46
Report to the New York Department of Financial Services New York State Medical Indemnity Fund 4 th Quarter 2017 Actuarial Analysis As of December 31, 2017 M arch 20 18 PINN ACLE ACTUARIAL RESOURCES, INC. 3109 Cornelius Drive Bl oomington, IL 61704 309.807.2300 pinnacleactuaries.com Commitment Beyond Numbers

Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

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Page 1: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

Report to the New York Department of Financial Services

New York State Medical Indemnity Fund

4 th Quarter 2017 Actuarial Analysis

As of December 31 2017

March 2018

~ PINN ACLE ACTUARIAL RESOURCES INC

3109 Cornelius Drive

Bloomington IL 61704 3098072300

pinnacleactuariescom

Commitment Beyond Numbers

TABLE OF CONTENTS

Section

Purpose amp Scope 1

Executive Summary 2

Backgrou nd 4

Data Methods amp Assumptions 5

Discussion and Analysis 7

Number of Qual ifying Participants 7

M ortality Experience Life Expectancy 8

Actuar ia l Calculation of Estimated Fund Liabilities 9

Amount of Benefit s Paid 11

Patterns of Utilization 11

Benefit Payments and Inj ury Type 14

Inflationary Pat terns of Types of Services 16

Administrative Expenses 17

Impact of Ava ilable Health Insurance 17

Investment Earnings 18

Distribut ion amp Use 18

Reliances amp Limitations 19

EXHIBITS

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund 4th Quarter 2017 Actuarial Analysis

As of December 31 2017

Purpose amp Scope

Pinnacle Actuarial Resources Inc (ldquoPinnaclerdquo) had been retained by the New York State Department of

Financial Services (NYS DFS or ldquothe Departmentrdquo) to provide quarterly actuarial reports regarding the

experience of the New York State Medical Indemnity Fund (MIF or the Fund) This analysis evaluates

data for the Fund as of December 31 2017

sect69‐1019 of the New York State Department of Health Regulation states that the quarterly reports

should ldquoinclude a review of the various elements contributing to the amount of benefits paid by the

Fund and to the expenses of administration of the Fund includingrdquo

The number of qualifying plaintiffs

The mortality experience of the qualified plaintiffs

The amount of benefits paid by the Fund

The patterns of utilization of types of services provided

Inflationary patterns by types of services provided

The expenses of administration of the Fund

The impact of available health insurance on benefits paid by the Fund and

Investment earnings of the Fund

sect69‐1020 of the New York State Department of Health Regulation also requires an actuarial

calculation of the estimated liabilities of the Fund for the coming year resulting from the qualified

plaintiffs enrolled in the Fund

Commitment Beyond Numbers

New York State Medical Indemnity Fund-4th Quarter 2017 Page 2 March 30 2018

Executive Summary

Based on our review of avai lable information regarding the New York State Medical Indemnity Fund as

of December 31 2017 Pinnacle has arrived at a number of key conclusions

bull As of December 31 2017 the Fund had accepted 516 participants (511 living) with expected

future benefit payments of approximately $7288 mill ion and future administrative expenses of

$1147 million assuming a discount rate of 25 With a Fund ba lance as of December 31 2017

of approximately $2361 million this results in an unfunded liability for the Fund of

approximately $6074 million

o Tota l future lifetime benefits for the 511 living Fund participants without discounting is

estimated to be $1779 billion

o The current present va lue of future benefit payments of $7288 million does not

consider any additiona l enrollees that may be admitted to the Fund in the future

o Prior to the impact of legislation passed on December of 2016 each new participant

admitted to the Fund after June 30 2017 would increase the Fund s f uture benefits

payment liabilities by $335 mi ll ion on a nominal basis or a present value of $132

mi ll ion increasing at approximately the medical inflation rate of 35 annual ly from

March 31 2017

o On December 31 2016 new legislation was signed expanding eligibility for the Fund to

non-hospital births and significantly raising rei mbursement rates for the period from

July 1 2017 through December 31 2019 For new participants admitted duri ng this

period a priori estimates of future lifetime benefit payment liabilities increased to $362

million on a nominal basis or a present value of $152 mi ll ion These liabilities vary

depending on the amount of an individual participants benefits that are pa id during the

period of higher reimbursement rates

bull Prior to the beginning of the fisca l year the Fund was expected to have almost

one hundred th ree (10292) additional participants accepted between March 31

2017 and March 31 2018 These new participants were expected to add future

discounted benefits liabi lities of about $1550 million

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 3

March 30 2018

bull There were eleven (11) new participants to the Fund in the third quarter of fiscal

year 2017-18 approximately fifteen (15) less than expected for this period Prior

to this quarter quarterly new participant counts have varied between fifteen

(15) and th irty-five (35) in the last two years

bull The number of eligible participants is expected to continue increasing for at least

thirty years as more eligible participants are admitted to the Fund each year

bull Actual benefit payments in the th ird quarter of the 2017-18 fiscal year (10117-123117) as of

123117 were $754 million for a tota l of $21264 million paid so far in the 2017-18 fiscal year

Of these payments $114 mill ion was allocated back to the second quarter of the fiscal year

(7 117-93017) as there were no claims payments processed in September Expected benefit

payments in the remainder of the 2017-18 fisca l year are $17693 million Estimated tota l

benefit payments for the 2017-18 fiscal year (4117- 33118) are therefore $38957 mi ll ion

It is important to recognize that these amounts can vary significantly each quarter due to the

inherent uncertainty in benefit payments the effect of the legislative change on payments and

the transition to a new third party claim administrator in the current quarter

bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting

Group (PCG) instead of Alica re This change decreased the administrative expenses of the Fund

on a per month per member basis Based on the current contract we expect $114 m illion to

be paid in administrative expenses over the remai nder of the 2017-18 fiscal year resu lting in

total administrative expenses for fiscal 2017-18 (including both Alicare and PCG) of $484

million

bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012

Compared to Virginia the Fund is having a substantially higher percentage of overall costs in

medical and hospital costs medical equipment and prescription drug costs and corresponding

lower percentages in nursing and long term care costs

bull As of December 31 2017 the number of participants that have received more than $1 million

in benefits payments is sixteen (16) Based on current annual severities by individual member

we expect eight (8) more members to cross this threshold in the next twelve months

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 4

March 30 2018

Background

The Medical Indemnity Fund was established in 2011 to provide a funding source for future health

care costs associated with birth-related neurological injuries Enrollees of the Fund are plaintiffs in

medica l malpractice actions who have received either court-approved settlements or j udgments

deeming the plaintiffs neurological impairments to be birth-related 1 More specifically a birthshy

related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of

labor delivery or resuscitation or by the provision or non-provision of other medical services duri ng

the delivery admission 2 These injuries must result in a physical impairment a developmental

disability or both

Benefits provided by the Fund include

bull Medical Dental Surgical and Hospita l Care

bull Nursing and Custodia l Care

bull Prescription and Non-Prescription Drugs

bull Rehabilitation Services

bull Durable Medical Equipment and Assistive Technology

bull Certain Home and Vehicle Modifications

bull Other Health Care Costs for Medical Services and Supplies for Participants

The New York State Department of Financial Services (NYS DFS) serves as the administrator of the

Fund For the fi rst year of the MlFs operations Sedgwick CMS served as the Funds third party

administrators (TPA) For the second year of operations they were replaced by Alica re As of

September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues

to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the

Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related

Neurologica l Injury Compensation Fund and the Florida Neurological Injury Compensation Association

The Fund currently is financed through a budget allocation from the state of New York Any party to a

medical professiona l liability claim can request for the judgment to reflect eligibility for participation in

the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund

1 Provided by NY DFS 2 htt pwwwdfsnygovinsurance mifmif_faqs ht m

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 5

March 30 2018

Data Methods amp Assumptions

Given that the Fund has been in operation for on ly six years a number of sources of information are

still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Publ ic

Consulting Group to ensure that their claims databases are sufficient to support these ongoing

quarterly reports and to enhance the ongoing management of the Fund As a result we have

introd uced more ana lysis by benefit category (ie nursing medical hospital prescription drugs etc)

and inj ury type

Early in the Funds operations some health care benefits that should have been paid by the Fund were

erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment

information on these costs by the New York Department of Health (DOH) and they are reflected in the

exhibits

Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for

the birth injury funds in Virginia and Florida as well as medical professional liabi lity insurers in the

state of New York These have been significantly modified based on data from the Fund as it becomes

more credible

One significant area of ongoing review of assumptions relates to the expected number of claims per

10000 live births Initia lly 110 participants per 10000 births were assumed based on data from

Virginia and Florida After the first year the frequency rate was increased to 290 participants per

10000 births In the first quarter 2014 report the expected number of eligible Fund participants was

increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal

years of experience and present more rea listic financia l projections for the next five years In late

2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing

frequency data It should be recognized that this is over four times the number of participants per

10000 live births experienced by the bi rth f unds in Florida and Virginia

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 6 March 30 2018

As we are accumulating more credible amounts of benefit payments data several differences are

emerging For example the annual benefit payments during 2016 to Fund participants that were

admitted to the program prior to 2016 (ie participants that have a full year of benefit payments

during 2016) are shown in the following graph and compared to data from Virginia Additional severity

information is contained in Exhibit 1 Page 2 and Exhibit 6

600o

500

400

300

200

100

I I I I 1 I 1 11 bullbull - -00

bull VA Data bull NY Data

There are at least th ree key issues

1) The Fund has sign ificantly more participants with $0 of benefit payments W ill these

participants have benefit payments at some point

2) The Fund has substantially more participants with less than $25000 in annual benefit

payments Is there something about the Funds enabling legislation that is causing this or will

their costs increase over time

3) The Fund had five participants with annual benefits costs over $400000 Virginia has no

participants that breached th is threshold Admittedly there are sample size issues but will this

phenomenon persist

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund -4th Quarter 2017 Page 7 March 30 2018

We are continuing to monitor these phenomena and will add additional analysis in the March 31 2018

actuarial report

In response to this information changes to the assumptions regarding the expected frequency and

severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016

The assumptions wi ll be detai led later in th is report

Discussion and Analysis

Number of Qualifying Participants

Based on the loss runs provided by Sedgwick CMS Alicare and DOH valued as of December 31 2017

there are five hundred sixteen (516) participants that have qualified for the Program as of th is date

five hundred eleven (511) were still living as of December 31 2017 Th is information is summarized in

Exhibit 2

There were eleven (11) new participants to the Fund in the third quarter of fiscal 2017 approximately

fifteen (15) fewer than expected for the quarter

The number of Fund participants and the distribution of participants by age warrants continued

monitoring The average age of a Fund participant at the time of admission is about 85 which is

approximately four years older than the age of a Virginia Birth Fund participant at admission

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

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2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

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1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

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8379

7258

15lt]87

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14873

10 15 14838

10208

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4505

13571 21265 13081

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17699

6S73 1157

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1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

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5734

19155

18633

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9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

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18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

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16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

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6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

ll16 3))45

156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

S8 lS3

18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

28S79 67733

12-46

72397

71SJ1

11SOSO

60958

sons

106613 u 12 66731

65684

~

45957

1S27J

126623 62708

129760

128822

32si

81136

S2amp06

M370 amp22S

133980

7~861 6391l

12656C S270S

1023

JWl 21195

17720 7418amp

158480

156200

36957 94708

105634

95506 11201

92S60 1 1-31

71305

lW 51248

242Sl

167 131 88 166

188953 II0064 3SJ1

1062S4

75988

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164791 111281

84599

156117

lW 56231

27783 184912

98871 211)16

203563 S2078

116280

amp922

12279 116307

18619

128877 108028

lW 60S61 29i48

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110970 llS772 221))92

57645

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94958 1613

1)t940

209167

147965

Siil 63067

31451

228570 120 l SO 258969

246076

66770

14012S

104169

190383

144573

227684

lW 67501

33179 250713

129218 291831

275891

73957

1SOS5

11661

2u1n 152813

Siil n38gt 37502

270969 139466

322187

298075

8033

161620

12602

235707

Jiil 295227 152319

34ABSO

32A-898S1

167434

137572

ma 84674

38987

317058

164644

370SOO 356319

98064 176090

1112 89190

40293 338117

H l180

415234

391371 102742

llZII 93743

43985 361616 18675lt

4S3432

114s1

lW 9SSgtI

9917 389135

202315 472517

lW 104246

59470

415819

21279

lW 110595

n122 37622

Jiil 116Q28

750S7

SW 121196

201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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201604 2011 201702 017Q3

201104

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717 lll m 216063

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1A63J3 31 812 to857 36713

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ml ma 47626 21564 22710 11639

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1140117 1 480454

1 311 684

ou

10

516 1sm 004

Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

CU-itlw IMllfltsbyFUNI P1nldpldon ~

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17194 JS1 7l2 S50336 444 04gt 639416 amp70096 1yenr7995 l 7382Sl 2 261 Ml

uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

3146 16 WOU

Ill 334 J91 937

l3710U 833319

1 44 l20 349Sl3

1 3S21

33$

1 S07937 lct1929 1 151115 2643417

1 03071S

t3nfiM

ga 16SU9 11337CJ

4 024 728 SU087 as357

11amp797

371966 1315gt1

17SS213 2301 605 1158207

33QSJ09

wsn 1334617 112308

lli sossn 1pound1002

2025914

1 57693 rnom

6A 110

deg419251

1813023 1000636 219 596

1 72S676 3923 472

843272 1 80454

11111 390 4 233149

2J635l3 185690 6339199

l l087U 25$7 109

487637

2007 051 2J8765amp

2 944 150

deg 1 140

ml 563731

2574 090 2 20414amp

755amp133 90031

deg 607900 233amp152 164gt313 3295amp18 2 114 339

2284tn 4 83963amp

gu 3056lJ

2 471773 1 Cll7815

1 1m J 13951

n3791

1 1 90769 3 722974 29161Sl

Qll

16

311321 32VDI 2714240

900 1 lil5460

11293S6 3480047

7S962 3057251 33734-93

4 lUJJ6 2au na

ma filH7U

3657 115 3(1(8145

103Sfl743 1 Z30378

2003 100

3113 J67 3617271 31A3JJ 4 553690

~ 742SlS 9

4 012529

32J0451 ll 7U25a 1 3794$3

221amp rn 4 064970

932996 382031

llll 851 lni

412Sll

3 486654 118amp7481 1 49037 2 410COI

bull HOn1 1 008190 4478436

QU 4511

4 7236Z7 ll7MCIOS

1 622 2 269515 rnonz l l0057

llll 931 410 4 28858

4 ll6 105

14amp320U 1781 597

2Ml 926 4 7SU14

ms 9Sl 08amp

soan 1611 3ampamp

1 956amp55

10122n

mil 1ou ns 4688Sl

l ampU7294 2087 27

JW 1086949 6226162 50578

189008

ml

663Ul3 S 319139

ml 1216546 7001918

ma l 176J04 ll961

SW 1 3JJ154

Ia l 3JJ lS4

82S961 7001 94amp

S319al9 1U 01l6 2087267 3082271 4 1S4 424

1 100574

4 4784 36

3820U8 4 553 690

2811 JJamp

2916752 m om 180454 11828 1 371684

S6333S 74amp4S

76898S

362013 316amp9

910

nm004

Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 2: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

TABLE OF CONTENTS

Section

Purpose amp Scope 1

Executive Summary 2

Backgrou nd 4

Data Methods amp Assumptions 5

Discussion and Analysis 7

Number of Qual ifying Participants 7

M ortality Experience Life Expectancy 8

Actuar ia l Calculation of Estimated Fund Liabilities 9

Amount of Benefit s Paid 11

Patterns of Utilization 11

Benefit Payments and Inj ury Type 14

Inflationary Pat terns of Types of Services 16

Administrative Expenses 17

Impact of Ava ilable Health Insurance 17

Investment Earnings 18

Distribut ion amp Use 18

Reliances amp Limitations 19

EXHIBITS

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund 4th Quarter 2017 Actuarial Analysis

As of December 31 2017

Purpose amp Scope

Pinnacle Actuarial Resources Inc (ldquoPinnaclerdquo) had been retained by the New York State Department of

Financial Services (NYS DFS or ldquothe Departmentrdquo) to provide quarterly actuarial reports regarding the

experience of the New York State Medical Indemnity Fund (MIF or the Fund) This analysis evaluates

data for the Fund as of December 31 2017

sect69‐1019 of the New York State Department of Health Regulation states that the quarterly reports

should ldquoinclude a review of the various elements contributing to the amount of benefits paid by the

Fund and to the expenses of administration of the Fund includingrdquo

The number of qualifying plaintiffs

The mortality experience of the qualified plaintiffs

The amount of benefits paid by the Fund

The patterns of utilization of types of services provided

Inflationary patterns by types of services provided

The expenses of administration of the Fund

The impact of available health insurance on benefits paid by the Fund and

Investment earnings of the Fund

sect69‐1020 of the New York State Department of Health Regulation also requires an actuarial

calculation of the estimated liabilities of the Fund for the coming year resulting from the qualified

plaintiffs enrolled in the Fund

Commitment Beyond Numbers

New York State Medical Indemnity Fund-4th Quarter 2017 Page 2 March 30 2018

Executive Summary

Based on our review of avai lable information regarding the New York State Medical Indemnity Fund as

of December 31 2017 Pinnacle has arrived at a number of key conclusions

bull As of December 31 2017 the Fund had accepted 516 participants (511 living) with expected

future benefit payments of approximately $7288 mill ion and future administrative expenses of

$1147 million assuming a discount rate of 25 With a Fund ba lance as of December 31 2017

of approximately $2361 million this results in an unfunded liability for the Fund of

approximately $6074 million

o Tota l future lifetime benefits for the 511 living Fund participants without discounting is

estimated to be $1779 billion

o The current present va lue of future benefit payments of $7288 million does not

consider any additiona l enrollees that may be admitted to the Fund in the future

o Prior to the impact of legislation passed on December of 2016 each new participant

admitted to the Fund after June 30 2017 would increase the Fund s f uture benefits

payment liabilities by $335 mi ll ion on a nominal basis or a present value of $132

mi ll ion increasing at approximately the medical inflation rate of 35 annual ly from

March 31 2017

o On December 31 2016 new legislation was signed expanding eligibility for the Fund to

non-hospital births and significantly raising rei mbursement rates for the period from

July 1 2017 through December 31 2019 For new participants admitted duri ng this

period a priori estimates of future lifetime benefit payment liabilities increased to $362

million on a nominal basis or a present value of $152 mi ll ion These liabilities vary

depending on the amount of an individual participants benefits that are pa id during the

period of higher reimbursement rates

bull Prior to the beginning of the fisca l year the Fund was expected to have almost

one hundred th ree (10292) additional participants accepted between March 31

2017 and March 31 2018 These new participants were expected to add future

discounted benefits liabi lities of about $1550 million

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 3

March 30 2018

bull There were eleven (11) new participants to the Fund in the third quarter of fiscal

year 2017-18 approximately fifteen (15) less than expected for this period Prior

to this quarter quarterly new participant counts have varied between fifteen

(15) and th irty-five (35) in the last two years

bull The number of eligible participants is expected to continue increasing for at least

thirty years as more eligible participants are admitted to the Fund each year

bull Actual benefit payments in the th ird quarter of the 2017-18 fiscal year (10117-123117) as of

123117 were $754 million for a tota l of $21264 million paid so far in the 2017-18 fiscal year

Of these payments $114 mill ion was allocated back to the second quarter of the fiscal year

(7 117-93017) as there were no claims payments processed in September Expected benefit

payments in the remainder of the 2017-18 fisca l year are $17693 million Estimated tota l

benefit payments for the 2017-18 fiscal year (4117- 33118) are therefore $38957 mi ll ion

It is important to recognize that these amounts can vary significantly each quarter due to the

inherent uncertainty in benefit payments the effect of the legislative change on payments and

the transition to a new third party claim administrator in the current quarter

bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting

Group (PCG) instead of Alica re This change decreased the administrative expenses of the Fund

on a per month per member basis Based on the current contract we expect $114 m illion to

be paid in administrative expenses over the remai nder of the 2017-18 fiscal year resu lting in

total administrative expenses for fiscal 2017-18 (including both Alicare and PCG) of $484

million

bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012

Compared to Virginia the Fund is having a substantially higher percentage of overall costs in

medical and hospital costs medical equipment and prescription drug costs and corresponding

lower percentages in nursing and long term care costs

bull As of December 31 2017 the number of participants that have received more than $1 million

in benefits payments is sixteen (16) Based on current annual severities by individual member

we expect eight (8) more members to cross this threshold in the next twelve months

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 4

March 30 2018

Background

The Medical Indemnity Fund was established in 2011 to provide a funding source for future health

care costs associated with birth-related neurological injuries Enrollees of the Fund are plaintiffs in

medica l malpractice actions who have received either court-approved settlements or j udgments

deeming the plaintiffs neurological impairments to be birth-related 1 More specifically a birthshy

related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of

labor delivery or resuscitation or by the provision or non-provision of other medical services duri ng

the delivery admission 2 These injuries must result in a physical impairment a developmental

disability or both

Benefits provided by the Fund include

bull Medical Dental Surgical and Hospita l Care

bull Nursing and Custodia l Care

bull Prescription and Non-Prescription Drugs

bull Rehabilitation Services

bull Durable Medical Equipment and Assistive Technology

bull Certain Home and Vehicle Modifications

bull Other Health Care Costs for Medical Services and Supplies for Participants

The New York State Department of Financial Services (NYS DFS) serves as the administrator of the

Fund For the fi rst year of the MlFs operations Sedgwick CMS served as the Funds third party

administrators (TPA) For the second year of operations they were replaced by Alica re As of

September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues

to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the

Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related

Neurologica l Injury Compensation Fund and the Florida Neurological Injury Compensation Association

The Fund currently is financed through a budget allocation from the state of New York Any party to a

medical professiona l liability claim can request for the judgment to reflect eligibility for participation in

the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund

1 Provided by NY DFS 2 htt pwwwdfsnygovinsurance mifmif_faqs ht m

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 5

March 30 2018

Data Methods amp Assumptions

Given that the Fund has been in operation for on ly six years a number of sources of information are

still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Publ ic

Consulting Group to ensure that their claims databases are sufficient to support these ongoing

quarterly reports and to enhance the ongoing management of the Fund As a result we have

introd uced more ana lysis by benefit category (ie nursing medical hospital prescription drugs etc)

and inj ury type

Early in the Funds operations some health care benefits that should have been paid by the Fund were

erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment

information on these costs by the New York Department of Health (DOH) and they are reflected in the

exhibits

Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for

the birth injury funds in Virginia and Florida as well as medical professional liabi lity insurers in the

state of New York These have been significantly modified based on data from the Fund as it becomes

more credible

One significant area of ongoing review of assumptions relates to the expected number of claims per

10000 live births Initia lly 110 participants per 10000 births were assumed based on data from

Virginia and Florida After the first year the frequency rate was increased to 290 participants per

10000 births In the first quarter 2014 report the expected number of eligible Fund participants was

increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal

years of experience and present more rea listic financia l projections for the next five years In late

2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing

frequency data It should be recognized that this is over four times the number of participants per

10000 live births experienced by the bi rth f unds in Florida and Virginia

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 6 March 30 2018

As we are accumulating more credible amounts of benefit payments data several differences are

emerging For example the annual benefit payments during 2016 to Fund participants that were

admitted to the program prior to 2016 (ie participants that have a full year of benefit payments

during 2016) are shown in the following graph and compared to data from Virginia Additional severity

information is contained in Exhibit 1 Page 2 and Exhibit 6

600o

500

400

300

200

100

I I I I 1 I 1 11 bullbull - -00

bull VA Data bull NY Data

There are at least th ree key issues

1) The Fund has sign ificantly more participants with $0 of benefit payments W ill these

participants have benefit payments at some point

2) The Fund has substantially more participants with less than $25000 in annual benefit

payments Is there something about the Funds enabling legislation that is causing this or will

their costs increase over time

3) The Fund had five participants with annual benefits costs over $400000 Virginia has no

participants that breached th is threshold Admittedly there are sample size issues but will this

phenomenon persist

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund -4th Quarter 2017 Page 7 March 30 2018

We are continuing to monitor these phenomena and will add additional analysis in the March 31 2018

actuarial report

In response to this information changes to the assumptions regarding the expected frequency and

severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016

The assumptions wi ll be detai led later in th is report

Discussion and Analysis

Number of Qualifying Participants

Based on the loss runs provided by Sedgwick CMS Alicare and DOH valued as of December 31 2017

there are five hundred sixteen (516) participants that have qualified for the Program as of th is date

five hundred eleven (511) were still living as of December 31 2017 Th is information is summarized in

Exhibit 2

There were eleven (11) new participants to the Fund in the third quarter of fiscal 2017 approximately

fifteen (15) fewer than expected for the quarter

The number of Fund participants and the distribution of participants by age warrants continued

monitoring The average age of a Fund participant at the time of admission is about 85 which is

approximately four years older than the age of a Virginia Birth Fund participant at admission

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

ll16 3))45

156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

S8 lS3

18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

28S79 67733

12-46

72397

71SJ1

11SOSO

60958

sons

106613 u 12 66731

65684

~

45957

1S27J

126623 62708

129760

128822

32si

81136

S2amp06

M370 amp22S

133980

7~861 6391l

12656C S270S

1023

JWl 21195

17720 7418amp

158480

156200

36957 94708

105634

95506 11201

92S60 1 1-31

71305

lW 51248

242Sl

167 131 88 166

188953 II0064 3SJ1

1062S4

75988

U3m7

lOS693

164791 111281

84599

156117

lW 56231

27783 184912

98871 211)16

203563 S2078

116280

amp922

12279 116307

18619

128877 108028

lW 60S61 29i48

205461

110970 llS772 221))92

57645

128B91

94958 1613

1)t940

209167

147965

Siil 63067

31451

228570 120 l SO 258969

246076

66770

14012S

104169

190383

144573

227684

lW 67501

33179 250713

129218 291831

275891

73957

1SOS5

11661

2u1n 152813

Siil n38gt 37502

270969 139466

322187

298075

8033

161620

12602

235707

Jiil 295227 152319

34ABSO

32A-898S1

167434

137572

ma 84674

38987

317058

164644

370SOO 356319

98064 176090

1112 89190

40293 338117

H l180

415234

391371 102742

llZII 93743

43985 361616 18675lt

4S3432

114s1

lW 9SSgtI

9917 389135

202315 472517

lW 104246

59470

415819

21279

lW 110595

n122 37622

Jiil 116Q28

750S7

SW 121196

201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

raquoUQ4

raquoUQgt

lOUC 2ltgtUQ3_ 1013QJ 2ltgt13Ql

1013Q3middotmiddot- 201) 1015QJ 2ltgt15Ql

raquolSCU gt)1SQ4 gt)16Ql

raquo1Ql

gt)1Q3

201604 2011 201702 017Q3

201104

25 Jl 16 UI

JS

15 29

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717 lll m 216063

17222 11) 468

1A63J3 31 812 to857 36713

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lS361 16455 10141 n 17929S

157250 1S1366

12231 174172 472382

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m 12070

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335796

4 10257 321337 16ffl 202020

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lit nno 1U11

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m 2529 60ll

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211111 300 45

110508 2554

181 615

431 269 um m n

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22301 151 593

m ~

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03929 1 165571 1 14amp1agt

1320U 116207 U5157 i 285

227482 40401 l72JU J27022 yen77991 264554

26C 161 l547gtJ 6 18 164 459971 175695 297615 1458J1

ml deg u osn

1218933 1 193tl

197201 31171

120264 J31801 254 065 JSl 669 JSS6M

2194 4561lt

llll 54812

mm U767 2564UI

1CIS91 427 l55

334 311 Sil

ml ma 47626 21564 22710 11639

369731 3017 927857 17645 ll4911

157023 273743 45171 550020

40362 )70J5

w 487111

155 414 22670S

l 3S4514 149015

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1174 223 110973

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ou

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516 1sm 004

Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

CU-itlw IMllfltsbyFUNI P1nldpldon ~

raquo U Q4

raquoUQJ

lOUQl 20UQ3

10Ultl4 211lJQ1

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1014 101SQJ OlSQl

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21116Qgt 21116Q1 21116Ql 21116Q4 2017Q)

2017Ql

21117Q4

16

30 17

19

10 19 17 31

16 10 11 lS 19 19

lll

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60

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1609 3902

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Ill 3

ll4 76U7 41 15841 ltO lJl

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ltl59U 508

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lll lli m lli

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437331 U 4 1S3 1 093SSS 1 313)11 (7089 622100 mm 104 l 278C81 1198927

U 6J7 48351 IS 4 17112S

109 114 196914 457936 990gt8 l7S521 623900 990171

000 145380 183334

U0389 107J8S deg 720517 H5179 1 157563 714 566 1 157055 144991amp 1 7551S

17194 JS1 7l2 S50336 444 04gt 639416 amp70096 1yenr7995 l 7382Sl 2 261 Ml

uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

3146 16 WOU

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1813023 1000636 219 596

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l ampU7294 2087 27

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ml 1216546 7001918

ma l 176J04 ll961

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 3: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund 4th Quarter 2017 Actuarial Analysis

As of December 31 2017

Purpose amp Scope

Pinnacle Actuarial Resources Inc (ldquoPinnaclerdquo) had been retained by the New York State Department of

Financial Services (NYS DFS or ldquothe Departmentrdquo) to provide quarterly actuarial reports regarding the

experience of the New York State Medical Indemnity Fund (MIF or the Fund) This analysis evaluates

data for the Fund as of December 31 2017

sect69‐1019 of the New York State Department of Health Regulation states that the quarterly reports

should ldquoinclude a review of the various elements contributing to the amount of benefits paid by the

Fund and to the expenses of administration of the Fund includingrdquo

The number of qualifying plaintiffs

The mortality experience of the qualified plaintiffs

The amount of benefits paid by the Fund

The patterns of utilization of types of services provided

Inflationary patterns by types of services provided

The expenses of administration of the Fund

The impact of available health insurance on benefits paid by the Fund and

Investment earnings of the Fund

sect69‐1020 of the New York State Department of Health Regulation also requires an actuarial

calculation of the estimated liabilities of the Fund for the coming year resulting from the qualified

plaintiffs enrolled in the Fund

Commitment Beyond Numbers

New York State Medical Indemnity Fund-4th Quarter 2017 Page 2 March 30 2018

Executive Summary

Based on our review of avai lable information regarding the New York State Medical Indemnity Fund as

of December 31 2017 Pinnacle has arrived at a number of key conclusions

bull As of December 31 2017 the Fund had accepted 516 participants (511 living) with expected

future benefit payments of approximately $7288 mill ion and future administrative expenses of

$1147 million assuming a discount rate of 25 With a Fund ba lance as of December 31 2017

of approximately $2361 million this results in an unfunded liability for the Fund of

approximately $6074 million

o Tota l future lifetime benefits for the 511 living Fund participants without discounting is

estimated to be $1779 billion

o The current present va lue of future benefit payments of $7288 million does not

consider any additiona l enrollees that may be admitted to the Fund in the future

o Prior to the impact of legislation passed on December of 2016 each new participant

admitted to the Fund after June 30 2017 would increase the Fund s f uture benefits

payment liabilities by $335 mi ll ion on a nominal basis or a present value of $132

mi ll ion increasing at approximately the medical inflation rate of 35 annual ly from

March 31 2017

o On December 31 2016 new legislation was signed expanding eligibility for the Fund to

non-hospital births and significantly raising rei mbursement rates for the period from

July 1 2017 through December 31 2019 For new participants admitted duri ng this

period a priori estimates of future lifetime benefit payment liabilities increased to $362

million on a nominal basis or a present value of $152 mi ll ion These liabilities vary

depending on the amount of an individual participants benefits that are pa id during the

period of higher reimbursement rates

bull Prior to the beginning of the fisca l year the Fund was expected to have almost

one hundred th ree (10292) additional participants accepted between March 31

2017 and March 31 2018 These new participants were expected to add future

discounted benefits liabi lities of about $1550 million

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 3

March 30 2018

bull There were eleven (11) new participants to the Fund in the third quarter of fiscal

year 2017-18 approximately fifteen (15) less than expected for this period Prior

to this quarter quarterly new participant counts have varied between fifteen

(15) and th irty-five (35) in the last two years

bull The number of eligible participants is expected to continue increasing for at least

thirty years as more eligible participants are admitted to the Fund each year

bull Actual benefit payments in the th ird quarter of the 2017-18 fiscal year (10117-123117) as of

123117 were $754 million for a tota l of $21264 million paid so far in the 2017-18 fiscal year

Of these payments $114 mill ion was allocated back to the second quarter of the fiscal year

(7 117-93017) as there were no claims payments processed in September Expected benefit

payments in the remainder of the 2017-18 fisca l year are $17693 million Estimated tota l

benefit payments for the 2017-18 fiscal year (4117- 33118) are therefore $38957 mi ll ion

It is important to recognize that these amounts can vary significantly each quarter due to the

inherent uncertainty in benefit payments the effect of the legislative change on payments and

the transition to a new third party claim administrator in the current quarter

bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting

Group (PCG) instead of Alica re This change decreased the administrative expenses of the Fund

on a per month per member basis Based on the current contract we expect $114 m illion to

be paid in administrative expenses over the remai nder of the 2017-18 fiscal year resu lting in

total administrative expenses for fiscal 2017-18 (including both Alicare and PCG) of $484

million

bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012

Compared to Virginia the Fund is having a substantially higher percentage of overall costs in

medical and hospital costs medical equipment and prescription drug costs and corresponding

lower percentages in nursing and long term care costs

bull As of December 31 2017 the number of participants that have received more than $1 million

in benefits payments is sixteen (16) Based on current annual severities by individual member

we expect eight (8) more members to cross this threshold in the next twelve months

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 4

March 30 2018

Background

The Medical Indemnity Fund was established in 2011 to provide a funding source for future health

care costs associated with birth-related neurological injuries Enrollees of the Fund are plaintiffs in

medica l malpractice actions who have received either court-approved settlements or j udgments

deeming the plaintiffs neurological impairments to be birth-related 1 More specifically a birthshy

related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of

labor delivery or resuscitation or by the provision or non-provision of other medical services duri ng

the delivery admission 2 These injuries must result in a physical impairment a developmental

disability or both

Benefits provided by the Fund include

bull Medical Dental Surgical and Hospita l Care

bull Nursing and Custodia l Care

bull Prescription and Non-Prescription Drugs

bull Rehabilitation Services

bull Durable Medical Equipment and Assistive Technology

bull Certain Home and Vehicle Modifications

bull Other Health Care Costs for Medical Services and Supplies for Participants

The New York State Department of Financial Services (NYS DFS) serves as the administrator of the

Fund For the fi rst year of the MlFs operations Sedgwick CMS served as the Funds third party

administrators (TPA) For the second year of operations they were replaced by Alica re As of

September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues

to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the

Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related

Neurologica l Injury Compensation Fund and the Florida Neurological Injury Compensation Association

The Fund currently is financed through a budget allocation from the state of New York Any party to a

medical professiona l liability claim can request for the judgment to reflect eligibility for participation in

the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund

1 Provided by NY DFS 2 htt pwwwdfsnygovinsurance mifmif_faqs ht m

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 5

March 30 2018

Data Methods amp Assumptions

Given that the Fund has been in operation for on ly six years a number of sources of information are

still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Publ ic

Consulting Group to ensure that their claims databases are sufficient to support these ongoing

quarterly reports and to enhance the ongoing management of the Fund As a result we have

introd uced more ana lysis by benefit category (ie nursing medical hospital prescription drugs etc)

and inj ury type

Early in the Funds operations some health care benefits that should have been paid by the Fund were

erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment

information on these costs by the New York Department of Health (DOH) and they are reflected in the

exhibits

Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for

the birth injury funds in Virginia and Florida as well as medical professional liabi lity insurers in the

state of New York These have been significantly modified based on data from the Fund as it becomes

more credible

One significant area of ongoing review of assumptions relates to the expected number of claims per

10000 live births Initia lly 110 participants per 10000 births were assumed based on data from

Virginia and Florida After the first year the frequency rate was increased to 290 participants per

10000 births In the first quarter 2014 report the expected number of eligible Fund participants was

increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal

years of experience and present more rea listic financia l projections for the next five years In late

2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing

frequency data It should be recognized that this is over four times the number of participants per

10000 live births experienced by the bi rth f unds in Florida and Virginia

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 6 March 30 2018

As we are accumulating more credible amounts of benefit payments data several differences are

emerging For example the annual benefit payments during 2016 to Fund participants that were

admitted to the program prior to 2016 (ie participants that have a full year of benefit payments

during 2016) are shown in the following graph and compared to data from Virginia Additional severity

information is contained in Exhibit 1 Page 2 and Exhibit 6

600o

500

400

300

200

100

I I I I 1 I 1 11 bullbull - -00

bull VA Data bull NY Data

There are at least th ree key issues

1) The Fund has sign ificantly more participants with $0 of benefit payments W ill these

participants have benefit payments at some point

2) The Fund has substantially more participants with less than $25000 in annual benefit

payments Is there something about the Funds enabling legislation that is causing this or will

their costs increase over time

3) The Fund had five participants with annual benefits costs over $400000 Virginia has no

participants that breached th is threshold Admittedly there are sample size issues but will this

phenomenon persist

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund -4th Quarter 2017 Page 7 March 30 2018

We are continuing to monitor these phenomena and will add additional analysis in the March 31 2018

actuarial report

In response to this information changes to the assumptions regarding the expected frequency and

severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016

The assumptions wi ll be detai led later in th is report

Discussion and Analysis

Number of Qualifying Participants

Based on the loss runs provided by Sedgwick CMS Alicare and DOH valued as of December 31 2017

there are five hundred sixteen (516) participants that have qualified for the Program as of th is date

five hundred eleven (511) were still living as of December 31 2017 Th is information is summarized in

Exhibit 2

There were eleven (11) new participants to the Fund in the third quarter of fiscal 2017 approximately

fifteen (15) fewer than expected for the quarter

The number of Fund participants and the distribution of participants by age warrants continued

monitoring The average age of a Fund participant at the time of admission is about 85 which is

approximately four years older than the age of a Virginia Birth Fund participant at admission

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

ll16 3))45

156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

S8 lS3

18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

28S79 67733

12-46

72397

71SJ1

11SOSO

60958

sons

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

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22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

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Ill 59762

105081

600632

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385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

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19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

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68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

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2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

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14A010 vow Sl-4U

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113345 158566 t04SlS ll2 14-4

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9 4)

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122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 4: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund-4th Quarter 2017 Page 2 March 30 2018

Executive Summary

Based on our review of avai lable information regarding the New York State Medical Indemnity Fund as

of December 31 2017 Pinnacle has arrived at a number of key conclusions

bull As of December 31 2017 the Fund had accepted 516 participants (511 living) with expected

future benefit payments of approximately $7288 mill ion and future administrative expenses of

$1147 million assuming a discount rate of 25 With a Fund ba lance as of December 31 2017

of approximately $2361 million this results in an unfunded liability for the Fund of

approximately $6074 million

o Tota l future lifetime benefits for the 511 living Fund participants without discounting is

estimated to be $1779 billion

o The current present va lue of future benefit payments of $7288 million does not

consider any additiona l enrollees that may be admitted to the Fund in the future

o Prior to the impact of legislation passed on December of 2016 each new participant

admitted to the Fund after June 30 2017 would increase the Fund s f uture benefits

payment liabilities by $335 mi ll ion on a nominal basis or a present value of $132

mi ll ion increasing at approximately the medical inflation rate of 35 annual ly from

March 31 2017

o On December 31 2016 new legislation was signed expanding eligibility for the Fund to

non-hospital births and significantly raising rei mbursement rates for the period from

July 1 2017 through December 31 2019 For new participants admitted duri ng this

period a priori estimates of future lifetime benefit payment liabilities increased to $362

million on a nominal basis or a present value of $152 mi ll ion These liabilities vary

depending on the amount of an individual participants benefits that are pa id during the

period of higher reimbursement rates

bull Prior to the beginning of the fisca l year the Fund was expected to have almost

one hundred th ree (10292) additional participants accepted between March 31

2017 and March 31 2018 These new participants were expected to add future

discounted benefits liabi lities of about $1550 million

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 3

March 30 2018

bull There were eleven (11) new participants to the Fund in the third quarter of fiscal

year 2017-18 approximately fifteen (15) less than expected for this period Prior

to this quarter quarterly new participant counts have varied between fifteen

(15) and th irty-five (35) in the last two years

bull The number of eligible participants is expected to continue increasing for at least

thirty years as more eligible participants are admitted to the Fund each year

bull Actual benefit payments in the th ird quarter of the 2017-18 fiscal year (10117-123117) as of

123117 were $754 million for a tota l of $21264 million paid so far in the 2017-18 fiscal year

Of these payments $114 mill ion was allocated back to the second quarter of the fiscal year

(7 117-93017) as there were no claims payments processed in September Expected benefit

payments in the remainder of the 2017-18 fisca l year are $17693 million Estimated tota l

benefit payments for the 2017-18 fiscal year (4117- 33118) are therefore $38957 mi ll ion

It is important to recognize that these amounts can vary significantly each quarter due to the

inherent uncertainty in benefit payments the effect of the legislative change on payments and

the transition to a new third party claim administrator in the current quarter

bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting

Group (PCG) instead of Alica re This change decreased the administrative expenses of the Fund

on a per month per member basis Based on the current contract we expect $114 m illion to

be paid in administrative expenses over the remai nder of the 2017-18 fiscal year resu lting in

total administrative expenses for fiscal 2017-18 (including both Alicare and PCG) of $484

million

bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012

Compared to Virginia the Fund is having a substantially higher percentage of overall costs in

medical and hospital costs medical equipment and prescription drug costs and corresponding

lower percentages in nursing and long term care costs

bull As of December 31 2017 the number of participants that have received more than $1 million

in benefits payments is sixteen (16) Based on current annual severities by individual member

we expect eight (8) more members to cross this threshold in the next twelve months

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 4

March 30 2018

Background

The Medical Indemnity Fund was established in 2011 to provide a funding source for future health

care costs associated with birth-related neurological injuries Enrollees of the Fund are plaintiffs in

medica l malpractice actions who have received either court-approved settlements or j udgments

deeming the plaintiffs neurological impairments to be birth-related 1 More specifically a birthshy

related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of

labor delivery or resuscitation or by the provision or non-provision of other medical services duri ng

the delivery admission 2 These injuries must result in a physical impairment a developmental

disability or both

Benefits provided by the Fund include

bull Medical Dental Surgical and Hospita l Care

bull Nursing and Custodia l Care

bull Prescription and Non-Prescription Drugs

bull Rehabilitation Services

bull Durable Medical Equipment and Assistive Technology

bull Certain Home and Vehicle Modifications

bull Other Health Care Costs for Medical Services and Supplies for Participants

The New York State Department of Financial Services (NYS DFS) serves as the administrator of the

Fund For the fi rst year of the MlFs operations Sedgwick CMS served as the Funds third party

administrators (TPA) For the second year of operations they were replaced by Alica re As of

September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues

to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the

Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related

Neurologica l Injury Compensation Fund and the Florida Neurological Injury Compensation Association

The Fund currently is financed through a budget allocation from the state of New York Any party to a

medical professiona l liability claim can request for the judgment to reflect eligibility for participation in

the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund

1 Provided by NY DFS 2 htt pwwwdfsnygovinsurance mifmif_faqs ht m

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 5

March 30 2018

Data Methods amp Assumptions

Given that the Fund has been in operation for on ly six years a number of sources of information are

still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Publ ic

Consulting Group to ensure that their claims databases are sufficient to support these ongoing

quarterly reports and to enhance the ongoing management of the Fund As a result we have

introd uced more ana lysis by benefit category (ie nursing medical hospital prescription drugs etc)

and inj ury type

Early in the Funds operations some health care benefits that should have been paid by the Fund were

erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment

information on these costs by the New York Department of Health (DOH) and they are reflected in the

exhibits

Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for

the birth injury funds in Virginia and Florida as well as medical professional liabi lity insurers in the

state of New York These have been significantly modified based on data from the Fund as it becomes

more credible

One significant area of ongoing review of assumptions relates to the expected number of claims per

10000 live births Initia lly 110 participants per 10000 births were assumed based on data from

Virginia and Florida After the first year the frequency rate was increased to 290 participants per

10000 births In the first quarter 2014 report the expected number of eligible Fund participants was

increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal

years of experience and present more rea listic financia l projections for the next five years In late

2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing

frequency data It should be recognized that this is over four times the number of participants per

10000 live births experienced by the bi rth f unds in Florida and Virginia

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 6 March 30 2018

As we are accumulating more credible amounts of benefit payments data several differences are

emerging For example the annual benefit payments during 2016 to Fund participants that were

admitted to the program prior to 2016 (ie participants that have a full year of benefit payments

during 2016) are shown in the following graph and compared to data from Virginia Additional severity

information is contained in Exhibit 1 Page 2 and Exhibit 6

600o

500

400

300

200

100

I I I I 1 I 1 11 bullbull - -00

bull VA Data bull NY Data

There are at least th ree key issues

1) The Fund has sign ificantly more participants with $0 of benefit payments W ill these

participants have benefit payments at some point

2) The Fund has substantially more participants with less than $25000 in annual benefit

payments Is there something about the Funds enabling legislation that is causing this or will

their costs increase over time

3) The Fund had five participants with annual benefits costs over $400000 Virginia has no

participants that breached th is threshold Admittedly there are sample size issues but will this

phenomenon persist

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund -4th Quarter 2017 Page 7 March 30 2018

We are continuing to monitor these phenomena and will add additional analysis in the March 31 2018

actuarial report

In response to this information changes to the assumptions regarding the expected frequency and

severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016

The assumptions wi ll be detai led later in th is report

Discussion and Analysis

Number of Qualifying Participants

Based on the loss runs provided by Sedgwick CMS Alicare and DOH valued as of December 31 2017

there are five hundred sixteen (516) participants that have qualified for the Program as of th is date

five hundred eleven (511) were still living as of December 31 2017 Th is information is summarized in

Exhibit 2

There were eleven (11) new participants to the Fund in the third quarter of fiscal 2017 approximately

fifteen (15) fewer than expected for the quarter

The number of Fund participants and the distribution of participants by age warrants continued

monitoring The average age of a Fund participant at the time of admission is about 85 which is

approximately four years older than the age of a Virginia Birth Fund participant at admission

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

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11909 717 213939

11222 371

780 41406

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10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

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lll 108661 475SS

322 973

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110923 1912ampS

I 51 481

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ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

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6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

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60 1609

15181 9529

132 707 105 657 731

118971

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100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

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3195)

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230680

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42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

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3163952 73694

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601 061

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601061

171 220 911892 S62 490 601061

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206 099

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015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

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10 141

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115 )61

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4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

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2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

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14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 5: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund-4th Quarter 2017 Page 3

March 30 2018

bull There were eleven (11) new participants to the Fund in the third quarter of fiscal

year 2017-18 approximately fifteen (15) less than expected for this period Prior

to this quarter quarterly new participant counts have varied between fifteen

(15) and th irty-five (35) in the last two years

bull The number of eligible participants is expected to continue increasing for at least

thirty years as more eligible participants are admitted to the Fund each year

bull Actual benefit payments in the th ird quarter of the 2017-18 fiscal year (10117-123117) as of

123117 were $754 million for a tota l of $21264 million paid so far in the 2017-18 fiscal year

Of these payments $114 mill ion was allocated back to the second quarter of the fiscal year

(7 117-93017) as there were no claims payments processed in September Expected benefit

payments in the remainder of the 2017-18 fisca l year are $17693 million Estimated tota l

benefit payments for the 2017-18 fiscal year (4117- 33118) are therefore $38957 mi ll ion

It is important to recognize that these amounts can vary significantly each quarter due to the

inherent uncertainty in benefit payments the effect of the legislative change on payments and

the transition to a new third party claim administrator in the current quarter

bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting

Group (PCG) instead of Alica re This change decreased the administrative expenses of the Fund

on a per month per member basis Based on the current contract we expect $114 m illion to

be paid in administrative expenses over the remai nder of the 2017-18 fiscal year resu lting in

total administrative expenses for fiscal 2017-18 (including both Alicare and PCG) of $484

million

bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012

Compared to Virginia the Fund is having a substantially higher percentage of overall costs in

medical and hospital costs medical equipment and prescription drug costs and corresponding

lower percentages in nursing and long term care costs

bull As of December 31 2017 the number of participants that have received more than $1 million

in benefits payments is sixteen (16) Based on current annual severities by individual member

we expect eight (8) more members to cross this threshold in the next twelve months

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 4

March 30 2018

Background

The Medical Indemnity Fund was established in 2011 to provide a funding source for future health

care costs associated with birth-related neurological injuries Enrollees of the Fund are plaintiffs in

medica l malpractice actions who have received either court-approved settlements or j udgments

deeming the plaintiffs neurological impairments to be birth-related 1 More specifically a birthshy

related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of

labor delivery or resuscitation or by the provision or non-provision of other medical services duri ng

the delivery admission 2 These injuries must result in a physical impairment a developmental

disability or both

Benefits provided by the Fund include

bull Medical Dental Surgical and Hospita l Care

bull Nursing and Custodia l Care

bull Prescription and Non-Prescription Drugs

bull Rehabilitation Services

bull Durable Medical Equipment and Assistive Technology

bull Certain Home and Vehicle Modifications

bull Other Health Care Costs for Medical Services and Supplies for Participants

The New York State Department of Financial Services (NYS DFS) serves as the administrator of the

Fund For the fi rst year of the MlFs operations Sedgwick CMS served as the Funds third party

administrators (TPA) For the second year of operations they were replaced by Alica re As of

September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues

to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the

Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related

Neurologica l Injury Compensation Fund and the Florida Neurological Injury Compensation Association

The Fund currently is financed through a budget allocation from the state of New York Any party to a

medical professiona l liability claim can request for the judgment to reflect eligibility for participation in

the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund

1 Provided by NY DFS 2 htt pwwwdfsnygovinsurance mifmif_faqs ht m

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 5

March 30 2018

Data Methods amp Assumptions

Given that the Fund has been in operation for on ly six years a number of sources of information are

still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Publ ic

Consulting Group to ensure that their claims databases are sufficient to support these ongoing

quarterly reports and to enhance the ongoing management of the Fund As a result we have

introd uced more ana lysis by benefit category (ie nursing medical hospital prescription drugs etc)

and inj ury type

Early in the Funds operations some health care benefits that should have been paid by the Fund were

erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment

information on these costs by the New York Department of Health (DOH) and they are reflected in the

exhibits

Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for

the birth injury funds in Virginia and Florida as well as medical professional liabi lity insurers in the

state of New York These have been significantly modified based on data from the Fund as it becomes

more credible

One significant area of ongoing review of assumptions relates to the expected number of claims per

10000 live births Initia lly 110 participants per 10000 births were assumed based on data from

Virginia and Florida After the first year the frequency rate was increased to 290 participants per

10000 births In the first quarter 2014 report the expected number of eligible Fund participants was

increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal

years of experience and present more rea listic financia l projections for the next five years In late

2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing

frequency data It should be recognized that this is over four times the number of participants per

10000 live births experienced by the bi rth f unds in Florida and Virginia

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 6 March 30 2018

As we are accumulating more credible amounts of benefit payments data several differences are

emerging For example the annual benefit payments during 2016 to Fund participants that were

admitted to the program prior to 2016 (ie participants that have a full year of benefit payments

during 2016) are shown in the following graph and compared to data from Virginia Additional severity

information is contained in Exhibit 1 Page 2 and Exhibit 6

600o

500

400

300

200

100

I I I I 1 I 1 11 bullbull - -00

bull VA Data bull NY Data

There are at least th ree key issues

1) The Fund has sign ificantly more participants with $0 of benefit payments W ill these

participants have benefit payments at some point

2) The Fund has substantially more participants with less than $25000 in annual benefit

payments Is there something about the Funds enabling legislation that is causing this or will

their costs increase over time

3) The Fund had five participants with annual benefits costs over $400000 Virginia has no

participants that breached th is threshold Admittedly there are sample size issues but will this

phenomenon persist

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund -4th Quarter 2017 Page 7 March 30 2018

We are continuing to monitor these phenomena and will add additional analysis in the March 31 2018

actuarial report

In response to this information changes to the assumptions regarding the expected frequency and

severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016

The assumptions wi ll be detai led later in th is report

Discussion and Analysis

Number of Qualifying Participants

Based on the loss runs provided by Sedgwick CMS Alicare and DOH valued as of December 31 2017

there are five hundred sixteen (516) participants that have qualified for the Program as of th is date

five hundred eleven (511) were still living as of December 31 2017 Th is information is summarized in

Exhibit 2

There were eleven (11) new participants to the Fund in the third quarter of fiscal 2017 approximately

fifteen (15) fewer than expected for the quarter

The number of Fund participants and the distribution of participants by age warrants continued

monitoring The average age of a Fund participant at the time of admission is about 85 which is

approximately four years older than the age of a Virginia Birth Fund participant at admission

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

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156 1380

348

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1885 5296 2329 4303

10483 6

6108

186

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27333 7823

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7389

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918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

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42839

13389 20382

14477

21n4

37924

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17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

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60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

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12-46

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65684

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126623 62708

129760

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133980

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12656C S270S

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158480

156200

36957 94708

105634

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92S60 1 1-31

71305

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167 131 88 166

188953 II0064 3SJ1

1062S4

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164791 111281

84599

156117

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27783 184912

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203563 S2078

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12279 116307

18619

128877 108028

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110970 llS772 221))92

57645

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31451

228570 120 l SO 258969

246076

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104169

190383

144573

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lW 67501

33179 250713

129218 291831

275891

73957

1SOS5

11661

2u1n 152813

Siil n38gt 37502

270969 139466

322187

298075

8033

161620

12602

235707

Jiil 295227 152319

34ABSO

32A-898S1

167434

137572

ma 84674

38987

317058

164644

370SOO 356319

98064 176090

1112 89190

40293 338117

H l180

415234

391371 102742

llZII 93743

43985 361616 18675lt

4S3432

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202315 472517

lW 104246

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415819

21279

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Jiil 116Q28

750S7

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201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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717 lll m 216063

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1A63J3 31 812 to857 36713

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ml deg u osn

1218933 1 193tl

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120264 J31801 254 065 JSl 669 JSS6M

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ml ma 47626 21564 22710 11639

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Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

CU-itlw IMllfltsbyFUNI P1nldpldon ~

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109 114 196914 457936 990gt8 l7S521 623900 990171

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uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

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ma l 176J04 ll961

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 6: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund-4th Quarter 2017 Page 4

March 30 2018

Background

The Medical Indemnity Fund was established in 2011 to provide a funding source for future health

care costs associated with birth-related neurological injuries Enrollees of the Fund are plaintiffs in

medica l malpractice actions who have received either court-approved settlements or j udgments

deeming the plaintiffs neurological impairments to be birth-related 1 More specifically a birthshy

related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of

labor delivery or resuscitation or by the provision or non-provision of other medical services duri ng

the delivery admission 2 These injuries must result in a physical impairment a developmental

disability or both

Benefits provided by the Fund include

bull Medical Dental Surgical and Hospita l Care

bull Nursing and Custodia l Care

bull Prescription and Non-Prescription Drugs

bull Rehabilitation Services

bull Durable Medical Equipment and Assistive Technology

bull Certain Home and Vehicle Modifications

bull Other Health Care Costs for Medical Services and Supplies for Participants

The New York State Department of Financial Services (NYS DFS) serves as the administrator of the

Fund For the fi rst year of the MlFs operations Sedgwick CMS served as the Funds third party

administrators (TPA) For the second year of operations they were replaced by Alica re As of

September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues

to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the

Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related

Neurologica l Injury Compensation Fund and the Florida Neurological Injury Compensation Association

The Fund currently is financed through a budget allocation from the state of New York Any party to a

medical professiona l liability claim can request for the judgment to reflect eligibility for participation in

the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund

1 Provided by NY DFS 2 htt pwwwdfsnygovinsurance mifmif_faqs ht m

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund-4th Quarter 2017 Page 5

March 30 2018

Data Methods amp Assumptions

Given that the Fund has been in operation for on ly six years a number of sources of information are

still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Publ ic

Consulting Group to ensure that their claims databases are sufficient to support these ongoing

quarterly reports and to enhance the ongoing management of the Fund As a result we have

introd uced more ana lysis by benefit category (ie nursing medical hospital prescription drugs etc)

and inj ury type

Early in the Funds operations some health care benefits that should have been paid by the Fund were

erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment

information on these costs by the New York Department of Health (DOH) and they are reflected in the

exhibits

Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for

the birth injury funds in Virginia and Florida as well as medical professional liabi lity insurers in the

state of New York These have been significantly modified based on data from the Fund as it becomes

more credible

One significant area of ongoing review of assumptions relates to the expected number of claims per

10000 live births Initia lly 110 participants per 10000 births were assumed based on data from

Virginia and Florida After the first year the frequency rate was increased to 290 participants per

10000 births In the first quarter 2014 report the expected number of eligible Fund participants was

increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal

years of experience and present more rea listic financia l projections for the next five years In late

2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing

frequency data It should be recognized that this is over four times the number of participants per

10000 live births experienced by the bi rth f unds in Florida and Virginia

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 6 March 30 2018

As we are accumulating more credible amounts of benefit payments data several differences are

emerging For example the annual benefit payments during 2016 to Fund participants that were

admitted to the program prior to 2016 (ie participants that have a full year of benefit payments

during 2016) are shown in the following graph and compared to data from Virginia Additional severity

information is contained in Exhibit 1 Page 2 and Exhibit 6

600o

500

400

300

200

100

I I I I 1 I 1 11 bullbull - -00

bull VA Data bull NY Data

There are at least th ree key issues

1) The Fund has sign ificantly more participants with $0 of benefit payments W ill these

participants have benefit payments at some point

2) The Fund has substantially more participants with less than $25000 in annual benefit

payments Is there something about the Funds enabling legislation that is causing this or will

their costs increase over time

3) The Fund had five participants with annual benefits costs over $400000 Virginia has no

participants that breached th is threshold Admittedly there are sample size issues but will this

phenomenon persist

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund -4th Quarter 2017 Page 7 March 30 2018

We are continuing to monitor these phenomena and will add additional analysis in the March 31 2018

actuarial report

In response to this information changes to the assumptions regarding the expected frequency and

severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016

The assumptions wi ll be detai led later in th is report

Discussion and Analysis

Number of Qualifying Participants

Based on the loss runs provided by Sedgwick CMS Alicare and DOH valued as of December 31 2017

there are five hundred sixteen (516) participants that have qualified for the Program as of th is date

five hundred eleven (511) were still living as of December 31 2017 Th is information is summarized in

Exhibit 2

There were eleven (11) new participants to the Fund in the third quarter of fiscal 2017 approximately

fifteen (15) fewer than expected for the quarter

The number of Fund participants and the distribution of participants by age warrants continued

monitoring The average age of a Fund participant at the time of admission is about 85 which is

approximately four years older than the age of a Virginia Birth Fund participant at admission

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

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11909 717 213939

11222 371

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10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

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lll 108661 475SS

322 973

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110923 1912ampS

I 51 481

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ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

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6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

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15181 9529

132 707 105 657 731

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SOU)

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3195)

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42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

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3163952 73694

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601 061

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601061

171 220 911892 S62 490 601061

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206 099

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015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

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213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

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124 654

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2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

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73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

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21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

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14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

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9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 7: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund-4th Quarter 2017 Page 5

March 30 2018

Data Methods amp Assumptions

Given that the Fund has been in operation for on ly six years a number of sources of information are

still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Publ ic

Consulting Group to ensure that their claims databases are sufficient to support these ongoing

quarterly reports and to enhance the ongoing management of the Fund As a result we have

introd uced more ana lysis by benefit category (ie nursing medical hospital prescription drugs etc)

and inj ury type

Early in the Funds operations some health care benefits that should have been paid by the Fund were

erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment

information on these costs by the New York Department of Health (DOH) and they are reflected in the

exhibits

Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for

the birth injury funds in Virginia and Florida as well as medical professional liabi lity insurers in the

state of New York These have been significantly modified based on data from the Fund as it becomes

more credible

One significant area of ongoing review of assumptions relates to the expected number of claims per

10000 live births Initia lly 110 participants per 10000 births were assumed based on data from

Virginia and Florida After the first year the frequency rate was increased to 290 participants per

10000 births In the first quarter 2014 report the expected number of eligible Fund participants was

increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal

years of experience and present more rea listic financia l projections for the next five years In late

2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing

frequency data It should be recognized that this is over four times the number of participants per

10000 live births experienced by the bi rth f unds in Florida and Virginia

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 6 March 30 2018

As we are accumulating more credible amounts of benefit payments data several differences are

emerging For example the annual benefit payments during 2016 to Fund participants that were

admitted to the program prior to 2016 (ie participants that have a full year of benefit payments

during 2016) are shown in the following graph and compared to data from Virginia Additional severity

information is contained in Exhibit 1 Page 2 and Exhibit 6

600o

500

400

300

200

100

I I I I 1 I 1 11 bullbull - -00

bull VA Data bull NY Data

There are at least th ree key issues

1) The Fund has sign ificantly more participants with $0 of benefit payments W ill these

participants have benefit payments at some point

2) The Fund has substantially more participants with less than $25000 in annual benefit

payments Is there something about the Funds enabling legislation that is causing this or will

their costs increase over time

3) The Fund had five participants with annual benefits costs over $400000 Virginia has no

participants that breached th is threshold Admittedly there are sample size issues but will this

phenomenon persist

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund -4th Quarter 2017 Page 7 March 30 2018

We are continuing to monitor these phenomena and will add additional analysis in the March 31 2018

actuarial report

In response to this information changes to the assumptions regarding the expected frequency and

severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016

The assumptions wi ll be detai led later in th is report

Discussion and Analysis

Number of Qualifying Participants

Based on the loss runs provided by Sedgwick CMS Alicare and DOH valued as of December 31 2017

there are five hundred sixteen (516) participants that have qualified for the Program as of th is date

five hundred eleven (511) were still living as of December 31 2017 Th is information is summarized in

Exhibit 2

There were eleven (11) new participants to the Fund in the third quarter of fiscal 2017 approximately

fifteen (15) fewer than expected for the quarter

The number of Fund participants and the distribution of participants by age warrants continued

monitoring The average age of a Fund participant at the time of admission is about 85 which is

approximately four years older than the age of a Virginia Birth Fund participant at admission

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

ll16 3))45

156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

S8 lS3

18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

28S79 67733

12-46

72397

71SJ1

11SOSO

60958

sons

106613 u 12 66731

65684

~

45957

1S27J

126623 62708

129760

128822

32si

81136

S2amp06

M370 amp22S

133980

7~861 6391l

12656C S270S

1023

JWl 21195

17720 7418amp

158480

156200

36957 94708

105634

95506 11201

92S60 1 1-31

71305

lW 51248

242Sl

167 131 88 166

188953 II0064 3SJ1

1062S4

75988

U3m7

lOS693

164791 111281

84599

156117

lW 56231

27783 184912

98871 211)16

203563 S2078

116280

amp922

12279 116307

18619

128877 108028

lW 60S61 29i48

205461

110970 llS772 221))92

57645

128B91

94958 1613

1)t940

209167

147965

Siil 63067

31451

228570 120 l SO 258969

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 8: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 6 March 30 2018

As we are accumulating more credible amounts of benefit payments data several differences are

emerging For example the annual benefit payments during 2016 to Fund participants that were

admitted to the program prior to 2016 (ie participants that have a full year of benefit payments

during 2016) are shown in the following graph and compared to data from Virginia Additional severity

information is contained in Exhibit 1 Page 2 and Exhibit 6

600o

500

400

300

200

100

I I I I 1 I 1 11 bullbull - -00

bull VA Data bull NY Data

There are at least th ree key issues

1) The Fund has sign ificantly more participants with $0 of benefit payments W ill these

participants have benefit payments at some point

2) The Fund has substantially more participants with less than $25000 in annual benefit

payments Is there something about the Funds enabling legislation that is causing this or will

their costs increase over time

3) The Fund had five participants with annual benefits costs over $400000 Virginia has no

participants that breached th is threshold Admittedly there are sample size issues but will this

phenomenon persist

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund -4th Quarter 2017 Page 7 March 30 2018

We are continuing to monitor these phenomena and will add additional analysis in the March 31 2018

actuarial report

In response to this information changes to the assumptions regarding the expected frequency and

severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016

The assumptions wi ll be detai led later in th is report

Discussion and Analysis

Number of Qualifying Participants

Based on the loss runs provided by Sedgwick CMS Alicare and DOH valued as of December 31 2017

there are five hundred sixteen (516) participants that have qualified for the Program as of th is date

five hundred eleven (511) were still living as of December 31 2017 Th is information is summarized in

Exhibit 2

There were eleven (11) new participants to the Fund in the third quarter of fiscal 2017 approximately

fifteen (15) fewer than expected for the quarter

The number of Fund participants and the distribution of participants by age warrants continued

monitoring The average age of a Fund participant at the time of admission is about 85 which is

approximately four years older than the age of a Virginia Birth Fund participant at admission

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

ll16 3))45

156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

S8 lS3

18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

28S79 67733

12-46

72397

71SJ1

11SOSO

60958

sons

106613 u 12 66731

65684

~

45957

1S27J

126623 62708

129760

128822

32si

81136

S2amp06

M370 amp22S

133980

7~861 6391l

12656C S270S

1023

JWl 21195

17720 7418amp

158480

156200

36957 94708

105634

95506 11201

92S60 1 1-31

71305

lW 51248

242Sl

167 131 88 166

188953 II0064 3SJ1

1062S4

75988

U3m7

lOS693

164791 111281

84599

156117

lW 56231

27783 184912

98871 211)16

203563 S2078

116280

amp922

12279 116307

18619

128877 108028

lW 60S61 29i48

205461

110970 llS772 221))92

57645

128B91

94958 1613

1)t940

209167

147965

Siil 63067

31451

228570 120 l SO 258969

246076

66770

14012S

104169

190383

144573

227684

lW 67501

33179 250713

129218 291831

275891

73957

1SOS5

11661

2u1n 152813

Siil n38gt 37502

270969 139466

322187

298075

8033

161620

12602

235707

Jiil 295227 152319

34ABSO

32A-898S1

167434

137572

ma 84674

38987

317058

164644

370SOO 356319

98064 176090

1112 89190

40293 338117

H l180

415234

391371 102742

llZII 93743

43985 361616 18675lt

4S3432

114s1

lW 9SSgtI

9917 389135

202315 472517

lW 104246

59470

415819

21279

lW 110595

n122 37622

Jiil 116Q28

750S7

SW 121196

201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

raquoUQ4

raquoUQgt

lOUC 2ltgtUQ3_ 1013QJ 2ltgt13Ql

1013Q3middotmiddot- 201) 1015QJ 2ltgt15Ql

raquolSCU gt)1SQ4 gt)16Ql

raquo1Ql

gt)1Q3

201604 2011 201702 017Q3

201104

25 Jl 16 UI

JS

15 29

QI Ill QI 114 1Ml73 U0 am

717 lll m 216063

17222 11) 468

1A63J3 31 812 to857 36713

4106 67708 78 411 17amp462 15717 Zl42 SlOUI 100251 166996 303 2302 1727611

U971 14125 137049 402 UBS07 80551 91 181 172019

lS361 16455 10141 n 17929S

157250 1S1366

12231 174172 472382

167611 lampU79 10

m 12070

16074amp 7030 55oampO

335796

4 10257 321337 16ffl 202020

119511

Ill 4217

219402 14102 1610ll ma 1306amp0

523451 211106 222131 16 1n

lit nno 1U11

171 70amp 2177~

401351 W4062amp2 deg 3amp1114

m 2529 60ll

Ill 101 413

211111 300 45

110508 2554

181 615

431 269 um m n

25471J 1ll 721 amp61 892

22301 151 593

m ~

69656 29373 5050 65147 3J7540

03929 1 165571 1 14amp1agt

1320U 116207 U5157 i 285

227482 40401 l72JU J27022 yen77991 264554

26C 161 l547gtJ 6 18 164 459971 175695 297615 1458J1

ml deg u osn

1218933 1 193tl

197201 31171

120264 J31801 254 065 JSl 669 JSS6M

2194 4561lt

llll 54812

mm U767 2564UI

1CIS91 427 l55

334 311 Sil

ml ma 47626 21564 22710 11639

369731 3017 927857 17645 ll4911

157023 273743 45171 550020

40362 )70J5

w 487111

155 414 22670S

l 3S4514 149015

llll l oamp661

mm

1174 223 110973

19128S

325761 4247

ml 51 481 1 oso

3aal15 Wd

gjl 8 287

isms 26411

ma 49671

3369S4 zg

l 779JSS 175251

~ llll

deg

o 314 147 J89Cll6

1 525926 763401 130411

~

21971

ml 14t Jn

ma

30423

llll IOlll 13JJ154

SJ19839

18900696 2087 267

3082171 475424 1100574 4178 43 J820 ua 45SJ690

2 811 331 2916751 4839618

1140117 1 480454

1 311 684

ou

10

516 1sm 004

Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

CU-itlw IMllfltsbyFUNI P1nldpldon ~

raquo U Q4

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lOUQl 20UQ3

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21116Qgt 21116Q1 21116Ql 21116Q4 2017Q)

2017Ql

21117Q4

16

30 17

19

10 19 17 31

16 10 11 lS 19 19

lll

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1609 3902

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Ill 3

ll4 76U7 41 15841 ltO lJl

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ltl59U 508

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437331 U 4 1S3 1 093SSS 1 313)11 (7089 622100 mm 104 l 278C81 1198927

U 6J7 48351 IS 4 17112S

109 114 196914 457936 990gt8 l7S521 623900 990171

000 145380 183334

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17194 JS1 7l2 S50336 444 04gt 639416 amp70096 1yenr7995 l 7382Sl 2 261 Ml

uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

3146 16 WOU

Ill 334 J91 937

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1 S07937 lct1929 1 151115 2643417

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11111 390 4 233149

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ml 1216546 7001918

ma l 176J04 ll961

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 9: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund -4th Quarter 2017 Page 7 March 30 2018

We are continuing to monitor these phenomena and will add additional analysis in the March 31 2018

actuarial report

In response to this information changes to the assumptions regarding the expected frequency and

severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016

The assumptions wi ll be detai led later in th is report

Discussion and Analysis

Number of Qualifying Participants

Based on the loss runs provided by Sedgwick CMS Alicare and DOH valued as of December 31 2017

there are five hundred sixteen (516) participants that have qualified for the Program as of th is date

five hundred eleven (511) were still living as of December 31 2017 Th is information is summarized in

Exhibit 2

There were eleven (11) new participants to the Fund in the third quarter of fiscal 2017 approximately

fifteen (15) fewer than expected for the quarter

The number of Fund participants and the distribution of participants by age warrants continued

monitoring The average age of a Fund participant at the time of admission is about 85 which is

approximately four years older than the age of a Virginia Birth Fund participant at admission

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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lll 8569

gs

13107

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2012Q2 2012Q3 2012Q4

16

25 40

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689

13371 2356

1890

13917

bull bull 779 l658

llSO

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10795

13797

630

15598

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20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

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2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

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16950 11971

2017Q2 2017Q3

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201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

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20 1SQl

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2016Ql

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11 11 16

25 0

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50S2

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11287

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

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11909 717 213939

11222 371

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22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 10: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 8 March 30 2018

Average Entry Age

120

110

100

90

80

70

60

m

so

40

~ Average Age

Mortal ity ExperienceLife Expectancy

It is reasonable to expect that average life expectancies for Fund participants will average in the high

twenties as a group unless the different admission standards materially change life expectancies

relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fu nd

are 284 years from birth and 292 years for participants that reach the age of three (3) As of

December 31 2017 the Fund has experienced the death of only five of its participants (we were

notified that one more member passed away after December 31 2017) The following graph compares

the age of current participants with the expected age distribution based on the Virginia Birth Fund

data

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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lll 8569

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bull bull 779 l658

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10248

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21060

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38148

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19085

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21803

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2017Ql 15 19

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16950 11971

2017Q2 2017Q3

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201704 11 83

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Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

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20 13Q2

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

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9 14417 21606l 117155 431812

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9 42 161

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9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

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1 165671 132023 116207 61 8U

92 29373 65 147

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136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

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69 738 229506 921857 124 918 213143

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42 227 312 432 2496n 2S4 713 212128

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404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

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3163952 73694

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601 061

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601061

171 220 911892 S62 490 601061

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148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

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165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

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73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 11: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 9 March 30 2018

Participant Distribution by Age 90

80

70

60 c

a middot sot n-0

Gl 40 Cl

E z

30

20

10

-

- - - - - -gt- gt- gt- - gt- - gt- - - -

_

IJ - I I bull I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Current Age

bull Actual ff of Participants bull Expected It of Participants

Actuarial Ca lculation of Estimated Fund Liabilities

We have been asked to project expected fund liabilities for the next ten fisca l years of the M IF To do

th is we have estimated the ultimate benefit payments for the participants admitted to the Fund each

quarter on both a nominal and discounted basis Three methods were used to estimate ultimate

benefit payments by the year in which a participant was accepted to the fund A loss development

method was used in which actua l benefit payments to date were d ivided by the expected percentage

of ultimate benefits as of each participant-quarters maturity These percentages were developed

based on information for the Virginia Birth Fund and modified to reflect the older average age of the

Fund participants upon admittance An expected loss method was also used in which expected

ultimate benefit payments by quarter were also estimated using a weighted average of expected

average ultimate benefit payments per Fund participant overall and by quarter of eligibi lity Finally a

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

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201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

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20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

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19

29

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85

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16353

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11287

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33179 250713

129218 291831

275891

73957

1SOS5

11661

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270969 139466

322187

298075

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235707

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34ABSO

32A-898S1

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137572

ma 84674

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164644

370SOO 356319

98064 176090

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40293 338117

H l180

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4S3432

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202315 472517

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201704 11 8l

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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1A63J3 31 812 to857 36713

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Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 12: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 10 March 30 2018

Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected

losses and loss development techniques

These ultimate benefits amounts are then allocated to future payment quarter based on the benefits

payment patterns described previously To state future payments on a discounted basis a discount

rate of 25 was used This is based on discount rates for other medical professiona l liability insurance

programs in New York Prior to the recent legislative change average lifetime benefit payments were

estimated to average $335 million per participant on a nominal basis and $132 mil lion on a

discounted basis using a 25 discount rate This amount increases annually to account for medical

inflation For new participants admitted subsequent to the law change an a priori estimate of future

lifetime benefits payment liabi lities increases to an average of $362 million on a nominal basis or a

present va lue of $152 mil lion These liabilities will vary depending on the amount of an individual

participant s benefits that are paid during the period of higher reimbursement rates The timing of the

payments used in our severity estimates also reflect the amount of time a participant is expected to

live so that these severities take participant mortality into account

Based on this approach and the new law we estimate that the 516 admitted Fund participants wi ll

ultimately receive benefits on the order of $1855 billion Adjusting for the time va lue of money at a

25 discount rate resu lts in a present value for these benefits of $8046 million

Actual benefit payments in the third quarter of the 2017-18 fisca l year were $754 million Of this

amount $114 million was allocated back to the second quarter of the 2017-18 fisca l year to account

for no claims payments being processed in September Based on updated severity and payment timing

estimates the expected 2583 additional participants and the legislative impact estimated benefit

payments for the 2017-18 fiscal year will be $38957 million It is important to recognize that these

amounts can vary significantly each quarter The change from our estimate of $52177 for fisca l year

2017-18 in the prior ana lysis is due to lower than expected benefit payments in the last four months

Severa l factors cou ld contribute to this development including both the impact of changing third party

administrators and a lower than expected increase in claim costs as a resu lt of the December 31 2016

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

ll16 3))45

156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

S8 lS3

18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

28S79 67733

12-46

72397

71SJ1

11SOSO

60958

sons

106613 u 12 66731

65684

~

45957

1S27J

126623 62708

129760

128822

32si

81136

S2amp06

M370 amp22S

133980

7~861 6391l

12656C S270S

1023

JWl 21195

17720 7418amp

158480

156200

36957 94708

105634

95506 11201

92S60 1 1-31

71305

lW 51248

242Sl

167 131 88 166

188953 II0064 3SJ1

1062S4

75988

U3m7

lOS693

164791 111281

84599

156117

lW 56231

27783 184912

98871 211)16

203563 S2078

116280

amp922

12279 116307

18619

128877 108028

lW 60S61 29i48

205461

110970 llS772 221))92

57645

128B91

94958 1613

1)t940

209167

147965

Siil 63067

31451

228570 120 l SO 258969

246076

66770

14012S

104169

190383

144573

227684

lW 67501

33179 250713

129218 291831

275891

73957

1SOS5

11661

2u1n 152813

Siil n38gt 37502

270969 139466

322187

298075

8033

161620

12602

235707

Jiil 295227 152319

34ABSO

32A-898S1

167434

137572

ma 84674

38987

317058

164644

370SOO 356319

98064 176090

1112 89190

40293 338117

H l180

415234

391371 102742

llZII 93743

43985 361616 18675lt

4S3432

114s1

lW 9SSgtI

9917 389135

202315 472517

lW 104246

59470

415819

21279

lW 110595

n122 37622

Jiil 116Q28

750S7

SW 121196

201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

raquoUQ4

raquoUQgt

lOUC 2ltgtUQ3_ 1013QJ 2ltgt13Ql

1013Q3middotmiddot- 201) 1015QJ 2ltgt15Ql

raquolSCU gt)1SQ4 gt)16Ql

raquo1Ql

gt)1Q3

201604 2011 201702 017Q3

201104

25 Jl 16 UI

JS

15 29

QI Ill QI 114 1Ml73 U0 am

717 lll m 216063

17222 11) 468

1A63J3 31 812 to857 36713

4106 67708 78 411 17amp462 15717 Zl42 SlOUI 100251 166996 303 2302 1727611

U971 14125 137049 402 UBS07 80551 91 181 172019

lS361 16455 10141 n 17929S

157250 1S1366

12231 174172 472382

167611 lampU79 10

m 12070

16074amp 7030 55oampO

335796

4 10257 321337 16ffl 202020

119511

Ill 4217

219402 14102 1610ll ma 1306amp0

523451 211106 222131 16 1n

lit nno 1U11

171 70amp 2177~

401351 W4062amp2 deg 3amp1114

m 2529 60ll

Ill 101 413

211111 300 45

110508 2554

181 615

431 269 um m n

25471J 1ll 721 amp61 892

22301 151 593

m ~

69656 29373 5050 65147 3J7540

03929 1 165571 1 14amp1agt

1320U 116207 U5157 i 285

227482 40401 l72JU J27022 yen77991 264554

26C 161 l547gtJ 6 18 164 459971 175695 297615 1458J1

ml deg u osn

1218933 1 193tl

197201 31171

120264 J31801 254 065 JSl 669 JSS6M

2194 4561lt

llll 54812

mm U767 2564UI

1CIS91 427 l55

334 311 Sil

ml ma 47626 21564 22710 11639

369731 3017 927857 17645 ll4911

157023 273743 45171 550020

40362 )70J5

w 487111

155 414 22670S

l 3S4514 149015

llll l oamp661

mm

1174 223 110973

19128S

325761 4247

ml 51 481 1 oso

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ma 49671

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1 525926 763401 130411

~

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18900696 2087 267

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ou

10

516 1sm 004

Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

CU-itlw IMllfltsbyFUNI P1nldpldon ~

raquo U Q4

raquoUQJ

lOUQl 20UQ3

10Ultl4 211lJQ1

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1014 101SQJ OlSQl

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21116Qgt 21116Q1 21116Ql 21116Q4 2017Q)

2017Ql

21117Q4

16

30 17

19

10 19 17 31

16 10 11 lS 19 19

lll

n1

371

60

deg 3094S

1609 3902

137049

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70

Ill 3

ll4 76U7 41 15841 ltO lJl

l30U1 74 960 mm 30164

ltl59U 508

1S7ZSO 122431

lll lli m lli

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437331 U 4 1S3 1 093SSS 1 313)11 (7089 622100 mm 104 l 278C81 1198927

U 6J7 48351 IS 4 17112S

109 114 196914 457936 990gt8 l7S521 623900 990171

000 145380 183334

U0389 107J8S deg 720517 H5179 1 157563 714 566 1 157055 144991amp 1 7551S

17194 JS1 7l2 S50336 444 04gt 639416 amp70096 1yenr7995 l 7382Sl 2 261 Ml

uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

3146 16 WOU

Ill 334 J91 937

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1 S07937 lct1929 1 151115 2643417

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17SS213 2301 605 1158207

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1813023 1000636 219 596

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843272 1 80454

11111 390 4 233149

2J635l3 185690 6339199

l l087U 25$7 109

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2007 051 2J8765amp

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l ampU7294 2087 27

JW 1086949 6226162 50578

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ml

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ml 1216546 7001918

ma l 176J04 ll961

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Ia l 3JJ lS4

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1 100574

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nm004

Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 13: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 11 March 30 2018

legislative change We will continue to monitor this estimation methodology closely as it is quite

sensitive to severa l key assumptions

The number of eligible participants is expected to continue increasing for at least 30 years as more

eligible participants are admitted to the Fund each year

Amount of Benefits Paid

Based on payment data provided by PCG $754 million has been paid to Fund participants during the

third quarter of the 2017-18 fiscal year (10 117 - 12 31 17) Due to the transition of claims handling

to PCG no claims were paid duri ng the 91 17-9 3017 period As shown in Exhibit 1 $114 million of

the payment amount was allocated to the second quarter of the 2017-18 fiscal year (7 1 17- 9 30 17)

while $639 million was attributed to the th ird quarter of the fiscal year (10 1 17 - 123117)

We are continuing to investigate to see if there are materia l differences in the t ypes of injuries

experienced by participants in the New York Fund versus those in Virginia and Florida that may explain

some of the differences we are seeing between actua l and expected payments We anticipate

providing some additiona l analysis in our March 31 2018 actuarial report

Patterns of Utilization

It is too early in the life of the Fund to provide any credible conclusions regarding patterns of

util ization However Pinnacle is working with PCG to develop the data capabi lities to provide th is type

of ana lysis in the future Specifically we are developing detai led benefit payment information by

participant Fund fisca l year and benefit type The benefit types being captured are intended to reflect

the benefits provided by the Funds legislation and follow form with existing databases in Florida and

Virginia

Exhibit 1 shows payment detail (provided through 12 31 17) grouped into the following categories

bull Medical Treatment

bull Hospita l Based Care

bull Surgical Care

bull Nursing Care

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

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186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 14: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 12 March 30 2018

bull Dental Care

bull Rehabilitation Care

bull Custodial Care

bull Durable Medical Equipment

bull Home Modifications

bull Vehicle Modificat ions

bull Prescription and Non-Prescriptive Drugs

bull Other Healt h Care Costs

bull Assistive Technology

bull Other Payments

Our analysis suggests benefits patterns that are showing some differences from the Virginia dat a To

date t he Fund is having a substantially higher percentage of overall costs in medical and hospita l costs

medica l equipment and prescription drug costs and corresponding lower percentages in nursing and

long-t erm care costs The prescription drug cost s merit continued monitoring and potentially a more

detailed invest igation This data is summarized in Exhibit 1 and shown graphically below Exh ibit 1 also

compares New York dat a t o benefit payments in Virginia Nursing cost s are t he majority of total

payments in bot h states

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

ll16 3))45

156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

S8 lS3

18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

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22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

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Ill 59762

105081

600632

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385028 60062

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2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

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19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

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100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

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3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

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612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

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2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

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113345 158566 t04SlS ll2 14-4

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9 4)

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122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 15: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 13 M arch 30 2018

Benefit Payments 1012 - 1217

bull Medical Treatment 534

bull Hospita l Based Care 1074

bull Surgical Care 069

bull Nursing Care Sl42

bull Denta l Care 0 21

bull Rehabilitation Care 4 80

bull Custodial Care 426

Durable Med Equip 519

bull Home Modifications 544

Vehicle Modifications 115

bull Rx and Non-Rx Drugs 1007

bull Other Health Care Costs 049

Assistive Technology 000

Other Pay ments 018

Another key aspect of the dat abase needed to evaluate patterns of utilization is d ifferences in the

medical and mental condition of the Funds participants To facilitate th is d imension of our future

analysis Pinnacle worked w ith Alica re to track a number of charact eristics for each Fund participant

including

bull Current Age

bull Gender

bull Injury Description

bull Other Insurance (ie whether participant holds other insurance)

bull Ambulatory Status

bull Use of a gastric feeding tube (G-Tube)

bull Abil ity to lift head from the prone position

bull Use of a ventilat or

bull Use of a tracheostomy tube (trach t ube)

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

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2065

lll 9226

lit 6l32

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lll4 2506~- Ill

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llll 9878

ml 4680

llll 2614

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2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

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17778

9 26132

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29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

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19

32

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~380 1973

200

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52113

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9212

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13432

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21358

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11234

9212 9634

18518

7187

10430

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22989

6376

12065

9399

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12313 4299

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18 191

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16067

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12341

12617 111723

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2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

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6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

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19 25 20

19 27 31 16

20

18

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22 15

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85

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191

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186

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27333 7823

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7389

lA764

38728

918 9627

31ASl 985S

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ll2A 20974 lS611

12ASl

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50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

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42839

13389 20382

14477

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24SOO S197

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17088

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18173 23729

37407

7296

2896S

23682 S6073

17751

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30198

20249

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68347 44973 lA365

15265 36673

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31333 71106

69907

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270969 139466

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

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11909 717 213939

11222 371

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9 14417 21606l 117155 431812

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9 42 161

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9 69656 45050

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92 29373 65 147

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136890 135 157 366426

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3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

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302 461 918 23 8145

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69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 16: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 14

March 30 2018

In Virginia several of t hese charact eristics have been shown to influence life expect ancies and average

annual benefit payments We expect t hey will serve equally va luable to t he Fund as more benefit

payment dat a becomes available

Benefit Payments and Injury Type

For near ly all Fund part icipants the nature of the injury and primary diagnosis permitting entrance into

the Fund has been provided t o Pinnacle as part of t he quarterly Alicare enro llment data Although

st r ict st andardization of participant injury types is not provided sufficiently det ailed descript ions of t he

nature of the injury have allowed us to judgmenta lly categorize participants into standardized injury

type groups As w ith the benefit type categorization injury type categorizat ion can aid in identifyi ng

d ifferences in injury types t hat are relevant to t he management of t he Fund

We have categorized the primary diagnosis for each Fund participant into one of t he followi ng injury

types

bull Brachia Plexus

bull Cerebral Palsy

bull Developmental Delays

bull Encephalopat hy

bull Erbs Palsy

bull Hemiplegia

bull Mental Ret ardation

bull Neurologica l Disabilities

bull Quadriplegia

bull Spast ic Diplegia

bull Spastic Paraplegia

bull Spastic Quadriplegia

bull Other

bull Not Available

The following is a graph of t he distribution of part icipants by injury type group above Spastic

quadriplegia cerebra l pa lsy and encephalopathy combine to make up nearly 73 of total benefit

payments

Pinnacle Actuarial Resources Inc

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

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156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

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18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

28S79 67733

12-46

72397

71SJ1

11SOSO

60958

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106613 u 12 66731

65684

~

45957

1S27J

126623 62708

129760

128822

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81136

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133980

7~861 6391l

12656C S270S

1023

JWl 21195

17720 7418amp

158480

156200

36957 94708

105634

95506 11201

92S60 1 1-31

71305

lW 51248

242Sl

167 131 88 166

188953 II0064 3SJ1

1062S4

75988

U3m7

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164791 111281

84599

156117

lW 56231

27783 184912

98871 211)16

203563 S2078

116280

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12279 116307

18619

128877 108028

lW 60S61 29i48

205461

110970 llS772 221))92

57645

128B91

94958 1613

1)t940

209167

147965

Siil 63067

31451

228570 120 l SO 258969

246076

66770

14012S

104169

190383

144573

227684

lW 67501

33179 250713

129218 291831

275891

73957

1SOS5

11661

2u1n 152813

Siil n38gt 37502

270969 139466

322187

298075

8033

161620

12602

235707

Jiil 295227 152319

34ABSO

32A-898S1

167434

137572

ma 84674

38987

317058

164644

370SOO 356319

98064 176090

1112 89190

40293 338117

H l180

415234

391371 102742

llZII 93743

43985 361616 18675lt

4S3432

114s1

lW 9SSgtI

9917 389135

202315 472517

lW 104246

59470

415819

21279

lW 110595

n122 37622

Jiil 116Q28

750S7

SW 121196

201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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717 lll m 216063

17222 11) 468

1A63J3 31 812 to857 36713

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1218933 1 193tl

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ml ma 47626 21564 22710 11639

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Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

CU-itlw IMllfltsbyFUNI P1nldpldon ~

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109 114 196914 457936 990gt8 l7S521 623900 990171

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uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 17: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State M edical Indemnity Fund - 4th Quarter 2017 Page 15 M arch 30 2018

Benefit Payments 1012 -1217

bull Brachia Plexus 008

bull Erbs Palsy 021

bull Spastic Diplegia 033

bull Hemiplegia 038

bull Mental Retardation 229

bull Developmental Delays 676

Neurological Disabilities 822

bull Spastic Paraplegia 023

bull Cerebral Palsy 2877

Encephalopathy 2400

bull Spast ic Quadriplegia 2004

bull Other 578

Quadriplegia 155

Not Available 136

It is clear from the graph that the Funds participant composition by injury type is varied but also

concentrated in a handful of categories The following graph illustrat es the number of participants and

average payment by injury type through the current quarter

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

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2065

lll 9226

lit 6l32

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lll4 2506~- Ill

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llll 9878

ml 4680

llll 2614

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2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

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17778

9 26132

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29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

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20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

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32

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~380 1973

200

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52113

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9212

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13432

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21358

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9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

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12313 4299

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18 191

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16067

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12341

12617 111723

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2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

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6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

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19 25 20

19 27 31 16

20

18

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22 15

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85

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191

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186

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27333 7823

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7389

lA764

38728

918 9627

31ASl 985S

112ao

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ll2A 20974 lS611

12ASl

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50S2

40837

12534

16353

9670

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11287

16178

2l97S

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42839

13389 20382

14477

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24SOO S197

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17088

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18173 23729

37407

7296

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23682 S6073

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30198

20249

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68347 44973 lA365

15265 36673

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31333 71106

69907

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270969 139466

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201704 11 8l

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

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11909 717 213939

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9 14417 21606l 117155 431812

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1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

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9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 18: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 16 March 30 2018

Average To Date Payments per Participant

1lt10

400000

300000

200000

100000

Braoial PltM ErbsPalsy Spastic ll)legia H1iplbullsbull Mortal OwlopmentgtI Heurclogk1 Spaslk Cerebral Pllsy EncephJopatJy Spastlt R~tlramptlon Qelm Orsalllmes PAtliltgii Quadrule9a

Icu

120

100

60

40

20

- bullQuadnilbullibull NotAvailbit

- Nlmbefof PirbOpiltS -e-AJfqge ParJCIPilnt Se-w-mv

Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise

approximately 52 of the tota l participants but account for approximately 73 of total payments

resulting in relatively large average payments Conversely participants with injury types of Brachia I

Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or

Neurologica l Disabilities have relatively low average payments and comprise approximately 41 of the

total participants but account for roughly only 18 of tota l payments The large number of

participants in the Developmental Delays and Neurological Disabi lities categories with relatively low

benefit payments are also noteworthy

Inflationary Patterns of Types of Services

It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary

patterns However based on our experience in Virginia we are confident that the detailed claims

benefits payment database being constructed will prove invaluable once more benefits experience has

been accumulated

_ Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

ll16 3))45

156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

S8 lS3

18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

28S79 67733

12-46

72397

71SJ1

11SOSO

60958

sons

106613 u 12 66731

65684

~

45957

1S27J

126623 62708

129760

128822

32si

81136

S2amp06

M370 amp22S

133980

7~861 6391l

12656C S270S

1023

JWl 21195

17720 7418amp

158480

156200

36957 94708

105634

95506 11201

92S60 1 1-31

71305

lW 51248

242Sl

167 131 88 166

188953 II0064 3SJ1

1062S4

75988

U3m7

lOS693

164791 111281

84599

156117

lW 56231

27783 184912

98871 211)16

203563 S2078

116280

amp922

12279 116307

18619

128877 108028

lW 60S61 29i48

205461

110970 llS772 221))92

57645

128B91

94958 1613

1)t940

209167

147965

Siil 63067

31451

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 19: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4th Quarter 2017 Page 17 March 30 2018

Administrative Expenses

Pinnacle was provided information in early 2017 on administrative expenses charged by Alicare to the

Fund for claims administration and enrollment services Based on this information we estimated that

the Fund wou ld incur approximately $497 million in administrative expenses during the 2017-18 fiscal

year As of 9 117 the claims administration was taken over by PCG while Alica re continues to service

enrollment to the Fund With this change in claims administration we expect total administrative

expenses for fiscal 2017-18 (including both Alicare and PCG) of $484 million

Prior to the change in claims administration Alicare was charging the Fund $809 per Fund participant

per month Under the current payment structure the tota l administrative costs are now $728 per

Fund participant per month This cost is set to increase each year by $2 per participant per month over

the next 5 years With the new administrative costs we expect $519 million in administrative

expenses during the upcoming 2018-2019 fiscal year or approximately 62 of the Funds tota l

expenditures (benefit payments plus expenses) during that year Th is percentage is comparable to the

administrative expenses in Virginia However the percentage is affected by the significantly higher

benefit payments expected due to recent legislation Once the legislation expires administrative

expenses as related to benefit payments are expected to return to levels more on the order of 20 of

the Funds total expenditures each year

Impact of Available Health Insurance

It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of

available health insurance However the detailed benefits payment database described earlier and

summarized in Exhibit 1 will prove invaluable once more benefits experience has been accumulated

One early item of note is the number of participants with Medicaid has been consistently tracking at

more than half of the Funds participants In the current 2017 fiscal year nearly 70 of the Funds

admitted participants rely on Medicaid

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

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16 o 15

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223 bull96 223 496 436 472 436 472

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214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

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61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

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157 S82 1575amp2 2360S6

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124 654

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2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

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605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

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118 034

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21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

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48572 96 295

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49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 20: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 18 March 30 2018

Investment Earnings

We have not had the opportunity to review significant informat ion regarding the Fund s investment

returns on the Funds invested assets at th is time We expect that more information will be provided

in upcoming quarterly reports Building up investment income on the Fund s balance will be essentia l

to the Funds ongoing fi nancial strength as participants continue to enter the Fund and calendar year

benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or

more years

Distribution amp Use

This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS on ly

Permission is granted to share this Report with representatives of M IF under the Departments

standard guidelines for such review Any other distribution of this report is not authorized without the

prior written consent of Pinnacle Third parties reviewing the report shou ld recognize that the

furnishing of this report is not a substitute for their own due diligence and should place no rel iance on

this report or the data contained herein that would result in the creation of any duty or liability by

Pinnacle to the third party

Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm

name in documents released by or at the direction of the Department concerning such financia l

examination findings In any instances other than the Departments fina l examination report regarding

the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of

a paraphrase quotation or partial quotation the Department sha ll notify Pinnacle prior to such

publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is

expressly proh ibited without the prior written consent of Pinnacle The nature of the materia l

contained in the Report is such that this limitation on distribution shou ld apply to requests made under

any Freedom of Information Act

The exhibits attached in support of our findings are an integral part of this Report These sections have

been prepa red so that our actuarial assumptions and j udgments are documented Judgments about

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

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llll 9878

ml 4680

llll 2614

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Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

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17778

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21096

11480 28720

1911 13918

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22362

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23109

9180

23196

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20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

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32

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~380 1973

200

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52113

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9212

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13432

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21358

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10430

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12313 4299

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12617 111723

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2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

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6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

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22 15

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191

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27333 7823

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3637 4786

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918 9627

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ll2A 20974 lS611

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50S2

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16353

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11287

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42839

13389 20382

14477

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18173 23729

37407

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158480

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129218 291831

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270969 139466

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201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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4 ll6 105

14amp320U 1781 597

2Ml 926 4 7SU14

ms 9Sl 08amp

soan 1611 3ampamp

1 956amp55

10122n

mil 1ou ns 4688Sl

l ampU7294 2087 27

JW 1086949 6226162 50578

189008

ml

663Ul3 S 319139

ml 1216546 7001918

ma l 176J04 ll961

SW 1 3JJ154

Ia l 3JJ lS4

82S961 7001 94amp

S319al9 1U 01l6 2087267 3082271 4 1S4 424

1 100574

4 4784 36

3820U8 4 553 690

2811 JJamp

2916752 m om 180454 11828 1 371684

S6333S 74amp4S

76898S

362013 316amp9

910

nm004

Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 21: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 19 March 30 2018

the conclusions drawn in this Report should be made on ly after considering the Report in its entirety

We remain avai lable to answer any questions that may arise regarding this Report We assume that

the user of this Report will seek such explanation on any matter in question

Our conclusions are predicated on a number of assumptions as to futu re conditions and events Those

assumptions which are documented in subsequent sections of this report must be understood in

order to place our conclusions in their appropriate context In addition our work is subj ect to inherent

limitations which are also discussed in this Report

Any and all Department communications records documents written ora l or electronic

communication or other information of any kind are confidentia l [Pinnacle] shall not copy transmit

deliver or communicate in any way to any other person or entity any such communications and or

information without the prior written consent of the Department

All information and materia ls received hereunder by [Pinnacle] from Department are and shall remain

the sole and exclusive property of Department and [Pinnacle] shall have no right title or interest in or

to any such information or materia ls by virtue of their use or possession hereunder by [P innacle]

Reliances amp Limitations

We have prepared th is Report in conformity with its intended use by persons technically competent in

the areas addressed and for the stated purposes on ly

Throughout our analysis we have without audit or verification relied on historical data and qualitative

information provided by NYS DFS related agencies and MIFs services providers The accuracy of our

results is dependent upon the accuracy and completeness of th is underlying data Therefore any

materia l discrepancies discovered in this data or other information provided by NYS DFS its related

agencies or M l Fs other service providers should be reported to us and th is report amended

accordingly

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

ll16 3))45

156 1380

348

~981

U12 6546

6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

JD USS 3

27333 7823

S557 2m

3637 4786

7389

lA764

38728

918 9627

31ASl 985S

112ao

6928

ll2A 20974 lS611

12ASl

lll 21962

50S2

40837

12534

16353

9670

6252 10204

11287

16178

2l97S

S8 lS3

18Sll 16micro6

42839

13389 20382

14477

21n4

37924

00473

~

24SOO S197

Sl635 31951

17088

9897 23107

18173 23729

37407

7296

2896S

23682 S6073

17751

3523

30198

20249

31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

37922

46303 877S8 2226

72958

23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

Sl760

U 967 S279S

60317

102596

7SS2 8S272

2778S

5769S

57262 39191

lll 39ill 11177

104071

s351 100618

102417

28S79 67733

12-46

72397

71SJ1

11SOSO

60958

sons

106613 u 12 66731

65684

~

45957

1S27J

126623 62708

129760

128822

32si

81136

S2amp06

M370 amp22S

133980

7~861 6391l

12656C S270S

1023

JWl 21195

17720 7418amp

158480

156200

36957 94708

105634

95506 11201

92S60 1 1-31

71305

lW 51248

242Sl

167 131 88 166

188953 II0064 3SJ1

1062S4

75988

U3m7

lOS693

164791 111281

84599

156117

lW 56231

27783 184912

98871 211)16

203563 S2078

116280

amp922

12279 116307

18619

128877 108028

lW 60S61 29i48

205461

110970 llS772 221))92

57645

128B91

94958 1613

1)t940

209167

147965

Siil 63067

31451

228570 120 l SO 258969

246076

66770

14012S

104169

190383

144573

227684

lW 67501

33179 250713

129218 291831

275891

73957

1SOS5

11661

2u1n 152813

Siil n38gt 37502

270969 139466

322187

298075

8033

161620

12602

235707

Jiil 295227 152319

34ABSO

32A-898S1

167434

137572

ma 84674

38987

317058

164644

370SOO 356319

98064 176090

1112 89190

40293 338117

H l180

415234

391371 102742

llZII 93743

43985 361616 18675lt

4S3432

114s1

lW 9SSgtI

9917 389135

202315 472517

lW 104246

59470

415819

21279

lW 110595

n122 37622

Jiil 116Q28

750S7

SW 121196

201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 22: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4 th Quarter 2017 Page 20 March 30 2018

There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any

estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for

claims is subj ect to the outcome of events yet to occur eg future program participant life

expectancies medical cost inflationary trends etc We have employed generally accepted actuarial

techniques and assumptions that we believe are reasonable and appropriate Further the conclusions

presented herein are reasonable and appropriate and supported by our analysis given the information

currently available However it shou ld be recognized that future loss emergence will likely deviate

perhaps materially from our estimates

Additiona l uncerta inty arises from lack of historical data and use of industry benchmarks Our

proj ections of future loss emergence and benefit payments are based primari ly on aggregate insurance

industry loss development patterns It is possible that these patterns may not be indicative of future

loss development for MIF

Pinnacle Actuarial Resources Inc

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

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201Ql

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20 1SQ1

20 1SQ2

20 1SQl

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20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

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19

29

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85

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188953 II0064 3SJ1

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33179 250713

129218 291831

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73957

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270969 139466

322187

298075

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235707

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34ABSO

32A-898S1

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137572

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370SOO 356319

98064 176090

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40293 338117

H l180

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43985 361616 18675lt

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201704 11 8l

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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1A63J3 31 812 to857 36713

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Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 23: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York State Medical Indemnity Fund - 4 th Quart er 2017 Page 21 March 30 2018

INDEX OF EXHIBITS

Exhibit Description

1 Fund Payments by Benefits and Injury Categories

2 Project ed Ba lance Sheets and Income St atements

3 Act ual vs Revised Expected Participant Counts

4 Payments by Admittance Quarter

5 Project ed Payments by Admittance Quart er - Nominal and Discounted

6 Est imated Ult imat e Benefit s Payments by Admittance Year

7 Participant Profi le

Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

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4851 96 188 94

1n9S3 149 S18 98591

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48518 96 188 94152

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103 4S4

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631748 95S 341

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668 315 06174

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113112 112 981

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149 710

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149 710 97708

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118417 n 118427

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Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

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21 661 311 148 801

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194 179 43688

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2015Q4 16 20

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192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 24: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 1

As of December 31 2017 Fund Payments by Benefits Cat egory

Virginia Birth Fund

Percent

Benefit category 201704 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Total Percent of Tot al Benefit CategoY ofTotal

Medical Treatment 351593 422421 397605 1111413 868110 573589 263209 35184 4023124 534 Hospital Based Care 239590 806184 1050283 1885043 2092358 1673039 300325 42922 8089744 1074 HospitalPhysician 140

Surgical care 55035 39970 42722 113032 146685 101149 18896 2190 519679 069

Nursing care 3432391 3336440 3831353 10627012 8153130 6438280 2345151 552120 38715877 5142 Nursing 6511 Dental Care 3183 16654 14592 43620 43956 28510 8619 586 159719 021

Rehabilitation care 71778 274055 380875 1135719 995410 630482 62821 60191 3611331 480 Physical The rapy 264

Custodial care 560326 560107 391187 1131480 485434 69581 9248 3207362 426 Durable Med Equip 352202 373949 364773 945751 880138 533009 416785 42169 3908775 519 Medical Equipment 187

Home Modifications 485772 467955 263254 1208614 674666 700673 292218 6110 4099261 544 Housing 1242 Vehicle Modifications 44379 56139 145296 249284 153585 180606 37247 866537 115 Vans 523

Prescription and Non-Prescriptive Drugs 618575 752359 784704 2537792 1669450 872352 281662 65176 7582071 1007 Prescription Drugs 099 Other Healt h care cost s 164077 49174 10598 46590 38122 43311 U976 360 365209 049 All Other 1033

Assistive Technology 442 500 1244 2186 000 Other Payments 11209 15388 25740 64014 14022 7404 (4) 8 137780 018

Total 6390551 7170794 7702981 21099865 162163 10 11851988 4049151 807015 75288655 10000

Note FY 1213 includes only 4th qua rter 20U a nd 1st quarter 2013 FY U13 doe s not include payments when Sedgwick was TP~ Some payments made in 2017Q4 allocated to 201703 to account for September claims payment

Claim Database t hru 2017Q4 3222018 ~ Pinnacle Actuarial Resources Inc

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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38148

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Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

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4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 25: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Exhibit 1

Quarterly Analysis of New York Medical Indemnity Fund Page 2 As of Deoember 31 2017

Fund Payments by Injury Category Total

Percent Total Injury Number of lnjury Category

Total Percent of Number of of Total Category Participant Annualized

Injury Category 201704 201703 201702 FY 1617 FV 1516 FY 1415 FY 1314 FV1213 Payments Total Pa~ents Participants Participants ~ quarters Severity Brachia Plexus 931 11781 6482 10549 11927 8466 2687 52823 008 20 388 264114 223 947

Erbs Patsy 17693 15066 15115 32885 34007 25 640 3617 144023 021 38 736 3790 422 1365

Spastic Oiplegia 3ns 25250 26137 58214 65865 53 702 232893 0 33 136 33 270 103 9044

Hemiplegia 12893 14756 21900 86939 18250 52 271 53464 4331 264803 0 38 16 310 16 550 213 4973

Mental Retardation 203286 117937 102187 433236 514888 176 580 32714 14964 1 595793 229 16 310 99 737 209 30541

Oeve-lopment1I Delays 320568 374705 393448 1251998 1265010 949 237 152 790 389 4 708144 676 62 1202 75938 791 23B09 Ne-urological Disabilities 577115 767969 699593 1788924 1130909 571830 169875 17260 5 723475 822 so 969 114469 653 35060

Spastic Paraplegia ssu 27165 9689 21081 39287 s1n9 160532 0 236 039 80 266 19 33796 Cerebral Patsy 1376748 1867176 22n089 5909418 4116581 3052208 1227845 212024 20039090 28 77 118 2287 169823 1539 52083

Encephalopathy 1208232 1436761 1662867 4109928 378S684 3244944 1055 853 209787 16714057 24000I 89 172S 187 798 1228 S4443

Spastic Quadriplegia 1S19221 1324748 1460176 3839667 2999106 2096547 675214 45764 13960444 20046 61 1182 228860 661 84481 Othe 323904 391201 344133 892244 640451 707 892 492 737 233864 4026426 578 27 523 149127 328 49103

Quadriplegia 129026 143991 80959 327236 272060 127 694 1080966 155 039 540483 21 205898 Not Available 93622 81040 31096 351832 1283S4 149 4S7 46031 68632 950064 136 155 118 758 159 23901

Total 5792545 6S99S47 71308n 19114lSl 15022378 11274197 3 912827 807015 69653532 516 10000 134 987 6569 42413

Note FY 1213 indudes onty 4th quarter 2012 and 1st quartelt 2013 MedCare invoices for prescriptions also excluded Some payments made in 201704 allocated to 2017Q3 to account flaquo September claims payments

Total Injury Category Severity = Total Payments Number of Participants Total Injury Category Annualized Severity= Total Payments Number of Participant Quaners x 4

Claim Database thru 2017Q4 3222018~ Pinnacle Actuarial Resources Inc

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

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1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 26: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financia l Services

Quarterly Analysis of New York Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

With 250 Discount

Exhibit 2

Page 1

BAlANCE SHEET

Assets

Fund Balance

AtlVll17

2361102

l2Z

2706919

~

2449186

~

2219165

~

2418879

Pro)tlttions as of Flscal Ybullarpoundnd

~ ~

2571829 2674452

~

272333A

~

2714057

~

2640842

~

2501332

~ Future Benefits for Curent Participants

Future Administrative Expenses

7287916

1147045

7547199

1201195

8490168

1441462

9431884

1689698

10852685

1947195

12326138

2214440

13857704

2492435

15447927

2781229

17094511

3080312

18792080

3388736

20540632

3706480

Surplus(Unfunded Uabillty (6073859) (6041475) (7482444) (8902417) (10381001) (11968749) (13675687) (15505822) (17460765) (19539974) (21745779)

INCOME STATEMENT

lnltlal Fund 8alance Annual Funding Investment Income 250

ampUfil 2017bull18 bull

2361102

520000 14168

2018-19 2706919

520000 57236

2019-20 2449186

520000 51214

2020-21 2219165

520000 50840

2021middot22 2418879

520000 55194

2022-23 2571829

520000 58349

2023-24 2674452

520000 60220

2024-25 2723334

520000 60709

2025middot26 2714057

520000 59690

2026-27 2640842

520000 57064

Benefit Payments

AdmintStrative Expenses

176927

11424

783113

51857

738656

62579

297214

73912

336344

85900

377224

98502

419716

111621

464562

125424

512996

139909

561500

155074

Final FuOO Balance 2361102 2706919 2449186 2219165 2418879 2571829 2674452 272333A 2714057 2640842 2501332

Change In Fund Balance 345817 (257733) (230021) 199714 152950 102623 48882 (9277 (73215) (139510)

Benefit Payments as of Initial Fund Balance 75 289 302 134 139 147 157 171 189 213

Number of Participants

Initial Expected New

Expected Deceased

FinaI 511

511 26

535

535 104

8

631

631 104

9

725

725 104 11

818

818 104 12

910

910 105 14

1001

1001

105 15

1091

1091

105 16

1180

1180

105 18

1268

1268

105 19

1354

bull Income Statement represents period from 123117 through the end of the flscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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16

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13917

bull bull 779 l658

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15598

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10248

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2258 12sn 22663

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21060

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38148

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19085

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21803

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16950 11971

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201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

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206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 27: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Quarterly Analysis of New Yorilt Medical Indemnity Fund

Future Fund Balances by Fiscal Year (OOOs) as of December 31 2017

Undiscounted

Exhibit 2

Page2

BALANCE SHEn

Assets Fund Balance

At1Y3117

2361102

mI

2692751

~

2377781

~

2096547

~

2245421

Projection$ as of Fiscal YearbullEnd

mll ~

2343177 2387450

m1

2376113

~

2306128

~

2173223

~

1976648

~ Future BerMfits for Current Participants Future Administratve Expenses

17794148 3095741

18678037 3241887

22259093 3971339

26063489 4752346

30627340

5590708

35525144 6490604

40789504 7458071

46439539 8496587

52487666 9608339

58939176 10794338

65809675 12057434

Surplus(Unfunded Uabillty) (18528786) 119227173) (23852650) (28719288) 133972627) 139672571) (45860124) (52560013) 159789877) (67560292) (758904609)

INCOME STATEMENT

lnltlal Fund Balance

Annual Funding

At1Y3117 2017bull18 bull

2361102 520000

20J819 2692751

520000

2019-20 2377781

520000

2020-21 2096547 520000

2021-22 2245421 520000

2022middot23 2343177 520000

2023-24 2387450

520000

2024-25 2376113 520000

2025-26 2306128 520000

2026-27 217 3223 520000

Benefit Payments Admlnistratve Expenses

176927 11424

783113 51857

738656 62579

297214 73912

336344 85900

377224 98502

419716 111621

464562 125424

512996 139909

561500 155074

Flnal Fund Balance 2361102 2692751 2377781 2096547 2245421 2343177 2387450 2376113 2306128 2173223 1976648

Change In Fund Balance 331649 (314969) 28U3S 148874 97756 44274 (11337) (69985) (132905) (196574)

Benefit Payments as of lnftlal Fund Balaoce 75 291 311 142 150 161 176 196 222 258

Number of Partldpants Initial

Expected New Expected Deceased

Final 511

511 26

535

535 104

631

631 104

9 725

725 104 11

818

818 104

12 910

910 105

14 1001

1001 105

15 1091

1091

105 16

1180

1180 105

18 1268

1268 105 19

1354

bull Income Statement represents period from 123117 through thbull end of thbull fiscal year at 33118

New Yorilt Medical Indemnity fund as of 12middot31bull17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

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9 42 161

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120508 162 5S4 U167S 431 269

9 69656 45050

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1 165671 132023 116207 61 8U

92 29373 65 147

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136890 135 157 366426

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3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

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302 461 918 23 8145

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69 738 229506 921857 124 918 213143

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120264 331801 66S

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16 o 15

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10 141

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103 501 91 181

115 )61

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69794 21 3J7 17618

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165 265 504408

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4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

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73785 12 543

131 ampS4 572 S43

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163 S8A 210815

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21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 28: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Exhibit 3

Quarterly Analysis of New York M edical Indemnity Fund As of Decembe r 31 2017 Actual vs Revised Expected

Fiscal New Participants Total Participants

Period Actual Expected Difference Actual Expected Difference (1) (2a) (2b) (2c) (3a) (3b) (3c)

Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580

2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1100 2583 1483 51600 541 90 2590 1st Qtr 2018

Fiscal 2017-18 Total to Date 5700 7710 2010 51600 54190 2590

Fiscal 2018-19 Total 10366 64556 Fiscal 2019-20 Total 10360 74916 Fiscal 2020-21 Total 10386 85302 Fiscal 2021-22 Total 10417 95719 Fiscal 2022-23 Total 10473 106192 Fiscal 2023-24 Total 10518 116711 Fiscal 2024-25 Total 10540 127250 Fiscal 2025-26 Total 10529 137779 Fiscal 2026-27 Total 10500 148279

New York Medical Indemnity Fund as of 12-31-17 pmiddot Act middot R 32220181 1 I~ innac e uana esources nc

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

201104 u Ill gz

lll 8569

gs

13107

ll1 2539

Qi

))ill

gz

2065

lll 9226

lit 6l32

llll 2670

llll 2621

llll 4983

llll 330

lll4 2506~- Ill

lS

llll 9878

ml 4680

llll 2614

Ill 4516

llZll 4SSl

llZl S070

lm ))

llZl 6349

llll S433

Im U68

2012Q1 11 gt083 2565 1AOlt 346 84) 2267 2670 409S S922 lOSS 3532 2()65 1728 4323 732 75) 1)06 3692 S932 9SSl ~852 2766

2012Q2 2012Q3 2012Q4

16

25 40

45

689

13371 2356

1890

13917

bull bull 779 l658

llSO

4710

10795

13797

630

15598

ll713 S920

ll022

17778

9 26132

17945 12018 29Sll

22SS2 17357

29142

21096

11480 28720

1911 13918

30gt73

17711

1070S

22362

20549 U 099 2 451

23109

9180

23196

22213 9()68

llW

20186

10248

29356

2258 12sn 22663

21131 12)06 25950

21060

9536 23499 1257

38148

27519 15561

19085

26M4 lQ419

21803

2013Q1 1S6 2171 734) 7418 17277 35542 32511 26405 2778 23 21499 17529 2-984 29BlS 22185 26411 31833 350S2 26()82

2013Q2 201lQ3

201lQ4

201Ql

2014Q2

201Q3

201404

30

27

19

2S 20

19

32

Ul8

1223 as

~380 1973

200

S308

52113

l861

2257 3321

2BOS

52n 8218

32222

5473

2615

6536

650 1

8789

9212

1962bull 9lt)93

3646

12903 7S51

13432

14 13

10

S67 ll566

4 74

14193 15262

8379

7258

15lt]87

190Sl

14873

10 15 14838

10208

6QS6

lS973

S278 19602

lUlA

l874

13-Ql

5161

11973

10amp94

18900

ll903

4505

13571 21265 13081

13228

17699

6S73 1157

150ll

1763

10187 17583 a n 1

857 10026

ll236

19181 10614

21358

17S96

S567 12611

5734

19155

18633

23018 19()88

9125

11234

9212 9634

18518

7187

10430

125S

22989

6376

12065

9399

223JS

9517 11548

8214

8656

4678

2015Ql 27 145 4- 5076 6919 7236 8544 10670 7919 ll139 125S7 aua 2M29 201S(U

201SQ3 31 16

421 12991

1BampS

14039 11387 SOlS

ll234

4362

16886 5735

12313 4299

21351

13939

19941

10981

1l838

18601

lA716

201SQ4

2016Ql 20

18 191

12

5104

931

5s9

10298

UOl 9142

16067

981S 10555

12341

12617 111723

903S 7292

2016ltU 35 290 2039 4599 7550 sn2 11891 70Sl 2016Q3 22 4303 9321 8150 9762 7706 2016Q4

2017Ql 15 19

l Q483 10491 9167

16950 11971

2017Q2 2017Q3

29

17

328 sno ~ o

6375

201704 11 83

TotI 516

Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

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201Ql

20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

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20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

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19

29

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85

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16353

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11287

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33179 250713

129218 291831

275891

73957

1SOS5

11661

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270969 139466

322187

298075

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235707

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34ABSO

32A-898S1

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137572

ma 84674

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164644

370SOO 356319

98064 176090

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40293 338117

H l180

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4S3432

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202315 472517

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201704 11 8l

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Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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1A63J3 31 812 to857 36713

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Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 29: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Senices Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page 1

Increment~ Average Payments per Participant by Admittance Quarter AsofOrecetnbef 31 2017

- - Incremental Severity per Participant byhrtldpMion Quartet

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Not~ 3NI Qt2017diagonal dlta adjJsted frcm prior anatysis to account for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Actuarial Resources Inc

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

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201Ql 20 14Q2

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31333 71106

69907

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lW 67501

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129218 291831

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270969 139466

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202315 472517

lW 104246

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201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

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1CIS91 427 l55

334 311 Sil

ml ma 47626 21564 22710 11639

369731 3017 927857 17645 ll4911

157023 273743 45171 550020

40362 )70J5

w 487111

155 414 22670S

l 3S4514 149015

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Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

CU-itlw IMllfltsbyFUNI P1nldpldon ~

raquo U Q4

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30 17

19

10 19 17 31

16 10 11 lS 19 19

lll

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1609 3902

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U 6J7 48351 IS 4 17112S

109 114 196914 457936 990gt8 l7S521 623900 990171

000 145380 183334

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uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

3146 16 WOU

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ma l 176J04 ll961

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Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 30: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

- -New York Department of Financial Senices ExNblt4

Quarterly Analysis of New Yotk Medlcal Indemnity Fund Page2

Cumulathre Awrage Payments per Participan t by Admfttanat Quarter AsofOrecetnber 31 2017

0-nuMM ~ ~Fund h rtldpationQwarter

201104 2012Q1 2012Q2 2012Q3 2012Q4 2013Q1

20 13Q2

2013Ql

201lQ4

201Ql 20 14Q2

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20 1404

20 1SQ1

20 1SQ2

20 1SQl

20 1SQ4

2016Ql

20 16ltU 20 16Q)

20 16Q4

20 17Ql

20 17Q2

20 17Q)

11 11 16

25 0

27

19 25 20

19 27 31 16

20

18

35

22 15

19

29

17

lU

689

32

~238 1223

85

145 421

191

12

290

328

Ill 10amp3

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156 1380

348

~981

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6506

394S

SS1

1712

1885 5296 2329 4303

10483 6

6108

186

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27333 7823

S557 2m

3637 4786

7389

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918 9627

31ASl 985S

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6928

ll2A 20974 lS611

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50S2

40837

12534

16353

9670

6252 10204

11287

16178

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42839

13389 20382

14477

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37924

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17088

9897 23107

18173 23729

37407

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23682 S6073

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3523

30198

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31S36

49896

Ill 6240

68347 44973 lA365

15265 36673

22917

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46303 877S8 2226

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23- 42538 39242

Ill 30399

8508 86126

31333 71106

69907

22523

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U 967 S279S

60317

102596

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2778S

5769S

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lll 39ill 11177

104071

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28S79 67733

12-46

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81136

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133980

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12656C S270S

1023

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158480

156200

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105634

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92S60 1 1-31

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lW 51248

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167 131 88 166

188953 II0064 3SJ1

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164791 111281

84599

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lW 56231

27783 184912

98871 211)16

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116280

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12279 116307

18619

128877 108028

lW 60S61 29i48

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57645

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94958 1613

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209167

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31451

228570 120 l SO 258969

246076

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104169

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lW 67501

33179 250713

129218 291831

275891

73957

1SOS5

11661

2u1n 152813

Siil n38gt 37502

270969 139466

322187

298075

8033

161620

12602

235707

Jiil 295227 152319

34ABSO

32A-898S1

167434

137572

ma 84674

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370SOO 356319

98064 176090

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40293 338117

H l180

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llZII 93743

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4S3432

114s1

lW 9SSgtI

9917 389135

202315 472517

lW 104246

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SW 121196

201704 11 8l

Toul 516

Not~ 3ld Qt2017 diagonaldata adjusted frcm prior anatysb toacoount for no paymet1ts made in Septffllbtt

Hew Yott Medk al Indemnity Fund as of 12middot31middot 17 3222018 ~ Pinnacle Act uarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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1A63J3 31 812 to857 36713

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157250 1S1366

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ml deg u osn

1218933 1 193tl

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120264 J31801 254 065 JSl 669 JSS6M

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ml ma 47626 21564 22710 11639

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Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

CU-itlw IMllfltsbyFUNI P1nldpldon ~

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uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

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NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

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11909 717 213939

11222 371

780 41406

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22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

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105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

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19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

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100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 31: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edilblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Incremental 8eMfits Payme-nts byAdmittance Quarter As of Oecembff )1 2011

lncNmellltlil llffllfttshid by hindPudpadcrl Quart-

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1A63J3 31 812 to857 36713

4106 67708 78 411 17amp462 15717 Zl42 SlOUI 100251 166996 303 2302 1727611

U971 14125 137049 402 UBS07 80551 91 181 172019

lS361 16455 10141 n 17929S

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12231 174172 472382

167611 lampU79 10

m 12070

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211111 300 45

110508 2554

181 615

431 269 um m n

25471J 1ll 721 amp61 892

22301 151 593

m ~

69656 29373 5050 65147 3J7540

03929 1 165571 1 14amp1agt

1320U 116207 U5157 i 285

227482 40401 l72JU J27022 yen77991 264554

26C 161 l547gtJ 6 18 164 459971 175695 297615 1458J1

ml deg u osn

1218933 1 193tl

197201 31171

120264 J31801 254 065 JSl 669 JSS6M

2194 4561lt

llll 54812

mm U767 2564UI

1CIS91 427 l55

334 311 Sil

ml ma 47626 21564 22710 11639

369731 3017 927857 17645 ll4911

157023 273743 45171 550020

40362 )70J5

w 487111

155 414 22670S

l 3S4514 149015

llll l oamp661

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1174 223 110973

19128S

325761 4247

ml 51 481 1 oso

3aal15 Wd

gjl 8 287

isms 26411

ma 49671

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l 779JSS 175251

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1 525926 763401 130411

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ma

30423

llll IOlll 13JJ154

SJ19839

18900696 2087 267

3082171 475424 1100574 4178 43 J820 ua 45SJ690

2 811 331 2916751 4839618

1140117 1 480454

1 311 684

ou

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Hott 1tdOtr 2017dlaonal data ad)ustedfrom pnoratysl5 to accouMfor nopaymmts made In September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Actuarial Resources Inc

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

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lll

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1609 3902

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l30U1 74 960 mm 30164

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437331 U 4 1S3 1 093SSS 1 313)11 (7089 622100 mm 104 l 278C81 1198927

U 6J7 48351 IS 4 17112S

109 114 196914 457936 990gt8 l7S521 623900 990171

000 145380 183334

U0389 107J8S deg 720517 H5179 1 157563 714 566 1 157055 144991amp 1 7551S

17194 JS1 7l2 S50336 444 04gt 639416 amp70096 1yenr7995 l 7382Sl 2 261 Ml

uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

3146 16 WOU

Ill 334 J91 937

l3710U 833319

1 44 l20 349Sl3

1 3S21

33$

1 S07937 lct1929 1 151115 2643417

1 03071S

t3nfiM

ga 16SU9 11337CJ

4 024 728 SU087 as357

11amp797

371966 1315gt1

17SS213 2301 605 1158207

33QSJ09

wsn 1334617 112308

lli sossn 1pound1002

2025914

1 57693 rnom

6A 110

deg419251

1813023 1000636 219 596

1 72S676 3923 472

843272 1 80454

11111 390 4 233149

2J635l3 185690 6339199

l l087U 25$7 109

487637

2007 051 2J8765amp

2 944 150

deg 1 140

ml 563731

2574 090 2 20414amp

755amp133 90031

deg 607900 233amp152 164gt313 3295amp18 2 114 339

2284tn 4 83963amp

gu 3056lJ

2 471773 1 Cll7815

1 1m J 13951

n3791

1 1 90769 3 722974 29161Sl

Qll

16

311321 32VDI 2714240

900 1 lil5460

11293S6 3480047

7S962 3057251 33734-93

4 lUJJ6 2au na

ma filH7U

3657 115 3(1(8145

103Sfl743 1 Z30378

2003 100

3113 J67 3617271 31A3JJ 4 553690

~ 742SlS 9

4 012529

32J0451 ll 7U25a 1 3794$3

221amp rn 4 064970

932996 382031

llll 851 lni

412Sll

3 486654 118amp7481 1 49037 2 410COI

bull HOn1 1 008190 4478436

QU 4511

4 7236Z7 ll7MCIOS

1 622 2 269515 rnonz l l0057

llll 931 410 4 28858

4 ll6 105

14amp320U 1781 597

2Ml 926 4 7SU14

ms 9Sl 08amp

soan 1611 3ampamp

1 956amp55

10122n

mil 1ou ns 4688Sl

l ampU7294 2087 27

JW 1086949 6226162 50578

189008

ml

663Ul3 S 319139

ml 1216546 7001918

ma l 176J04 ll961

SW 1 3JJ154

Ia l 3JJ lS4

82S961 7001 94amp

S319al9 1U 01l6 2087267 3082271 4 1S4 424

1 100574

4 4784 36

3820U8 4 553 690

2811 JJamp

2916752 m om 180454 11828 1 371684

S6333S 74amp4S

76898S

362013 316amp9

910

nm004

Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 32: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

--- -New Y0lt1c Dbullpartmbullnt of Flnandal Sbullrvlcft Edllblt 4

Quartfffy Anafysis ofNlw York Medkal Indemnity Fund Cumulative Bendlts Payments byAdmittance Quarter As of Oecembff )1 2011

CU-itlw IMllfltsbyFUNI P1nldpldon ~

raquo U Q4

raquoUQJ

lOUQl 20UQ3

10Ultl4 211lJQ1

deg10lJQ3

204

raquolAQl 101l)

1014 101SQJ OlSQl

101SQ3

21116Qgt 21116Q1 21116Ql 21116Q4 2017Q)

2017Ql

21117Q4

16

30 17

19

10 19 17 31

16 10 11 lS 19 19

lll

n1

371

60

deg 3094S

1609 3902

137049

3

70

Ill 3

ll4 76U7 41 15841 ltO lJl

l30U1 74 960 mm 30164

ltl59U 508

1S7ZSO 122431

lll lli m lli

mm

59J70

437331 U 4 1S3 1 093SSS 1 313)11 (7089 622100 mm 104 l 278C81 1198927

U 6J7 48351 IS 4 17112S

109 114 196914 457936 990gt8 l7S521 623900 990171

000 145380 183334

U0389 107J8S deg 720517 H5179 1 157563 714 566 1 157055 144991amp 1 7551S

17194 JS1 7l2 S50336 444 04gt 639416 amp70096 1yenr7995 l 7382Sl 2 261 Ml

uun 214 ll0 184014 197098 169 117 69043 901 60 202325 165693 ombull 11248S9 299734 333$

3146 16 WOU

Ill 334 J91 937

l3710U 833319

1 44 l20 349Sl3

1 3S21

33$

1 S07937 lct1929 1 151115 2643417

1 03071S

t3nfiM

ga 16SU9 11337CJ

4 024 728 SU087 as357

11amp797

371966 1315gt1

17SS213 2301 605 1158207

33QSJ09

wsn 1334617 112308

lli sossn 1pound1002

2025914

1 57693 rnom

6A 110

deg419251

1813023 1000636 219 596

1 72S676 3923 472

843272 1 80454

11111 390 4 233149

2J635l3 185690 6339199

l l087U 25$7 109

487637

2007 051 2J8765amp

2 944 150

deg 1 140

ml 563731

2574 090 2 20414amp

755amp133 90031

deg 607900 233amp152 164gt313 3295amp18 2 114 339

2284tn 4 83963amp

gu 3056lJ

2 471773 1 Cll7815

1 1m J 13951

n3791

1 1 90769 3 722974 29161Sl

Qll

16

311321 32VDI 2714240

900 1 lil5460

11293S6 3480047

7S962 3057251 33734-93

4 lUJJ6 2au na

ma filH7U

3657 115 3(1(8145

103Sfl743 1 Z30378

2003 100

3113 J67 3617271 31A3JJ 4 553690

~ 742SlS 9

4 012529

32J0451 ll 7U25a 1 3794$3

221amp rn 4 064970

932996 382031

llll 851 lni

412Sll

3 486654 118amp7481 1 49037 2 410COI

bull HOn1 1 008190 4478436

QU 4511

4 7236Z7 ll7MCIOS

1 622 2 269515 rnonz l l0057

llll 931 410 4 28858

4 ll6 105

14amp320U 1781 597

2Ml 926 4 7SU14

ms 9Sl 08amp

soan 1611 3ampamp

1 956amp55

10122n

mil 1ou ns 4688Sl

l ampU7294 2087 27

JW 1086949 6226162 50578

189008

ml

663Ul3 S 319139

ml 1216546 7001918

ma l 176J04 ll961

SW 1 3JJ154

Ia l 3JJ lS4

82S961 7001 94amp

S319al9 1U 01l6 2087267 3082271 4 1S4 424

1 100574

4 4784 36

3820U8 4 553 690

2811 JJamp

2916752 m om 180454 11828 1 371684

S6333S 74amp4S

76898S

362013 316amp9

910

nm004

Mlte 1tdOtr 2017 dlilgonal ampu adjuncdfngtm prioratysls to accouM 3r nopaymmts madeIn September

NewYork Medal Indemnity flld asofUmiddot31-17 31222018~ Pinnacle Act uarial Resources Inc

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 33: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department ofFinancial Services QuarterlyAnalysis of New Yoric Medical Indemnity Fund

Projected Incremental Nominal Payments per Participant byAdmittanu Quarter As of Decembet 31 2017

Exhibits

1

lnaemental lfflefia hid by FIWld hrtidpatlon ~ -middot -9 2011Q4 2012Ql 2012Q2 201Ql 20124 201JQl 01JQ2 OllQl

11

11 16 2S 30 r

lll lll

11909 717 213939

11222 371

780 41406

9394

lll 28215

22261S 119468 146H3

10857 67708 89664

9 14417 21606l 117155 431812

71 441

11462

ll 7926

22010 1607-41 W9l4 37090

1093169 348 379

9 42 161

927S 219402 148012 161013

91 22120 24 k2

284 4S6 211218

1 045 294 moe 21174 t073S1

9 10183 281128 00445

120508 162 5S4 U167S 431 269

9 69656 45050

360amp15 433929

1 165671 132023 116207 61 8U

92 29373 65 147

l37 S40

26997 1 148800

136890 135 157 366426

lll 3607

3 105n 349458

1 218933 119318 191202 311761

9 54 812 38857

284 497 261625 894 490 111 497 2S6 410 270692

lll 47626

22110 790

302 461 918 23 8145

16102l

9 2754 176l9

69 738 229506 921857 124 918 213143

0310

ill 19004

355414

226106 13S4514

1490S 215624

lll 108661 475SS

322 973

deg 1174223

110923 1912ampS

I 51 481

SOSO 88125 321 808 9064

ll 87

9296

307643 1 038009

lll 49618

238 399

S 50087 40610

315984

lll ssm 6amp249

Ill 59762

105081

600632

lll

385028 60062

Ila 30423

2071 l87 21287 38S

6006)2 201JQ4 gtOlltQl 201Q2 gtOlltQ)

gtOlSQl

19 2S o 19

60 1609

15181 9529

132 707 105 657 731

118971

22 42

100258 644449 103984 1l704I

SOU)

166996 tn768 184 125

SS080 143 414 33S 796 2amp2 863 198623 195 370

3195)

1fi9659 222 313OS 159 20)

230680

152406 2amp2592 350314 296163 193955

42 227 312 432 2496n 2S4 713 212128

41 185 227412 21253 in991 264161 S4 7S3

68386

404028 117022 264 554 33627S

120264 331801 66S

20S891 64 447 26SJ46

45872

3163952 73694

62Sn4 562 490

601 061

911892 S62 490

601061

171 220 911892 S62 490 601061

4006 n 1 220 911892 S62 490

601 061

1486)S

612212 6 10069 72137 U S 847

148 635 612212 6Ugt069 121 37 127 UO 11SM7

H863S 612212 610069 206099 127130 l35847

148 6)5

612212 174 305

206 099

130 llS 847

015Q2 31 137049 402726 435 224 2996 410257 S2U51 381 114 661892 111682 1176828 1 130352 1 ll0352 1 130352 322958 255 473 2SS 413 255413 255 413 015Q3 Ot5Q4 2016Ql 2016Q2 216Ql 016Q4

16 o 15

210

10 141

30164 102088 164 71 361 94 668

1572SO

103 501 91 181

115 )61

160956 205067

80558 tn019 164559 264 241

69794 21 3J7 17618

9175a 211106

68m

165 265 504408

16526amp 484 766 7M26S 504408

492 111 484766 884ampS4 265

4085 416472 689026 4S4 157

213 496 443085 436412 796 689026 1291S9

223 bull96 223 496 436 472 436 472

796 702 227629 1968M 19686S 129759 1291S9

214 610 42S S86 119181 189090 1246)5

214670 121 596 119181 21840 189090 124635

61334 121 596 119781 2186deg 189090 124 6l5

61 334 121 596 119781 218640 189090 124635

4851 96 188 94

1n9S3 149 S18 98591

48518 9412

172 953 149 578 98591

48518 96 188 94152

172953 149 S18 98591

48518 172953

149 S18 98591

2017Ql

201702 19 19 1 05 768

703 454 1053768

103 4S4

1053168 637148 955 341

6377-48 9SS 341

631748 95S 341

631748 27295S

164061 145 762

164061 245 762

164061 245 762

1154 061l4S

157 581 2)6 056

157 S82 1575amp2 2360S6

1S758l 236056

124 654

186131

124 654

186131

1246

l86731 12A6S4 196131

2017Q) 2011Q4

17 11 414 880

668 315 06174

668315 436174

668 315 436174

668 31S 436174

605891 19lt 434

605 891 112 981

113112 112 981

173112 112981

155866 Ugtl 726

155866 101726

155866 101726

155866 101 726

149 710

97708 lA9 710 97108

149 710 97708

149 110

97708 1184l1 17291

118417 n 118427

17291 118 417 n291

Total St6

Sources

NYMIF for Funddatacalculated diagonals based ~ Exhibit6 lnduted lltiffwte Sewrity Note 3nl Qtr 2017 dh1gonal data adjusted from prioranalysis toaocolfflt for no~ ntsmacleln September

~ Pinnacle Actuarial Resources Inc 3222018

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 34: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

--New York Oepanment of Financial Services QuarterlyAnalysis of NewYork Medkal Indemnity Fund

Projected Incremental Nominal Payments per Participant by Admittance Quarter As of ~bet31 2017

Ill 9 gn 9 91 91 Ill 9a 2011Q4 11 ~ US996 US996 135996 U9749 139149 1391-49 U97bull9 2012Q1 11 7S 506 1S S06 7S S06 7S S06 11 590 nS90 17S90 n590 201202 20UQ)

16 25

na 034

551163 118 03-4 557 163

118 034

S57163 718 034 5 7 163

73785 12 543

131 ampS4 572 S43

73785-4

163 S8A 210815

20UQ4 2 073 SOS 2 01 SOS 2 073 SOS 2 013 SOS 2 llO 740 608783 60873 2030 213 107 233 107 2]3 107 233107 68Ul 8 4Al 8lt41 1 201)0 30 3854SI 385 458 38S458 110131 113171 113111 Ul 171 113171 201303 203Q4

21 661 311 148 801

661 371 -42 51

188 963 42 515

188963 42 1

194 179 43688

194179 194 119 194 179 201AQ1 19 175 lll 11S U l 17S 131 17S Ul 179965 179965 119 179965 201Ql 25 174 SOO 114 500 174 SOO 174 SOO 179 317 179317 179 317 179317 20IAltU 0 206 3lO 206330 206 3)0 206330 212 OlS 212 025 21202S 212 OlS 20IAQ4 19 121212 1212n 121212 1n2n uo1ts 130 785 deg 130715 201SQl 27 135 999 135999 US 999 llS 999 139 7J 139 7S3 1l9 7S) 1397Sl 201502 )1 2SS 1S9 2SS 759 25 7S9 2S5 759 262 819 261819 262 819 262 819 201S03

2015Q4 16 20

48S72 96 29S

-48Sn 96 295

48572 96 295

48S12 96 l9S

~91l 989Sl

-49913 ~913 98953

49913 2016Q1 18 94858 94858 9488 94858 97-417 97 417 97-417 97 417 201602 35 17) 147 113 147 173 1-47 1731-47 117926 117926 117926 111926 201603 22 149 7-46 U 9 74 149 746 149 74 153879 mm 153879 153819 2016Q4 15 98702 98702 98702 9870l 101426 101 426 101 -426 101 426 20170l 201702

19 29

124 194

1169t0

124 794

186940

124 794

186940

12-4 194

116940

128 238

192 100 238192100 128238 192 100

12 2)j

192 100 2017Q) 17 118 S60 118 S60 118 SltO 118 S60 121 83J 121833 121833 1218l 2017Q4 11 n318 111n nna n111 79S14 1914 19S14 79514

Total S16

Sounes

lff MIF for F-d dataalcufatecl ciqonab based on Exhibit6 lndatedUltimate Sewrity HotekII Or 2017 diagonal data acfJUsted from prioranalysis toaccount for nopayments mNe in September

UhibitS

P~gt2

Incremental a-fits Paid by klftd ~Qualter 9 Ill 38610 38610 21437 21 437

20385 20J ampS4 158112 158182 588 680 588 680 66 181 66181

109 434 109 434

18111i7 18717 42 246 42 246

114022 174 022 173 396 17) 396 20S 024 2QS 024 126 466 126 466

us 138 115 138 254 141 25 141

-48265 48 MS

9S686 9S 686 94 2S8 94 2S8

1nos1 112os1 148798 148 798 98(117 98017

U 4 004 124004

18 756 l ts 7S6 111810 111810 16888 16 888

9ll 13SUS 21437

203

158 182 588680 66181

109 434 187 761 42246

174 022 173396 205024 126 466

135138 2S4141 48 206 95686 258

172051 148198 98011

124004 18S 756 117810

76888

9 91 38610 19696 21 -437 2200

2Qa8S4 lcraquoS90

158 1amp2 162 633 588680 60 246 66 131 6100

109-434 112 SU

187 761 193051 bull2 246 43-434

114022 171919 113 396 171275 20502-4 210793 126-466 130025 us U8 1389-41 254 141 261 292 -48265 49 623 9S686 -98379 94258 96910

172051 176892 13198 1S2 985 98011 100amp37

124004 127493

18S 756 190 914 117810 121 us 76W 790S2

9 -41 144

22844 217 2l6 168566 61712-4 116618 20009)

-45019

185-446 719

218-483 134 768 4010 270824

Sl-431

101967 10046 Ul34S 158566 104 sis 1l2 144 197950 us S4)

81935

9 -41144

217236 168566 621314

70525 116 618

deg4019 18 446 149 218 483 147 144 010 2082A

Sl-433 101 967 1004A6

113 345 1S8

104515 U2 144 1255-43

81935

9l 41 144

22844 211236 168Sti6 6l7324 116618 200093 45019

185 4-46 18lt 779

2U483 l lA 78 1440 10 270 824 S1 43l

101967 100446

1amp3 345 158 566 104515 132144 191950 12SS4l 8193S

9 43250 24 013

22 351 111 192 659-4lS

74 134 122585 210332

-47 l22 194935 194234 229661 141665 151 319 284682 54065

101 ias 105585 192n1 166680 109864 138906 131967 86U8

9 43250 24 013

22835 177192 66942

7-4 134 122 S8S 210 312 4 322

194 93 194234 229 663 141 66S 11 379 2M682 107 18S 10SS8S 192127 166680 109864 10 906

208 080 131967 86128

9l 39696 22040

209 590

162633 605 24 1US13 193051 43 434

118919 17827S

210793 13002S 138941 261 292 49 623 98379 96910

176892 1Sl 98S 1008]1 127493 190 121 US 19052

m gt09590

605 146 61043

112513 1nos1 43-434

118919 171175 210 793 13002S

138941 261292

49623 176892 15298S 100837 1l7 49 1909 121 llS 79002

92 22040

161633 60526 112 13 193051 178919 178 275 210 79] 130025 1]8941 261 292 4962] 96 910

176892 152 98S

100 8l7 121 49] 190 121 US 1902

41 14-4 217236 168566 617 324

70S2S 116618 20009)

-4S019 149 218-48) 1l4 768

14A010 vow Sl-4U

101967 100446

113345 158566 t04SlS ll2 14-4

197950 us S4l

81935

9 4)

240U 228352 117192 6S9 425 714

122 SIS 210 332 41322

19-4935 194 229 663 141 665 151 319 28A 682 107 l8S 1os sa5 192 727 166680 109864 10906 131 967 86128

9 -43250

24013 228352 117 192 659 425

74 134 U2S8S 210 332

-47322

194935 19424 229661 141665

151 379 107 18S 192127 166680

138906 208080 131967 86128

9 -4 396

220 2)9612

U5983 692 142

17812 128 661 220 49670

gt04607 203871 2410 7 14869)

1Sl889 298806

56748 112 S03 110824 202 219 174 950 11l14 14 798 218 404 138 515 90 401

92 25204

239 682 18598] 692142

77812 128 667 220768 49670

203171 241 QS7 158889 567

112 SOl 11124 17-49SO

11531414 218 404 138S1S 90401

~ Pinnacle Act uarial Resources Inc 3222018

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 35: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Quamr1y Analysis of New Yoftt tffdical Indemnity Fund

EgthibitS ProjKted Incremental Nominal Payments per Participant by Admittance Quarter M of December 31 2017

-- 9 9 9i 9 9ll IIIICfefflental lenotfits hid bffYnd PMtidpatioftQuarter

92 ga 9 ~ 9 9 9 9 After9 _

2011Qt 11 4596 45 396 4903 490a6 49 036 49 036 477l) 47713 47713 47713 48113 48111 4Ull 48 113 15666172 19474669 2012Q1 11 2S204 deg 27225 21225 2722S 2722 26491 26 491 26491 26 491 26713 26713 26111 26113 8 10920214 2012Q2 16 219 682 239682 2S8904 2S8904 2S890I 2S8 904 251917 251 917 2S1 911 251917 25 021 254027 254027 2S4011 8l 714 17) 103184 713 2012Ql 2012Q4 201Ql 2013Q2 2013Ql 2013()4

bullbull 27

185 983 692142 n812

128 667 22078 49670

11S98l 692 142 nu2

128667 220168

bull9670

200899 747 652 8402

138936 238 413 Sl6S4

200899 747652

84052 138986 218413 53654

200899 747 6SJ

84052 138986 238 473

S36S4

200899 19Sm 7476S2 721474 8402 al 784

118986 U5US 238 47l n2031 S2 206

19S 4n 727 474 784

135215 232037 52 206

1954n n1474 St 784

135 23S 232037 S2206

19S 4n n7 474

81184 us 235 232 037

S2206

197114

S66 82469

1316 3168 213980

197 114 733566 82 469

136368 233980 5260

197 114 73566 82469

1

2319t0 197114 133566 82469

136)68

2l980 52643

6 183111 238 859936 26 853086 44 40J 350

7i 187445 17141322

80101117 2971S1 l44

31 497930 5S 233 28l

94 598068 21395999

2014Ql 2014Ql

19 20t 607 20 111

204601 200871

2210 16 220121

221016 220221

221016 220221

221 016 220221

215052 214 271

21SOS2 21 218

215052 214 211

215051 214 278

216 852 216 012

216852 216 072

216 852 216072

216152 216on

7061039 703S6 211

81417666 81824639

2014Q) 20 241 057 2A1 OS 260190 26090 260 390 260390 253 362 253 362 253 362 251362 2SS484 2SS484 255484 2SS484 amp3 Lt9 372 10t 314 134 2014()4 201SQ1 201Sltl2 201SQ1

19 27

16

148 693 151119 298806

14869)

1S8889 S6148

160618 111632 122n1 61299

160618 171 632 321771 61299

160 618 ln32 122n1

61299

160611 171 632 u2n1 61 299

156284 167000 314060

S9644

1562amp4 161000 ) 14060

156284 167000 314060

S9644

1S6 284 167000 3 14 060

S9644

1S7S92 16899 60144

157 592 116690 60 144

157592 168399 316690 60144

157 592 168399 316690 60144

51 114 358 5 amp33099

10) 118181

19 Sil 712

64 61S 524 69 245 147

13007604 2S019938

201504 2016Qt

20 1U503 110124

112 SO 110824

121 526 119 712

121526 119112

121 526 119 711

121 526 119 712

118 246 116ol1

111 246 116481

118146 116481

111246 116481

119 236 111451

1192316 11757

119 26 117457

119 236 11757

1812500 l8 2S626

49 009208 -4111705amp

2016Q2 2016Ql 22

202 289 174 9SO

202 219 174 950

218 Sll 188980

218513 188980

218 5lJ 188980

218513 188980

212616 212616 183880

212 616 113180

212 616 183880

21bull l96 185 420

214 396 185410

21396 18S 420

214 96 185420

69 110S29 60375514

81577gt67 n no111

20Ui04 1S 115114 115)1 124 562 114562 124 562 l lA S62 121 201 121201 121201 121201 122216 122 216 122 216 122216 39195 246 50151617 201Ql 2011Q2

19 29

145198 1bull5 m 2184deg

151491 235919

lS7491 215919

1S7 491 235919

1S7 491 235 919

1532AO 2292

151240 229552

153240 229552

153 240 129 552

15523 231 475

lS4 S23 n u 1S

154 Sll 231 4S

1S4523 231 475

50115095 1S 171 SIO

63180594 9072196

2017Ql 2017Qt

17 11

118515 90401

mm 90401

149 614 97652

149624

976S2

149 6lA 149 624 97652

1A5 586 95016

14S S86 95016

145 S86

95016 14 S86 9S016

146 80S 95112

1468QS

95812 146 8 9S812

146806

95812

47 801 186

11 197129 60 301 S9S 39 468 )56

Tot1 S16 Total thru2011Q- 1855191 755

rt Mlfflaquo kind ~ cdoate6d iagon~s ~on uchibit 6 Indicated UlimateSeYerity Note lrdCltr2017 diagONtldataadjusted from prior anlllysis to KCOUntfor nopayments made In September

~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 36: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Qua rterly Analysis of New Yorilt Medical Indemnity Fund PTOjeltted lncnmental Discounted Payments per Partldpant byAdmittance Quarter As of December 31 2017

Exh[blt s Page4-

Admittance- - Incremental leneflts hid br fund hltlcrwetion Quarter

2011Ql

2012Q1

11

11

ll1 Q1

3146

11909

III 2215

JI 1173

15

lli 27926

3802

lit 42167

9275

lll 22720

24-942

Ill 01483

29365

ll2 69656

450SO

w 29373

6517

jW

28B27

33607

~

5812 38857

ml 47626

22710

11li 27564

17639

IIIi 4amp782

Jiil 108661

4 7SSS

ml 51481

80SO

WI 28752

8287

ll12 49678

14-368

~ 50081

40610

lW ssns 65249

ga ~

69834

141372

Jlli 59758

3)423

2012Q2 16 717 213939 222675 216063 220760 219402 2ampt456 287128 360835 337540 310577 lM497 328 369738 lSS14 322973 388125 349296 336954 375984

2012Ql 25 17222 58895 119A68 117755 160748 148))12 211218 300445 433929 286997 34958 267625 2461 229506 226706 256203 321808 307643 238399

2C12Qlt 40 371 75588 146lll 431812 623934 520889 1045294 1180508 1165671 1148800 1218933 894(90 978263 927857 13S4S14 117223 1038009

2CIJQ1

2013Q2

2Cl3Q3 30

27

780 9394

10857

67708 36713

78441

176462

37090

109369

348379

86384

161013

366278

177708

217746

407351

162SSoe 181675

431269

132023 116207

361886

136890

135157

366426

119318 197202

311761

117497

256410

270692

87645 167023

34048S

124918

273743

303310

149075

215624

110923

19128S

648510 644519

228574

375637

60552

227168

373325

636610

2013Qt 60 15787 2242 52010 55()80 37953 152406 4 2227 middot~285 68386 120264 105891 45872 73p94 134449 145010 144 117 143230 142349

2014Q1 19 602 39529 100258 166996 13474 269659 282592 372431 227482 404028 331801 36447 759803 755 127 593662 590009 586378 582769

2014Q2

2CIAQ3 201AQ4

2015Ql

25

20

19

27

30945 ~ 3902

132707

105657

73151

118971

20542

64449 103984

137))48

230289

392488 172768

lM125

335796

282863

198623

195370

222383

305247 159203

23)680

350374

296763 193955

280346 272353 2496n 1n991

trade ~713 264161

212718

327022

264554

336275

254665

351669

265346

6 14292

574872

610512 582792

757069

889651

55393

579206

75210

884176

542037 575641

747779

878735

538701

572099

587886

690840

423514

128506

584268

686588

120259

127715

580672

194961 119519

126929

164885

193761

118784

126148

2C15Q2 31 1370C9 402726 415224 352996 410257 523451 381714 661892 1148124 1141059 1089250 1(182547 1075885 5504 240180 238702 237233 215773

2015Q3 16 30164 103507 80558 69794 9 ~758 68778 219395 218045 216703 215370 205591 204326 58020 57662 45333 45()54 4n1 44501

2C15Qlt 20 3829 102088 91181 172019 321337 211106 483081 432278 429618 426974 424346 405079 115025 114317 113613 89)20 88no 88224 87681

2016Q1 18 210 16754 185361 164559 475871 472943 423206 420602 418Q13 41541 113308 112611 111918 111229 8745 86907 86372 8SB41 2016Q2 35 10141 71367 160956 264242 863272 857960 767713 763C)08 758313 215327 205551 204286 203()29 201779 158634 157657 156687 155723

2016Q3 22 94668 20SQ67 751223 746600 74200S 73738 659886 655825 186226 185079 176676 175589 174508 173 34 136350 135511 134677 133B48

2C16Qlt 15 157 lSO 492105 489077 486Q67 483076 432273 122747 121991 121240 115736 11S023 114316 113612 89319 88769 88223 87680

2017QJ 19 122431 686296 618364 614558 610776 607018 155 195 154240 153290 152347 145430 144535 14365 142761 112215 11155 110asa 110176 2017Q2 29 103lA32 1028Q66 1021739 920603 914938 909307 258203 231()49 229628 228214 226810 216512 215 179 213855 212539 167093 166065 165043 164Q27 2017Q3 17 652015 648002 644014 580267 576696 163756 162749 145633 144737 143846 142961 136470 135630 134796 133966 105321 104673 104028 103388

2017Qt 11 407267 425536 422917 420JlS 417728 376380 106875 106217 105564 2 93881 93303 92729 88519 87974 87433 86895 68314 6789 67476 67061

Totll 516

Soulaquo bullbull HY MIF forFund datacakulated diagonals basedonCchibit 6 frldicattd Ultimate Seovtriryanda ci1count fldCNof 25 Note ltd Qtt 2017diagonaldall a djusttd ftom priOtanatysis to accountfOt no paymttIIS madeInSeptembe

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 37: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Departmentof Financial Services

ltluartMYAnalysls of IMw Yo rilt Medical lndbullmnlty Fund

ProJbullcted lncnmental Discounted Payments per Partld pant by Admlttancbull Quartbullr As ofDecembetll 2017

poundxhtbltS

Paces

lnaemental lenetltsPaid byfWICI hrtidpadonQuarter

2011Q4 11 ~ 135159 134327 133SOO 136341

ll1A 135502

lW 134668

lW 133839

lW 128623

Jlll 36523

Im 36299

IUi 36075

Jiil Jlll 36615

Im 36410

IIIQ

36186

11l 37275

QS

37045

w 36818

llli 36591

~

bullbullm llli 37991

llSl 37758

119

37525 3915

lllQ 38904

2012Q1 11 75041 1579 74 121 73664 75232 7 769 74309 73851 20278 201S3 20029 19906 20340 20215 20091 19967 20568 20441 20316 20191 21Q93 20963 20amp34 20706 21600 21467 2012Q2 16 709223 704859 700521 696210 7U014 706649 702300 199422 191650 190471 189299 18S134 192237 19105 189879 188710 194390 193194 192005 190823 199354 198127 196906 195696 20-11 202885

2012Q3 2012Q4 201JQ1

25 S46940 2022932

226022

sus1 2ot0482

224631

S40229 1998 109

223249

536904 1985811

221875

548329 2028069

6742

5495 575882

6343

154743 572138

63947

15379 1 568816

63554

147797

546648 61on

146888

53284 60701

14598

539941

60328

145))85 536618

59956

143250

548323

61264

147338

544948

60887

146431 51594

60512

145SlO 538261

6010

149910 55463

61950

148988 5510Sl

61569

148071 57660

61190

147160 544290

60813

153738 56862()

63532

152192 565121

63141

151851 56160

627S2

150917 558 187

62366

157430

582275 156461 578692

M657 201JQ2 0 371443 369157 366885 104119 106396 105741 105090 104444 100373 99756 99142 98532 100681 100061 99445 98833 101808 101182 100559 99940 104- 103765 103127 102492 106915 106257

2013Q3 27 633401 629502 111751 tn651 181131 180315 119205 17amp102 171161 170108 169061 168020 171685 170629 169579 168535 173608 172540 171478 170423 11 176945 175856 174n 182316 181194 20 13Q4 141631 40217 39969 39723 40569 40319 40071 39824 38raquo272 38037 37803 37570 38390 38153 37919 37685 38820 38581 38343 38107 39811 39566 39322 39080 40767 40516

20101 19 165666 164646 163633 162626 166087 165065 164049 163039 156685 155721 154763 1S3S10 157165 156198 155237 154281 158925 157947 156975 156(I09 162983 161980 160983 159993 166897 165870 201AQ2 25 164054 163 162041 1611)44 1671 163458 162452 161453 155161 15lt206 153257 152314 155636 1s4678 153726 152780 157319 156 10 155448 15449 1 161397 160404 159417 158436 165273 162S6 2016Q3 20 192784 191598 190418 1amp927 19327 192084 190902 1amp9727 182333 181211 180096 178988 182192 181766 180648 119536 184- 183802 182671 181S46 189662 18895 187335 186182 194217 193021 2014()4

20 1SQ1

19

27

1181amp5

125512

117457 124739

11673 123972

116Q16

123209

118W

125830

117756 125056

117031

124286

116311 123522

111778

118708

111090

1119n

110406

117251

109727

116529

112120

119071

111(30

118338

11074

117610

110063

116886

113376

120405 112678 119664

111985

118927

111)96 118195

116271 123419

115555

122719 114844 m-

114137

121213

119063

126444 118330

125666 2015Q2

20 1SQ3 2015Q4

2016Q1

31

16 20

18

23lt584

44ln 87239

85408

233140

44()04 86702

84882

231705

43733 86 168

84360

230279 43A64

BS638

83841

215180 87460

85625

233732 4116 86922

85_Q98

middot 86387

8457

23064

43575

85BS6 22167 bullU876 amp2510

80778

220502

bullU619 82002

80281

219145

bullU63 81497

19787

217796 41108

80996

79296

22257

4200S 82762

81026

2211n 41746

82253

80527

219816 4 1489

8177

80031

218463

41234 81244 79539

225039 42475 83689

81933

223654

4221 83174

81(29

222278 80928

220910 82154

230785

43560

BS26

ampt025

229365

43291 85298

83508

2279SJ

43025

Mm 82994

226SSO

42760 84251

2)6327 87B87

86043

234173

44331 87346

85513 2016Q2 35 1S4938 153984 153037 152o9S 155lll 154375 153425 152481 146539 15637 144741 143BSO 146987 1A60B3 15184 144290 148634 147 719 146810 145906 152429 15191 150SSS 149632 156069 155128 2016Q3

2016()4 22

15

133173

87238

132353

86701

131S39

86 168

130729

BS637

133511

87460

132690

86911 131873

86386

131061

85BS5

12595

82509

115179

82001

1244()8 12363

80995

126340 amp2762

125562

82252

124789 81746

uo21 81243

127754

83688

126968

83173

126187

82662

125410

82153

131o16

BS25 130210

85297

129409 an2

128612

84250

134163

87B86 133337

87345 2017Ql 19 109620 106946 108275 107609 100899 109223 108550 107882 103678 103040 1024()6 101776 103996 103356 102719 102087 105160 104513 103870 103231 107845 1071amp2 106522 105866 110435 109755

2017Q2 29 163200 162196 161197 160205 16361A 162608 161607 160612 15353 153403 152459 151521 15826 153873 152926 151985 156560 155596 154639 153687 160557 159569 158587 157611 16413 163401 2017Q3

2017Q4

17

11

102867

66723

10223lt

66312 101605

65904

100979 103128 661192

102493

66480

101863

66071

101236 65665

97290

63~06

96692 62717

96097

62331

95505

61948 97588

63299

96988

62909

96391 62522

95798 62137

98681 98074

6361

97471

63222

96871

62833

10120 1

65642

100578

65238

99959 99344

64438

103631

67218

102994

66805

Total 516

NY MIF tor Funddata calolated diagonalsbased on Ellhibit6 11dkatedUltimate Severityanda disiooutltfacto Of 25 Nott 3rdQtr 2017 clagonal data adjusted from priot analy$is t o account for noJ)aymenu made in 5epcemblaquo

New York Medk al lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 38: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

-- -New Yorilt Departmentof Financial Services Exhtblt s Quartbullrlv Analvss of New Yorilt Mtdlcal lndomnltv Fund Page6

Projocttd lncttmontal Dlscounttd Pavnonts per Participant bv Admlttana Quarter As of Oecember 31 2017

lncrenwntal lendts lid by fund hrtldpltion Qigrter

IW IW lll1 Ila w ga IW ga IW lllll w lli4 llU ~ lalll 2011Q4 11 8426 bull 1253 40999 40746 40A96 39160 38919 38600 3852S 38288 38052 37818 S21117 8826966

2012Ql 11 2133S 21203 22763 22623 22484 2234S 21608 21475 2133 21212 212S8 21127 20997 20868 2amp92009 4985336

2012Q2

2012Ql

2012Q4

201)(U

16

25

40

201636

lSS498

575131

64259

20039S

11 571591

215135

165908

613613

68561

213811

164887 68139

212495

163872

606103

67720

211187 602373

6130)

204223

15793

S82S09

615084

202966

156S2bull 578924

64683

201717

15S560

57S362

64285

200176

15603

571821 63B90

200910

1S4938

S73061

64028

19967bull

153985

S69S3

6363

198445

153037 566029

63242

197224 1S21)9S

562546

62B53

27332673

21078458

77961540 8710645

46S268M

3S967014 132872167

14890862 2013Q2 0 105603 10lt9S3 112673 Ul979 Ul290 110605 1069S8 106300 l OS646 10499S 105223 l(W576 103932 103292 14314985 24346859

2013Q)

2013Q4 27 180079

40266 178971 40D19

192llS

middot~962 190952 42698

189777 188609

42174

182390

407amp3

181267

40S32

180 152

lt0283

17903

4003S 17901 40122

178327

39875 177229

39629

176139

3938S

24o110SS2 S458302

41398872

938062S

2014Q1 19 164849 1638JS 175885 174803 173727 172658 166964 165937 164915 163900 164256 163245 162240 161242 22346()40 38731664 2010 25 16324S 1622lt0 174173 173102 172036 170978 165339 164322 163311 162306 162657 161656 160662 159673 22l28S96 38126012

20140) 20 191833 190653 204676 203416 202164 200920 19)))99 191910 190729 191143 189967 188798 187636 26003881 4S32333

201bullQ4 19 117602 116878 125475 124703 12393S 123172 119111 118378 117649 11692S 117179 116458 US741 115029 lS941466 28))66199

201SQ1 27 124893 124124 U325 13243lt 131619 130gt09 126495 llS717 12490 124174 lli43 123677 122916 122160 16929775 300S9216

201SQ2

201SQ)

201SQ4

2016Q2

31

16

20

18

233427 86B09

84987

231991

43787

8627S 1490SA

bull1ooa 92620

90676

247S21

46718 920SO

90118

245998

46431middot~ 89564

244A84

461s

90921

89D13

236422

462

87922

86on

234967 87381

233521

44076

86M4

ampS021

232o84

43BOS

86309 232587

0900

86f96

84681

231156

0 630

85964

SA160

229733

43361

8S435

83642

228319

43D94 amp3127

31642093

5972298

11767319

11520367

560l688

10918576

20947118

20438953

2016Q2 35 lSA174 1S322S 164495 163483 162477 161477 156152 15S191 154236 1S3287 153619 15267bull 15173 150BOO 20898951 36736612

20160)

2016Q4

21

15

132516

86808

131701

86274

11388

92619

140518

92049

139653

9J48)

138793

90920 13216

87922

13)390

87380

132570

8684)

131754

86308

132039

86495

131227

8596) 130419

ampS434

129617 17963189

11767192

316337SS

21151377

2017Q1 19 109DOO 108A09 1163amp2 115666 114954 11247 110479 109BOO 109124 108452 108687 108019 10715 106693 14786281 26717816

2017Q2 29 16239S 161396 173267 172201 17111 170 164479 163466 162460 161461 161811 160815 159825 158M2 22oll410 39344566 2017Q)

2017Q4

17

11

102360 101730

6598S 109212

70838

108540

70402

107812

69969

107208 69S39

103673

67245

1030lS

66832

102401

66420

101771

66D12

101991

66lSS

101364

65748

100740

65343

100120

649lt1

1387S315

8999963

2482S242

16227923

Total S16 Totalthru2017Q4 804S68647

Sources

NY M IF lot Funddata calcutated diagonals based on uhibil6 lndcated UhimateSeverity and a discount factorot 25 Note 3tdQtf 2017 diagonal data ad)Jsted fom prior anatysis to account tot no payments made in Sepufflber

New York Medkal lndemnfty Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 39: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of December 31 2017 Expected Fund Payme nts by Admitta nce Yea r

Exhibit 6

Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitt ed Benefit Benefit of Benefits of Current Benefit Ultimate Ult imate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

2011 239608 22 2373617 31120771 744 31923416 31180450 31408213 1427646 2012 238237 86 33625643 528354667 660 509259533 527093844 521569348 6064760 2013 235956 84 13395388 261671507 572 234344047 260109436 260109436 3096541 2014 237491 91 14044564 339057181 465 301787630 337322734 337322734 3706843

2015 236335 85 8571585 248193481 353 242907000 248006934 248006934 2917729 2016 235084 91 3698704 226917166 228 162113835 225438647 226177907 2485472 2017 233832 57 387788 178355476 096 40531349 177036830 177696153 3117476

Tota l 1656542 516 76097288 1813670249 1522866810 1806188876 1802290725 3492811

Sources (2) Vita l Statist ics of New York State adjusted to MIF fiscal year (3) Provided by MI F includes participants admitted t hrough 123117 (4) Provided by MIF includes 80 load for prescription drugs

(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year

(7) Col (4) I Col (6) (8) Col (4) + Col (5) x (1-Col (6))) (9) Judgmentally selected from (5) (7) and (8) bull these selections do not reflect the impact of recent legislation see Exh ibit 5 page 3 (10) Col (9) I Col (3)

New York Medical Indemnity Fund as of 12-31-17 ~ Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 40: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 1

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

3926 123699 123699 251 5 57453 35221 92673

23234 3082 329232 329232 276786 1631 278416

15367 1762 333646 333646

860 3965 137908 137908 280 280

124605 67257 2467783 2467783 2091 8946 11038

14194 14194

843 202 77059 7885 84944 1417 1417

15986 3858 28401 11723 40124 8505 106 142540 142540

13237 1853 15090

2970 1674 77489 10875 88363 825 335 87003 87003

4078 1529 65329 65329 10270 10434 1447101 1447101 15920 284712 284712

221780 25289 247068 719 8025 8744

19333 10565 29898 5276 109080 109080

6530 6530 2702 2719 138322 138322

9660 9660 73829 14383 1798595 3057 1801653

335 49944 49944

11174 11174 510 255 23055 23055

147 147 53611 9231 62842

57677 12833 390 182 390182 1691 453 39758 39758

7418 7418 57577 924 545865 65793 611659

752 5040 84086 84086 6783 2520 107621 10762 1

17618 56522 56522 2780 730 16760 16760

147 32211 32211 113154 113154

582 582 1092 209 64745 4130 68875

5650 5650 9361 165494 165494

130 76937 76937 165902 165902

12316 1884 301342 301342 18303 3626 345835 50146 395981

332 7963 7963 1551 64175 64175 5999 438159 22702 460860

375 190 26869 26869 11606 1609 565507 38552 604059

309 309 291 291

96687 6676 1221099 1221099

45300 23021 1328486 1328486 32497 68106 723626 723626

1050 6349 6349 99889 99889

9429 62796 62796 3280 21445 21445

322022 322022 40980 10315 450952 450952 35979 14161 1028967 1028967

52206 14118 841341 841341

45178 12340 1197470 1197470 411 22002 22002

19696 12335 274211 2742 11 3886 996902 996902

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 41: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

I

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 2

State Paid Benefits Paid Benefits Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

15543 15543 3350 80 138757 138757

2623 2623 400 28799 28799

48361 5985 1052738 1052738

9523 177755 177755 46825 7400 644897 644897 24828 1878 270381 270381 17435 1579 290631 290631

177945 17742 3547053 3547053 2343 373793 373793

50317 22400 1746074 1746074 190 5035 5035 73 23593 23593

470 10511 10511

5030 155489 155489 5235 5235 3782 3782

77382 77382 22151 10651 1235646 1235646

63 40854 40854 3719 9 38734 38734

597 35372 35372 1862 9 150405 150405

9497 9497

630 4777 4777 5320 350084 350084 2199 22752 22752

55965 19065 877274 877274 1835 1835

36946 6012 683281 683281 22682 2306 305368 305368

2615 379 62637 62637 37475 37475 15807 15807

35281 8525 569052 569052 250 8710 8710

370 2444 2444 6276 56616 56616

666 1440 25333 25333 3098 3098

106 1102 1102

10332 5 320841 320841

6736 6736 2633 2633

265 653 653

177 8868 8868 14453 6724 119253 119253

6977 2952 191470 191470 21757 270 732652 732652

7135 7135 1504 1504

316 7838 7838 3414 16105 16105

1435 1435 27192 10627 509959 509959

2SDO 206401 206401

247 92369 92369 14829 3105 168017 168017

1240 4595 4595 4055 83598 83598

6584 6584 82 82

47786 47786 15979 67016 67016

2986 29164 29164 37 37

15980 15980

New York M edical Indemnity Fund as of 12middot31bull17 3222018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 42: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 3

State Paid Benefits Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Medicaid

Incurred to Date

86733 112 262877 262877 107 6609 6609

1510 1510 27330 84 505774 505774

2470 52 18669 18669

284 17868 17868 43676 299147 299147

71453 71453 2127253 2127253

10657 523392 523392 474 474

1114 370 20955 20955 9499 9499

481 18055 18055 162 162

13242 2860 382678 382678 250 1265 13669 13669

4161 4161 17199 17199

69847 2404 554540 554540 7854 7854 1104 1104

400 694 35127 35127 31243 9887 787742 787742

54735 54735 188726 74865 898179 898179

4154 4154 1580 1580

11673 5648 369410 369410

22320 2579 144510 144510 10719 10719

9991 34469 34469

102215 14017 1268365 1268365 1272 24904 24904

86 54524 54524 6382 5504 157300 157300

33076 33076 10749 288155 288155

3597 3597

7333 6682 148190 148190

12253 12253 51746 17628 930690 930690

105 105

450 4680 4680

3349 3349 6292 99051 99051 1325 21700 21700

12011 1646 221427 221427 8193 8193

1402 186438 186438

130 31734 31734 62 82062 82062

30975 166 520775 520775 429 106 156062 156062

5581 6051 160532 160532 1721 363 104699 104699

1663 1663

51914 5483 452030 452030 16741 5251 386372 386372

8088 8088 23632 5446 284470 284470

13793 13793 66765 4666 917467 917467 11396 60918 107090 107090

9942 9942 1040 1040 6315 6315

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 43: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull4

State Paid Benbullflts Paid Benefits

I Affiliate Number

Current Age Gender

Effective Date Primary Diagnosis Injury

Years In MIF

Date of Death (If applicable)

Current Quarter

Belonging to Prlor Quarter

OJmulatlve To Date Mbulldlcaid

Incurred to Date

1272 37786 37786 5545 5545

213 23987 23987 5807 68459 68459

446 5499 5499

6748 6748 1461 16324 16324

57 40961 40961 24509 1082 138952 138952

200642 93564 2519857 2519857

7308 7308

2572 61943 61943 60866 9938 587310 587310 12272 13723 225372 225372

3517 85 302010 302010 1681 1045 41401 41401

1748 1748 3221 85408 85408

295 295 43 5247 5247

93859 1794 593200 593200 14882 2003 158861 158861

123776 3747 352390 352390 250 6660 6660

so 4350 4350 14971 150207 150207

10787 3019 162221 162221 1290 3374 32376 32376

10341 2047 285644 285644

2047 4832 100472 100472 6000 6000

181 9 15496 15496

325 2343 2343

1111 1111 2914 2914

915 67852 67852 87 4917 4917

641 10746 10746

43050 7120 414006 414006 437982 2790 717667 717667

7801 85975 85975 5854 2040 90732 90732 3838 113622 113622

13195 250901 250901 5821 4551 157945 157945

2282 2282

2044 62610 62610 27275 88760 88760

283 283 42302 4842 429 169 429169

5200 11600 34213 34213

1259 1259 632 8478 8478

19251 19251 1440 1440

46078 10993 864901 864901 2500 2500

40671 4016 129611 129611 2433 2433

219002 1868868 1868868

13484 737 340614 340614 1001 90 13701 13701

832 112 30216 30216

5942 172600 172600

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 44: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Pagbull 5

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

30479

Paid Benefits Belonging to Prlor Quarter

2108

OJmulatlve To Date

198306 204

Mbull dlcaid Incurred to Date

198306 204

122 122

3532 3532

2370 1wl 757

25185 6960

1231

757 25185 6960 1231

5512

245

29488

1388

459 4266

281481 11365 13669

58257 87098

3167

281481 11365 13669

58257 87098

3167

10027 51015

4194

14633

155983

1510

2466 2706

725 64

sos

99681

248193 76480

2134 1923

14227 64276

178 352552

99681

248193 76480

2134 1923

14227 64276

178 352552

4180

1000 828

40037

3371 11845

2937

1282

4728

118 4900

25116 32027

3386 68929

141704 11093 24025 72103

562 2105

181

25116

32027 3386

68929 141704

11093 24025 72103

562 2105

181

30 30

3534

927 47862 10518

3470 8799

11561 1536

477

875 753 586

367

191763 776

3103 278651

23838 45858

459020

93800 5402

191763 776

3103 278651

23838 45858

459020 93800

5402

935 5435

55891 9788

2277

10061 2534

300 13983

54606 1065

143721 267517

300 13983

54606 1065

14372 1 267517

12052 8466 8393 2100

54 1067 1703 1910

89354 76696 64564 22130

3190

89354 76696 64564 22130

3190

16894 3981

375

3697 2467

107

167965 64537 13738

167965 64537 13738

933 11950 614

11950

614

6864 6440 1523

21245 147

1523 21245

147

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 45: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partld pant Profit

Exhibit 7

Page 6

I State Paid Benefits Paid Benefits

Affiliate Current Effective Years In Date of Death Current Belonging to OJmulatlve Incurred Number Age Gender Date Primary Diagnosis Injury MIF (If applicable) Quarter Prlor Quarter To Date Medicaid to Date

1085 5521 5521 10633 579 16406 16406

1665 1665 4 4

1601 1319 12485 12485

1532 1532 23196 11262 1 112621

14 47 31507 31507 12102 31589 31589

62261 163499 163499 723 250 36698 36698

2855 2855 16003 2589 108056 108056

315 315

24312 13606 92684 92684 2784 81656 81656

16048 5470 197645 197645 2061 2330 21077 21077

4795 4795 2125 2125

6681 2210 33902 33902

30847 7136 236516 236516 510 3517 3517

5043 3683 16289 16289

20 20

3326 7049 7049 4801 21301 21301

2057 5882 5882 9918 326 44902 44902

1333 1333 275 275

6086 7122 7122 593 593

89 89 118 118

124433 104562 674390 674390

1693 1693 1693 879 1211 1211 390 26631 26631

87 388 388

69086 5141 291808 291808 190 3474 3474

33876 7780 148495 148495 11100 1926 78195 78195

500 1502 1502

11315 7207 57711 57711

1567 3236 3236 21175 375 23410 23410

5332 475 24227 24227

2000 2000 24481 24481

2615 1004 11436 11436 4011 1004 11919 11919

11071 24998 24998 29682 4090 113465 113465

4125 7585 7585 636 636

310183 225 318618 318618 5725 9667 9667

15955 17356 17356 21889 12723 91184 91184

New York M edical Indemnity Fund as of 12middot31bull17 322 2018 - Pinnacle Actuarial Resources Inc

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018

Page 46: Report to the NYDFS - NYS Medical Indemnity Fund 4th Quarter … · 2018. 11. 19. · Report to the New York Department of Financial Services New York State Medical Indemnity Fund

New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund A5 of Dtamber 31 2017 Partldpant Profit

Exhibit 7

Pagbull7

I Affiliate Number

Current Age Gender

State Effective

Date Primary Diagnosis Injury Years In

MIF Date of Death (If applicable)

Paid Benbullflts Current Quarter

5572

221 20384

3371

3973

91975 250 567

719

23606 1488

10290

24217

265 3570

600 4874

1186

16620

664 5085 3664

165 815

1031

825

Paid Benefits Belonging to Prlor Quarter

1891

6389

2469

475

9087

1101

1073

750

OJmulatlve To Date

1080 19105

2824 411

83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570 1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

Mbull dlcaid Incurred to Date

1080 19105 2824

411 83362

2348

8938

4125

151991 250

3416

18088

96083

1488 13554

28296

265 3570

1053 5947

1186

150

16620

664 5835 3664

165 815

1031

825

ITotal

598006

6390551 1144554

5037116 598006

25232

75802236 322301

5037116 598006

25232

76124537

New York M edical Indemnity Fund as of 12middot31bull17 - Pinnacle Actuarial Resources Inc 3222018