.02$ 29 PROVIDENCE HEALTH & SPORT THER 3 $ 2,609.00 2,609.00$ 30 TANANA VALLEY MED SURG GROUP 10 $ 5,187.00 2,484.11$

Top 30 Total 411 1,701,271.58$ 573,405.42$

5

RANK DESCRIPTION# OF

CLAIMSSUBMITTED CHARGES PAID BY PLAN

1 RENAL CARE GROUP ALASKA INC 1410 4,283,383.70$ 941,912.98$ 2 PROVIDENCE HEALTH & SERV WASH 2016 2,673,520.22$ 384,160.20$ 3 LIBERTY DIALYSIS ALSASKA 324 2,627,815.47$ 375,399.16$ 4 GALEN HOSPITAL ALASKA INC 222 436,394.67$ 290,537.75$ 5 CENTRAL PENINSULA HOSP PROV 774 282,694.70$ 173,780.11$ 6 GUARDIAN FLIGHT INC 4 163,850.00$ 155,113.90$ 7 VROM LLC 3 159,999.33$ 149,104.12$ 8 FAIRBANKS MEMORIAL HOSP 630 278,003.16$ 138,097.31$ 9 AMERICAN HYPERBARIC CENTER 58 135,725.00$ 133,444.41$ 10 AROM INC 3 140,732.36$ 133,031.85$ 11 MIDNIGHT SUN ONCOLOGY INC 378 734,846.80$ 114,299.05$ 12 MAT-SU VALLEY MEDICAL CTR LLC 438 286,345.60$ 102,083.84$ 13 SOUTH PENINSULA HOSPITAL INC 702 282,696.68$ 83,930.74$ 14 UNIVERSITY OF WASHINGTON 145 245,711.99$ 77,218.77$ 15 HARBORVIEW MEDICAL CENTER PHYS 110 120,550.84$ 71,727.49$ 16 ALASKA ONCOLOGY & HEMATOLOGY 984 304,892.20$ 50,903.03$ 17 ALASKA SURGERY CENTER A HEAL 45 102,687.00$ 48,091.81$ 18 ORTHOPEDIC PHYSICIANS ANCHORAG 270 64,966.05$ 35,044.67$ 19 ALASKA SPINE CENTER LLC 12 55,340.00$ 33,444.00$ 20 PROVIDENCE IMAGING CENTER 528 86,521.24$ 32,414.48$ 21 DIALYSIS ASSOCIATES OF ALASKA 534 138,210.00$ 29,446.57$ 22 ALASKA HEART INSTITUTE LLC 1008 121,932.73$ 28,783.92$ 23 ALASKA RADIATION ONCOLOGY 3 32,634.00$ 28,763.00$ 24 VALLEY RADIATION ONCOLOGY 8 26,071.00$ 24,225.10$ 25 IMAGING ASSOC OF PROVIDENCE 282 59,435.00$ 23,561.15$ 26 MAYO FOUNDATION 450 25,883.42$ 20,966.49$ 27 AA PAIN CLINIC INC 264 47,314.20$ 20,136.38$ 28 PROVIDENCE ANCH ANESTHESIA MED 234 58,713.00$ 19,430.01$ 29 REHABILITATION MEDICINE ASSOC 210 34,412.28$ 19,009.03$ 30 AWH HOLDINGS 4 19,408.00$ 16,085.88$

Top 30 Total 12053 14,030,690.64$ 3,754,147.20$

Alaska Comprehensive Health Insurance AssociationTop Providers Year to Date

January 2013 - December 2013

6

Alaska Comprehensive Health Insurance AssociationClaims Lag Report - Using Incurred, Showing Dollars

July 2012 - June 2013

INCURRED 2012 2013

IN MONTH JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL MAY JUNE %

SAME 367013 354623 352467 457949 181369 221378 74598 122684 210268 195697 275185 207222 24.14

1 768230 360998 391326 551841 463380 380608 602518 508828 344291 470095 440671 338091 44.93

2 182809 100306 51728 207603 74186 209380 192452 194612 136868 146452 91185 57051 13.15

3 15686 191660 17452 78441 181161 25295 76004 79367 44125 41537 12961 31154 6.35

4 141870 3971 7938 4750 8976 -20100 22347 22111 12125 9244 16067 8892 1.90

5 4651 9831 5726 16108 9099 -7939 21407 10443 105649 11346 40849 16036 1.94

6 2443 5595 21401 14076 2258 10149 1049 44003 39170 20944 1177 8846 1.37

7 20913 4751 2346 12646 166087 1452 5365 74023 2619 1896 25282 321 2.54

8 255 799 292 427 74218 1285 5124 491 2584 506 1020 12404 0.79

9 586 5037 1511 135 26656 1783 1849 242 1961 1196 651 166 0.33

10 1197 2092 476 3771 34 1382 -824 121 366 2434 95361 640 0.86

11 316 1275 -130 0 292 284 1384 178 221 860 1758 871 0.06

12+ 1600 29349 1494 10435 3325 -3266 -897 -300 3112 2961 -2046 158502 1.63

*****

TOTAL 1507569 1070287 854027 1358182 1191041 821691 1002376 1056803 903359 905168 1000121 840196 100%

7

Alaska Comprehensive Health Insurance AssociationAverage Cost Per Non Medicare Plan Claim Paid

July 2012 - June 2013

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13

$1,000 Deductible $1,500 Deductible $2,500 Deductible $5,000 Deductible $10,000 Deductible $15,000 Deductible $1,000 Std Deductible

8

Alaska Comprehensive Health Insurance AssociationAverage Cost Per Medicare Plan Claim Paid

July 2012 - June 2013

-$100

$100

$300

$500

$700

$900

$1,100

Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13

Carveout Med Supp A Med Supp I Med Supp F

9

Alaska Comprehensive Health Insurance AssociationPPO Savings Analysis

PPO Network Charge PPO Discount % of Discount

First Choice Health Network 12,325,136$ 2,648,534$ 21.5%Negotiated 78,940$ 70,593$ 89.4%

July 2012 - June 2013

10

Month / Year Case Provider Total Billed Total Paid Total OOP Date of ServiceDate

Received Date Paid Primary Diagnosis

December 2012 None

January 2013 1 Alaska Regional Hospital $223,114.55 $181,280.57 $0.00 12/13/12-

12/14/12 01/11/13 01/25/13 437.3 - Cerebral aneurysm, nonruptured

February 2013 None

March 2013 None

April 2013 None

May 2013 None

June 2013 None

12 Month Average Amount Billed: $31,873.51

12 Month Average Amount Paid: $25,897.22

Alaska Health Insurance Association (ACHIA)High Dollar Paid Claims Report

December 2012 - June 2013

Includes claims with paid amounts ≥ $100,000

11

Alaska Comprehensive Health Insurance AssociationPlan Age Distribution Summary

June 2013

Traditional PlanAge Carveout Med Supp A Med Supp I Med Supp F Age $1,000 Age $1,000 $1,500 $2,500 $5,000 $10,000 $15,0000-17 0 0 0 0 0-17 1 0-17 1 1 1 2 1 1

18-29 0 0 0 0 18-29 2 18-29 1 1 8 3 7 130-34 0 0 0 0 30-34 0 30-34 2 1 9 3 4 335-39 1 0 0 0 35-39 1 35-39 1 0 8 7 9 140-44 2 0 0 1 40-44 1 40-44 0 2 15 8 9 845-49 1 0 0 1 45-49 2 45-49 2 6 9 10 11 750-54 4 1 0 5 50-54 3 50-54 0 1 15 12 26 1455-59 5 0 0 5 55-59 2 55-59 1 1 12 28 38 2060-64 19 2 0 8 60-64 0 60-64 0 0 9 19 47 3965-69 0 3 0 3 65-69 0 65-69 0 0 0 0 0 070-74 0 2 0 3 70-74 0 70-74 0 0 0 0 0 075-79 0 1 0 1 75-79 0 75-79 0 0 0 0 0 080-84 0 0 1 1 80-84 0 80-84 0 0 0 0 0 085+ 0 0 0 1 85+ 0 85+ 0 0 0 0 0 0

Total 32 9 1 29 Total 12 Total 8 13 86 92 152 94528

.TOTAL ENROLLMENT:

Medicare Plans PPO Plans

020406080

100120140160180

329

1

2912 8 13

8692

152

94

Carveout Med Supp A Med Supp I Med Supp F Traditional $1,000 Plan $1,500 Plan $2,500 Plan $5,000 Plan $10,000 Plan $15,000 Plan

12

Alaska Comprehensive Health Insurance AssociationTotal Enrollment Activity

July 2012 - June 2013

514512

535537

539

542 542

538

533534

533

528

495

500

505

510

515

520

525

530

535

540

545

Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13

13

Alaska Comprehensive Health Insurance AssociationEnrollment Activity by Plan - Non Medicare Plans

July 2012 - June 2013

0

20

40

60

80

100

120

140

160

180

Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13

$1000 Deductible $1,500 Deductible $2,500 Deductible $5,000 Deductible

$10,000 Deductible $15,000 Deductible $1,000 Std Deductible

14

Alaska Comprehensive Health Insurance AssociationEnrollment Activity by Plan - Medicare Plans

July 2012 - June 2013

0

5

10

15

20

25

30

35

40

45

50

Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13

Carveout Med Supp A Med Supp I Med Supp F

15

Alaska Comprehensive Health Insurance AssociationEnrollment Activity

July 2012 - June 2013

Month Start AddsPended Adds* Terms

Retro Terms** End Net Change

Jul-12 514 10 1 12 9 504 (10) Aug-12 504 15 4 10 4 509 5 Sep-12 509 32 2 7 6 530 21 Oct-12 530 13 1 6 5 533 3 Nov-12 533 12 2 7 - 540 7 Dec-12 540 15 2 11 4 542 2 Jan-13 542 14 1 13 8 536 (6) Feb-13 536 8 2 9 7 530 (6) Mar-13 530 14 - 11 1 532 2 Apr-13 532 12 2 11 5 530 (2) May-13 530 7 - 5 6 526 (4) Jun-13 526 8 - 6 - 528 2

332 36 222 141

Enrollment is reported by month of initial effective coverage. * Pended Adds represent pended applications that were approved in the reporting month but have a prior effective date. These enrollees are reported in the row representing initial effective coverage date. **Retro Terms represent terminations that were processed in the reporting month but have a prior termination date. These terminations are reported in the row representing the actual month of the termination.

Count Percent Jun-13Pended Adds*

111 31% 3 - 111 31% 1 - 105 29% 2 - 33 9% 2 -

360 100% 8 -

Count Percent Jun-13Retro

Terms**6 2% - -

10 3% - - 18 5% - - 1 0% - -

70 20% - - 22 6% 3 - 32 9% - -

117 33% - 7 74 21% 3 -

350 100% 6 7

Lifetime Max

Totals since June 2011

Qualifying Event Reasons (data from 6/1/11 - 6/30/13)No other health insurance - HIPAA eligibleRejection of other health coverage due to pre-existing conditionPre-qualified health conditions on the listReinstatedTotal

Termination Reasons (data from 6/1/11 - 6/30/13)Free look periodToo costlyDeceased

Medicare / MedicaidMoved out of stateUnknown - Letter sent to request reason for terminationNon-paymentObtained other coverage Total 16

Alaska Comprehensive Health Insurance AssociationTop Producers

Agent Name Agency LocationCommissioned

AppsJoann Jensen Anchorage 4

Lisa Sanders Anchorage 4

Khrista Huntley Alaska Insurance Solutions Wasilla 3

July 2012 - June 2013

17