HIGH COSTCLAIMANTS Encrypted Member ID Group ID Product Line Relationship Member Status Most Recent Medical Pharmacy Total Pooled Var. to Prior DOS Paid Paid Paid Month 2620974413088255581 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Dependent ACTIVE 12/28/2021 $125,617 $25 $125,642 $25,642 $1,615 1337529694658139434 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Subscriber ACTIVE 12/25/2021 $121,705 $721 $122,426 $22,426 $10,492 5752228905898884128 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Subscriber ACTIVE 12/31/2021 $102,077 $1,620 $103,697 $3,697 -$640 4114939063587695124 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Subscriber ACTIVE 12/20/2021 $79,314 $2 $79,316 NEW 8816351387601068106 004068168 HMO BLUE NE PREMIER VALUE Spouse ACTIVE 12/27/2021 $56,255 $13,325 $69,580 NEW 2976124683996996472 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Subscriber ACTIVE 12/29/2021 $45,614 $16,130 $61,744 $4,354 2511864468795196981 004068168 HMO BLUE NE PREMIER VALUE Subscriber ACTIVE 12/30/2021 $27,879 $26,945 $54,824 NEW 4952019859519145306 004068168 HMO BLUE NE PREMIER VALUE Spouse ACTIVE 12/27/2021 $54,473 $9 $54,482 $1,954 $612,934 $58,777 $671,710 $51,764 -39% -36% -39% -87% PRIOR ROLLING 12 Encrypted Member ID Group ID Product Line Relationship Member Status Most Recent Medical Pharmacy Total Pooled DOS Paid Paid Paid 1337529694658139434 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Subscriber ACTIVE 12/21/2020 $370,680 $5,295 $375,975 $275,975 9081164538480431134 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Dependent CANCELLED 11/30/2020 $230,339 $290 $230,629 $130,629 8417164670189283097 004023728 HMO BLUE NE $2000 DEDUCTIBLE Subscriber ACTIVE 12/22/2020 $98,119 $170 $98,288 6085902688542653469 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Dependent CANCELLED 12/25/2020 $53,242 $20,055 $73,297 4430605701715264929 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Subscriber ACTIVE 12/21/2020 $71,843 $9 $71,852 3896046506495496401 004068168 HMO BLUE NE PREMIER VALUE Subscriber ACTIVE 12/01/2020 $2,582 $63,481 $66,063 2260362067240808555 004023728 HMO BLUE NE $2000 DEDUCTIBLE Subscriber CANCELLED 12/22/2020 $58,940 $2,053 $60,993 5835849420894148445 002354873 BLUE CARE ELECT $2000 DEDUCTIBLE Subscriber ACTIVE 12/31/2020 $58,784 $124 $58,908 7338279881020529462 004023728 HMO BLUE NE $2000 DEDUCTIBLE Dependent CANCELLED 12/31/2020 $56,462 $610 $57,072 $1,000,991 $92,086 $1,093,076 $406,603 • HCC spend is 39% lower in 2021 than it was in 2020. • HCC spend accounts for 25% of total plan spend, where the norm is around 40%. • Rx accounts for 11% of HCC spend, where we are seeing it reach as high as 30-40% due to the increase in utilization of specialty drugs across the board. [ 3 ]
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