West Valley Mission Community College District March 9, 2010

PPO Claim Report West Valley Mission Community College District Blue Shield PPO Rolling 12 Month Period: February 1, 2009 - January 31, 2010   Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 12 Month Total Enrollment Total Employees 736 734 733 732 728 726 725 724 8,745 Monthly Premium - Medical $615,311 $613,650 $612,682 $611,159 $637,922 $634,430 $631,091 $630,070 $630,929 $7,491,034 Paid Claims PPO Medical $373,887 $564,040 $443,965 $548,245 $507,978 $592,088 $531,516 $693,569 $560,950 $545,039 $425,797 $456,965 $6,244,039 Total Medical Claims Claims over Specific Stop Loss $0 $953,497 Total Net Paid Claims $5,290,542 Average Claim Cost Per Employee $508.00 $768.45 $605.68 $746.93 $693.96 $813.31 $732.12 $956.65 $774.79 $752.82 $588.12 $630.30 $604.98 Fixed Expenses PEPM Administration $99.14 $72,967 $72,769 $72,670 $72,570 $72,174 $71,976 $71,877 $71,777 $866,979 Stop Loss $52.14 $38,377 $38,273 $38,221 $38,169 $37,960 $37,856 $37,804 $37,752 $455,993 Total Fixed Expenses $111,345 $111,042 $110,891 $110,739 $110,134 $109,832 $109,680 $109,529 $1,322,972 Total Plan Cost $485,232 $675,082 $554,856 $659,287 $618,717 $702,222 $641,348 $803,249 $670,479 $654,568 $535,326 $566,645 $6,613,514 Gain/(Loss) $130,079 ($61,432) $57,826 ($45,637) ($7,558) ($64,300) ($6,918) ($172,158) ($40,409) ($24,498) $94,744 $64,284 $877,520 Paid Loss Ratio 78.9% 110.0% 90.6% 107.4% 101.2% 110.1% 101.1% 127.3% 106.4% 103.9% 85.0% 89.8% 88.3%

Renewal Projection West Valley Mission Community College District Blue Shield PPO Renewal Projection for July 2010 Gross Paid Claims $6,244,039 Pooled Claim Credit ($953,497) Net Paid Claims $5,290,542 Change in Reserve $89,939 Pool Charge $455,964 Incurred Medical Claims $5,836,446 Total Employees 8,745 Incurred Medical Claims PEPM $667.40 Trend Factor (14.5% for 17 months) 1.2115 Expected Medical Claims PEPM $808.53 Retention $99.14 Needed Premium PEPM $907.67 Current Premium PEPM $870.25 Percentage Increase 4.30%

Plan Design Option Projections West Valley Mission Community College District Blue Shield Medical Plan Design Alternatives HMO (Current Plan Design - $5 copay / 100%) Change to $10 copay / 100% -2.44% Change to $10 copay / $250 per hosp admit -4.15% Change to $10 copay / $100 per day for hosp -5.06% Change to $10 copay / $200 per day for hosp -6.43% Change to $15 copay / $500 per hosp admit -6.44% Change to $20 copay / $250 per hosp admit -6.46% Change to $20 copay / $500 per hosp admit -7.55% Change to $25 copay / $500 per hosp admit -9.09%

Plan Design Option Projections West Valley Mission Community College District Blue Shield Medical Plan Design Alternatives PPO (Current Plan Design - $250 ded, 100% / 80%) Change to $0 ded in net, $500 out net, 90% / 70%, $1K/$2K/$3K in-net, $3K/$6K/$9K out net OOP -2.93% Change to $250 ded, 90% / 70%, $1K/$2K in-net, $3K/$6K out net OOP -8.29% Change to $500 ded, 90% / 70%, $2K/$4K/$6K in-net, $5K/$10K/$15K out net OOP -14.95% Change to $1000 ded, 90% / 70%, $3K/$6K/$9K in-net, $6K/$12K/$18K out net OOP -21.74%

Plan Design Option Projections West Valley Mission Community College District Kaiser Medical Plan Design Alternatives HMO (Current Plan Design - $5 copay / 100%) Change to $10 copay / 100% -1.56% Change to $10 copay / $250 per hosp admit -2.30% Change to $15 copay / $250 per hosp admit -3.80% Change to $20 copay / $250 per hosp admit -5.30% Change to $25 copay / $500 per hosp admit -8.20%

Utilization Review INPATIENT UTILIZATION

Utilization Review OUTPATIENT UTILIZATION

Utilization Review PROFESSIONAL UTILIZATION

Claims Analysis CLAIMS BY DIAGNOSIS Other includes all other diagnosis codes that did not account for at least 2% of total costs.

Demographic Information ENROLLMENT TIER DATA

Demographic Information AGE BRACKET DATA

Drug Claim Report West Valley Mission Community College District Prescription Drugs - Walgreens Rolling 12 Month Period: March 1, 2009 - February 28, 2010 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Total Claims   Retail Claims 2,019 1,877 1,896 1,981 1,949 1,942 859 809 831 912 3 15,078 Mail Order Claims 483 543 519 532 574 295 314 349 329 1 4,422 Monthly Total Claims 2,502 2,360 2,439 2,500 2,481 2,516 1,154 1,123 1,180 1,241 19,500 Plan Cost Retail Cost $142,269 $135,110 $141,584 $141,762 $145,879 $151,963 $72,549 $73,904 $66,263 $77,053 $0 $72 $1,148,408 Mail Order Cost $96,805 $107,409 $101,154 $102,830 $109,726 $113,265 $66,799 $60,584 $74,795 $65,136 $16 $898,519 Total Net Paid Claims $239,074 $242,519 $242,738 $244,592 $255,605 $265,228 $139,348 $134,488 $141,058 $142,189 $2,046,927 Average Cost Per Claim $95.55 $102.76 $99.52 $97.84 $103.02 $105.42 $120.75 $119.76 $119.54 $114.58 $16.00 $24.00 $104.97

Drug Claim Report West Valley Mission Community College District Prescription Drugs - Envision Rolling 12 Month Period: March 1, 2009 - February 28, 2010 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Total Claims   Retail Claims 945 1,119 988 1,173 1,889 1,759 7,873 Mail Order Claims 233 191 186 243 487 561 1,901 Monthly Total Claims 1,178 1,310 1,174 1,416 2,376 2,320 9,774 Plan Cost Retail Cost $59,349 $78,112 $68,818 $76,195 $168,762 $135,602 $586,838 Mail Order Cost $46,043 $30,013 $30,761 $46,757 $94,071 $109,606 $357,251 Total Net Paid Claims $0 $105,392 $108,125 $99,579 $122,952 $262,833 $245,208 $944,089 Average Cost Per Claim $89.47 $82.54 $84.82 $86.83 $110.62 $105.69 $96.59

Drug Claim Report West Valley Mission Community College District Prescription Drugs - Combined Group Rolling 12 Month Period: March 1, 2009 - February 28, 2010 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Total Claims   Retail Claims 2,019 1,877 1,896 1,981 1,949 1,942 1,804 1,928 1,819 2,085 1,889 1,762 22,951 Mail Order Claims 483 543 519 532 574 528 505 535 572 488 561 6,323 Monthly Total Claims 2,502 2,360 2,439 2,500 2,481 2,516 2,332 2,433 2,354 2,657 2,377 2,323 29,274 Plan Cost Retail Cost $142,269 $135,110 $141,584 $141,762 $145,879 $151,963 $131,898 $152,016 $135,081 $153,248 $168,762 $135,674 $1,735,246 Mail Order Cost $96,805 $107,409 $101,154 $102,830 $109,726 $113,265 $112,842 $90,597 $105,556 $111,893 $94,087 $109,606 $1,255,770 Total Net Paid Claims $239,074 $242,519 $242,738 $244,592 $255,605 $265,228 $244,740 $242,613 $240,637 $265,141 $262,849 $245,280 $2,991,016 Average Cost Per Claim $95.55 $102.76 $99.52 $97.84 $103.02 $105.42 $104.95 $99.72 $102.22 $99.79 $110.58 $105.59 $102.17

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