GOVERNMENT EMPLOYEES HEALTH ASSOCIATION GMG 1799 TABLE 1 PROJECTION OF FINANCIAL RESULT FOR PLAN #42 FOR 1983 AND 1984 IN THOUSANDS

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP86-00964R000100040023-8
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 6
• Document Creation Date: December 16, 2016
• Document Release Date: August 2, 2005
• Sequence Number: 23
• Content Type: STATEMENT

Approved For Release 2005/08/15 : CIA-RDP86-00964R000 )00040023-8
Government Employees Health Association
GMG 1799
Projection of Financial Result for Plan #42
for 1983 and 1984 in Thousands
1982
Estimated
1982
Actual
1983
Projected
1983
Estimated
1984
Projected
1. Subscri tion Income $20,999
$21,515
$26,039
$26,794
$36,172
STAT
2?
3,361
3,369
804
975
1,000
3. Interest 404
161
777
264
276
Total $24,764
$25,045
$27,620
$28,034
$37,449
B.
Outgo
1. Incurred Claims $20,852
$22,080
$25,023
$27,535
$33,317
2. Expense 1,925
1,885
2,256
2,287
2,836
Total $22,777
$23,965
$27,279
$29,822
$36,153
C.
Gain (Loss) $ 1,986
$ 1,080
$ 341
$(1
788)
$ 1
295
,
,
D.
Special Reserve
1. Beginning $ 921
$ 753
$ 2,907
$ 1,833
$ 45
2. Ending 2,907
1,833
3,248
45
13.30
Approved For Release 2005/08/15 : CIA-RDP86-00964R000100040023-8
 Approved For Release 2005/08/15 : CIA-RDP86-009648000100040023-8
GOVERNMENT EMPLOYEES HEALTH ASSOCIATION
GMG-1799
Plan #42
1983 and 1984 Bi-Weekly Net-to-Carrier Rates for Plan #42 with
No Rate Redistribution.
Self Self & Family
A. 1983 Rates $33.04 $ 82.80
B. 1984 Proposal
(1) Experience Increase 11.56 28.98
(2) Benefit Changes -0- -0-
(3) Total A + B(l) + B(2) 44.60 111.78
C. 1984 Increase over 1983 35.0% 35.0%
-9-
Approved For Release 2005/08/15 : CIA-RDP86-00964R000100040023-8
 Approved ForRelease 2005/08/15: CIA-RDP86-00964RO0100040023-8
1981
1982
Hospital Admissions
4,102
5,121
24.80
Hospital Days
30,211
35,375
17 .:L 50
?Major Surgery Procedures
4,669
4,912
5.2%
Mental & Nervous
Hospital
$ 840,647
$1,657,500
97.2%
Outnatient
$1,161,058
$1,326,873
14.3%
Total
$2,001,703
$2,984,373
49.'_;0
Hospital Cost Per Day
$ 360
$ 450
25.0%
Hospit l Length of Stay
7.2 days
8.4 days
16.7%
Cost Per Hospital Ad-
$ 2,593
$ 3,777
45. %
mission
Major Surgery Cost Per
$ 508
$ 578
13.:3
Procedure
Approved For Release 2005/08/15 : CIA-RDP86-00964R000100040023-8
 Approved For Release 2005/08/15 : CIA-RDP86-00964R000100040023-8
A.
1983 BIWEEKLY RATES
SELF
$34.36
TOTAL COST
$86.11
21.27
GOV'T PAYS
47.54
$13.09
$38.57
B. 1984 BIWEEKLY RATES (ASSUMING 10% INCREASE IN GOVERNMENT CONTRIBUTION)
$46.38 TOTAL COST
23.39 GOV'T PAYS
$116.25
52.29
$22.99 (76%) YOU PAY $ 63.96 (66%)
($9.90 Inc. over 1983) ($25.39 Inc. over 1983)
C. 1984 BIWEEKLY RATES (ASSUMING 15% INCREASE IN GOVERNMENT CONTRIBUTION)
$46.38 TOTAL COST
24.46 GOV'T PAYS
$116.25
54.67
$21.92(67%) YOU PAY $61.58 (60%)
($8.83 Inc. over 1983) ($23.01 Inc. over 1983)
D. 1984 BIWEEKLY RATES (ASSUMING 20% INCREASE IN GOVERNMENT CONTRIBUTION)
$46.38 TOTAL COST $116.25
25.52 GOV'T PAYS 57.05
$20.86(59%) YOU PAY $59.20 (53%)
($7.77 Inc. over 1983) ($20.63 Inc. over 1983)
E. 1984 BIWEEKLY RATES (ASSUMING 25% INCREASE IN GOVERNMENT CONTRIBUTION)
$46.38 TOTAL COST $116.25
26.59 GOVT PAYS 59.43
$19.79 (51%) YOU PAY $ 56.82 (47%)
($6.70 Inc. over 1.983) ($18.25 Inc. over 1983)
Approved For Release 2005/08/15 : CIA-RDP86-00964R000100040023-8
 Approved For Release 2005/08/15 : CIA-RDP86-00964R0100100040023-8
1984 POSSIBLE CI-IANGES
COST SAVINGS
Self
Family
I.
Hospital Inpatient (General)
A. Deductible Per Confinement
-$
.67
-$1.74
1
$100
.
1.01
- 2.61
2
$150
.
1.34
- 3.48
3.
$200
B. Deductible Per Calendar Year
51 -$1.32
-$
1
$100
.
.
.76 - 1.98
2
50
$1
.
.
1.02 - 2.64
3.
$200
C.
Co-pay Per Day Confinement, First 10 Days
-$ .14
.37
-$
1.
$ 5
28
.74
2
$ 10
.
.
42
- 1.11
3
$ 15
.
.
56
- 1.48
4.
$ 20
.
II.
Hospital Inpatient (Mental $ Nervous)
A. 100" first 60 days
nothing thereafter
$ .24
-$ .60
B. 100% first 60 days
80% thereafter
-$ .05
-$ .12
III.
Surgery (Including Anesthesia)
80% Inpatient and
100% Outpatient
-$1.19
-$2.96
IV.
Hospital Outpatient
Transfer $400 Basic Benefit
06
-$
-$ .14
to Major Medical
.
Approved For Release 2005/08/15 : CIA-RDP86-00964R000100040023-8
 Approved For Release 2005108115 : C1A-RDP86-00964R000100040023-8
CURRENT BENEFITS AND COST
C:\ 1:-1S1ROI1 I I C
IIPTnl TI;
BI-WEEK1,1 COST
000/pcr person
51
100% up to 365
IP-1000 up to 365
,
$200/1lao
days, 800 there
100%
80%
days, OP-70% limit
$13.09
$38.57
$1,000/per family
after
to SO visits per
year.
-
---
sI:LF
- -
A
NO U RINGE FROM
1PJtENT BENEFITS --
----------------
---------------
------------
-
------------
$22.99
-
$63.96
($9.90 inc.
($25.3
over 1983)
over
(75.6%)
j65.
Transfer $400
IP-.100% up to 60
$22.68
$63.19
OP Basic Ben.
days.per confine-
($9.59 inc.
($24.62
Q
NO CHANGE FRD?;
RRENT BENEFITS---
--- ------------
'___________ __
to Major il1ed.
ment
over 1983)
over 19
OP - No change
(73.3%)
63.8
100% up to 365
Transfer $400
IP - 100% up tor
$20.01
$56.49
clays following
IP - 80%
OP Basic Ben.
60 days per confine
- ($6.92 inc.
($17.92 i
C
NO C}1VNGE FROM
RRENf BENEFITS
$200 deductible
to Major Med.
ment
over 1983)
over 198
er hosppital
Uonfinement
OP - 100%
OP - No change
(52.9%)
(46,50
J
?~
100% up to 36S
IP - 75%
IP - 100% up to 30
$19.61
$55.09
$2,000
days'subject to
?5
days per confineme
($6.52 inc.
($16.52 in
D
(Excludes Mental
$250/Two
$200 calendar
?
OP - 50% with 50
over 1983)
over 1983
Nervous)
year deductible
OP - 100%
visit limit
(49.8?0)
42 8%
(ASS1!U:S 10-0 I Ni:ItI.1.51: nF
C,OVC:rN'1E 1 CO)N'TRIRUriONS
Approved For Release 2005/08/15 : CIA-RDP86-00964R000100040023-8