The Empire Plan is a unique health insurance plan designed especially for public employees in New York State. Empire Plan benefits include inpatient and outpatient hospital coverage, medical/surgical coverage, Centers of Excellence for transplants, infertility and cancer, home care services, equipment and supplies, mental health and substance abuse coverage and prescription drug coverage.
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
COMMISSIONER
DANIEL E. WALL
EXECUTIVE
DEPUTY COMISSIONER
PA00-02
TO: Participating Agency Health Benefits Administrators
FROM: The Employee Benefits Division
SUBJECT: Empire Plan Quarterly Experience Report
DATE: February 23, 2000
Enclosed are the Fourth Quarter Empire Plan Experience Report for 1999 and the cover letter to Chief Executive Officers.
This report provides projected 1999 experience and projected premium rates for the year 2001.
February 23, 2000
Dear Chief Executive Officer:
Attached is the Participating Agency Fourth Quarter Report for 1999. This report provides projected 1999 Empire Plan experience based on claims paid through December 31, 1999, and projected premium rates for 2001.
The Empire Plan carriers project a combined surplus of $17.1 million or 0.9% of premium. The report includes details for each of the carriers. Final 1999 experience will be provided in the next report.
The projected premium rates for 2001, are included in Exhibit II. These initial projections reflect increases in the gross and net premiums of approximately 13.8% and 13.6% respectively. Please note that these are preliminary projections which have been made without any claims experience for 2000. The report explains the basis for these projections and future reports will include revisions based on actual experience.
The Keeping You Informed section of the report includes information on transmission of reports via E-mail. If you are interested in using this technology to receive future reports, please complete and return the form on Attachment 1.
I hope this report is informative and useful to you. If you have any questions, comments or suggestions, please don't hesitate to contact me.
Sincerely,
Robert W. DuBois, CEBS
Director
Employee Benefits Division
EMPIRE PLAN EXPERIENCE REPORT
OCTOBER - DECEMBER 1999
Produced for
PARTICIPATING AGENCIES IN THE
NEW YORK STATE
HEALTH INSURANCE PROGRAM
by
the Employee Benefits Division
New York State Department of Civil Service
George C. Sinnott
President, New York State Civil Service Commission
NYS HEALTH INSURANCE PROGRAM
PARTICIPATING AGENCY GROUP
EMPIRE PLAN EXPERIENCE REPORT
4TH QUARTER REPORT
PROJECTED 1999 EMPIRE PLAN EXPERIENCE
Based on claims paid through December 31, 1999, the Empire Plan carriers project a composite dividend of $17.1 million (0.9% of premium), or $19.7 million less than the margin loaded in the 1999 rates. The 1999 annual experience projected by the insurance carriers is reported in Exhibit I with individual carrier projections explained as follows:
Blue Cross
Blue Cross projects a 1999 gain of $38.8 million (6.0% of premium). This is $23.4 million more than the margin loaded in the 1999 rates and is primarily attributable to a lower 1998 claims base than was used in the 1999 rate development.
UnitedHealthcare Medical
UnitedHealthcare projects a composite 1999 dividend of $17.2 million (2.0% of premium) representing an $2.5 million reduction over the margin loaded in the 1999 rates.
Group Health Incorporated Mental Health and Substance Abuse Program
Group Health Incorporated projects a 1999 surplus of $1.7 million (2.5% of premium) for the Mental Health and Substance Abuse (MHSA) Program, or $90,000 more than the margin loaded in the 1999 rates.
Cigna
Cigna projects a 1999 loss of $40.6 million representing 9.5% of premium. This loss is primarily attributable to an increase in prescription drug trends over the last two years from 15% to approximately 22%. As reported in the 3rd Quarterly Report, this surge in prescription drug costs is attributable to a number of factors including increase in Direct Consumer Advertising (DCA) and acceleration of new, more expensive drugs to market. Please refer to the 3rd Quarterly Report for more details.
2001 PREMIUM RATES
Exhibit II presents projected 2001 Empire Plan gross and net premium assuming the application of $59.2 million in dividend to all payors. In the aggregate, the Empire Plan gross premium is projected to increase approximately 13.8% while the net premium is projected to increase 13.6%.
Insurance markets in general and NYSHIP, in particular, are rather dynamic and as a consequence these estimates for the year 2000 must be considered soft. A range of projected gross and net premium increases is provided in Exhibit II.
For comparison purposes, Exhibit III presents the individual and family rate history for the Core Plus Medical and Psychiatric Enhancements option based on the Two Tier Empire Plan rate structure in effect prior to January 1, 1996, while Exhibit IV presents the five tier history from 1996 to 2001.
KEEPING YOU INFORMED
Transmission of Reports Electronically
The Employee Benefits Division has the capability to transmit the Participating Agency Quarterly Experience Report via E-mail. Using a software product called Adobe Acrobat Reader™, the PA Quarterly Report is converted into a portable document format (PDF). This is a format that can be read by any recipient, if they have Adobe Acrobat Reader™ installed on their system. Adobe Acrobat Reader™ is available free from Adobe Systems, Inc., at http://www.adobe.com.
There are many advantages to receiving the reports electronically including: reports will be received sooner; there will be less paper to handle; and the reports can be stored electronically and/or a hard copy may be printed.
If you would like to receive the report electronically, please provide your E-mail address by completing the bottom section of Attachment 1 and returning it to the Employee Benefits Division.
NYSHIP Representation at Municipal Events
NYSHIP's Empire Plan was represented at the following municipal events: 2000 Legislative Conference sponsored by the NYS Association of Counties on January 30-31, 2000, in Albany. The 2000 Training School and Annual Meeting sponsored by the Association of Towns of the State of New York on February 20-22, 2000, in New York City.
Name and Address Changes
Please be sure to notify the Employee Benefits Division of any changes so that we may keep our mailing lists up-to-date. This updated information may be sent to:
Mr. Stephen Kavanaugh
Assistant Director
Employee Benefits Division
NYS Department of Civil Service
State Office Building Campus
Building #1, Rm. 159
Albany, New York 12239
TRANSMISSION OF REPORTS ELECTRONICALLY
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If you would like to receive the report electronically, please complete this form and return it to:
Mr. Stephen Kavanaugh
Assistant Director
Employee Benefits Division
NYS Department of Civil Service
State Office Campus, Building #1
Albany, New York 12239
Exhibit I
1999 EMPIRE PLAN EXPERIENCE
In (000's)
|
| BLUE CROSS | UnitedHealthcare MEDICAL - Core | UnitedHealthcare MEDICAL - | UnitedHealthcare MEDICAL - | UnitedHealthcare MEDICAL - | GHI MHSA - Core | GHI MHSA - | GHI MHSA - | GHI MHSA - | CIGNA | TOTAL |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Premium (1) | 646,650 | 697,754 | 89,315 | 74,910 | 861,979 | 54,754 | 6,292 | 5,086 | 66,132 | 428,449 | 2,003,210 |
| Incurred Claims (2) | 574,791 | 599,681 | 88,422 | 64,255 | 752,358 | 43,276 | 4,973 | 4,020 | 52,269 | 457,233 | 1,836,651 |
| Administrative Expense (3) | 33,051 | 75,570 | 9,153 | 7,676 | 92,399 | 10,085 | 1,159 | 936 | 12,180 | 11,832 | 149,462 |
| Gain/(Loss) (A-B-C) | 38,808 | 22,503 | (8,260) | 2,979 | 17,222 | 1,393 | 160 | 130 | 1,683 | (40,616) | 17,097 |
(1) Earned Premium - Premium that pays for coverage for the period reported (accrual basis).
(2) Incurred Claims - Represents the cost of covered services provided during the period reported by the insurance company (accrual basis).
(3) Administrative Expenses - All charges by the insurance carrier other than for the payment of claims. Includes carrier's cost to administer the program, interest charges, and retention.
Source: 1999 Annual Statement
Exhibit III
EMPIRE PLAN
Participating Agency Premium Rates
Comparison of 2000 and Projected 2001 Rates
CORE ONLY
Plan Prime - Individual
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 261.99 | 286.65 | 9.4% | 256.64 | 278.27 | 8.4% |
| Best Estimate | 261.99 | 295.22 | 12.7% | 256.64 | 286.84 | 11.8% |
| Pessimistic | 261.99 | 304.24 | 16.1% | 256.64 | 295.86 | 15.3% |
Plan Prime - Family
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 540.83 | 591.07 | 9.3% | 529.89 | 573.86 | 8.3% |
| Best Estimate | 540.83 | 608.85 | 12.6% | 529.89 | 591.64 | 11.7% |
| Pessimistic | 540.83 | 627.58 | 16.0% | 529.89 | 610.37 | 15.2% |
MediPrime - Individual
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 209.65 | 245.19 | 17.0% | 206.55 | 240.52 | 16.4% |
| Best Estimate | 209.65 | 249.21 | 18.9% | 206.55 | 244.54 | 18.4% |
| Pessimistic | 209.65 | 253.52 | 20.9% | 206.55 | 248.85 | 20.5% |
MediPrime - Family 1
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 489.15 | 550.08 | 12.5% | 480.46 | 536.59 | 11.7% |
| Best Estimate | 489.15 | 563.30 | 15.2% | 480.46 | 549.81 | 14.4% |
| Pessimistic | 489.15 | 577.33 | 18.0% | 480.46 | 563.84 | 17.4% |
MediPrime - Family 2
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 436.06 | 508.13 | 16.5% | 429.63 | 498.34 | 16.0% |
| Best Estimate | 436.06 | 516.80 | 18.5% | 429.63 | 507.01 | 18.0% |
| Pessimistic | 436.06 | 526.10 | 20.6% | 429.63 | 516.31 | 20.2% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating employer.
Exhibit III
EMPIRE PLAN
Participating Agency Premium Rates
Comparison of 2000 and Projected 2001 Rates
CORE PLUS MEDICAL ENHANCEMENT
Plan Prime - Individual
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 293.01 | 319.85 | 9.2% | 284.97 | 310.43 | 8.9% |
| Best Estimate | 293.01 | 330.16 | 12.7% | 284.97 | 320.74 | 12.6% |
| Pessimistic | 293.01 | 340.93 | 16.4% | 284.97 | 331.51 | 16.3% |
Plan Prime - Family
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 602.75 | 657.33 | 9.1% | 586.46 | 638.06 | 8.8% |
| Best Estimate | 602.75 | 678.59 | 12.6% | 586.46 | 659.32 | 12.4% |
| Pessimistic | 602.75 | 700.81 | 16.3% | 586.46 | 681.54 | 16.2% |
MediPrime - Individual
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 217.84 | 253.95 | 16.6% | 214.16 | 249.00 | 16.3% |
| Best Estimate | 217.84 | 258.44 | 18.6% | 214.16 | 253.49 | 18.4% |
| Pessimistic | 217.84 | 263.21 | 20.8% | 214.16 | 258.26 | 20.6% |
MediPrime - Family 1
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 528.23 | 591.91 | 12.1% | 516.30 | 577.12 | 11.8% |
| Best Estimate | 528.23 | 607.33 | 15.0% | 516.30 | 592.54 | 14.8% |
| Pessimistic | 528.23 | 623.56 | 18.0% | 516.30 | 608.77 | 17.9% |
MediPrime - Family 2
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 452.31 | 525.52 | 16.2% | 444.75 | 515.19 | 15.8% |
| Best Estimate | 452.31 | 535.11 | 18.3% | 444.75 | 524.78 | 18.0% |
| Pessimistic | 452.31 | 545.32 | 20.6% | 444.75 | 534.99 | 20.3% |
(1) Represents premiums charged by the carriers
(2) Represents cost to a participating agency
Exhibit III
EMPIRE PLAN
Participating Agency Premium Rates
Comparison of 2000 and Projected 2001 Rates
CORE PLUS MEDICAL & PSYCHIATRIC ENHANCEMENTS
Plan Prime - Individual
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 294.94 | 321.70 | 9.1% | 286.53 | 312.03 | 8.9% |
| Best Estimate | 294.94 | 332.11 | 12.6% | 286.53 | 322.44 | 12.5% |
| Pessimistic | 294.94 | 342.97 | 16.3% | 286.53 | 333.30 | 16.3% |
Plan Prime - Family
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 607.33 | 661.71 | 9.0% | 590.16 | 641.85 | 8.8% |
| Best Estimate | 607.33 | 683.20 | 12.5% | 590.16 | 663.34 | 12.4% |
| Pessimistic | 607.33 | 705.65 | 16.2% | 590.16 | 685.79 | 16.2% |
MediPrime - Individual
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 217.94 | 254.04 | 16.6% | 214.25 | 249.08 | 16.3% |
| Best Estimate | 217.94 | 258.54 | 18.6% | 214.25 | 253.58 | 18.4% |
| Pessimistic | 217.94 | 263.31 | 20.8% | 214.25 | 258.35 | 20.6% |
MediPrime - Family 1
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 530.97 | 594.53 | 12.0% | 518.52 | 579.37 | 11.7% |
| Best Estimate | 530.97 | 610.09 | 14.9% | 518.52 | 594.93 | 14.7% |
| Pessimistic | 530.97 | 626.46 | 18.0% | 518.52 | 611.30 | 17.9% |
MediPrime - Family 2
| Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) | |
|---|---|---|---|---|---|---|
| Optimistic | 453.22 | 526.39 | 16.1% | 445.51 | 515.96 | 15.8% |
| Best Estimate | 453.22 | 536.02 | 18.3% | 445.51 | 525.59 | 18.0% |
| Pessimistic | 453.22 | 546.28 | 20.5% | 445.51 | 535.85 | 20.3% |
(1) Represents premiums charged by the carriers
(2) Represents cost to a participating agency
EMPIRE PLAN
PA GROUP RATES
1985-2001 Monthly Rates
Core Plus Medical & Psychiatric Enhancement
Individual
| Year | Gross Rate | % Changes | Net Rate | % Change |
|---|---|---|---|---|
| 1985 | 95.71 | 92.85 | ||
| 1986 | 91.97 | -3.9% | 91.45 | -1.5% |
| 1987 | 103.14 | 12.1% | 101.65 | 11.1% |
| 1988 (1) | 142.01 | 37.7% | 141.52 | 39.2% |
| 1989 | 168.72 | 18.8% | 168.05 | 18.7% |
| 1990 (2) | 179.50 | 6.4% | 167.09 | -0.6% |
| 1991 (3) | 202.09 | 12.6% | 185.09 | 10.8% |
| 1992 | 198.85 | -1.6% | 181.81 | -1.8% |
| 1993 | 214.30 | 7.8% | 194.64 | 7.1% |
| 1994 | 213.83 | -0.2% | 197.39 | 1.4% |
| 1995 | 214.70 | 0.4% | 193.54 | -2.0% |
| 1996 (4) | 219.20 | 2.1% | 192.27 | -0.7% |
| 1997 | 219.87 | 0.3% | 198.37 | 3.2% |
| 1998 | 227.35 | 3.4% | 204.38 | 3.0% |
| 1999 | 239.24 | 5.2% | 222.00 | 8.6% |
| 2000 | 260.67 | 9.0% | 253.98 | 14.4% |
| 2001 (projected) | 297.63 | 14.2% | 289.90 | 14.1% |
Individual Average Percent Increase
| Gross Rate % Changes | Net Rate % Change | |
|---|---|---|
| From Inception | 7.8% | 7.8% |
| Most Recent 10 Years | 4.1% | 4.7% |
| Most Recent 5 Years | 6.4% | 8.7% |
Family
| Year | Gross Rate | % Changes | Net Rate | % Change |
|---|---|---|---|---|
| 1985 | 203.97 | 197.57 | ||
| 1986 | 195.31 | -4.2% | 194.30 | -1.7% |
| 1987 | 222.39 | 13.9% | 219.20 | 12.8% |
| 1988 (1) | 324.13 | 45.7% | 323.06 | 47.4% |
| 1989 | 383.42 | 18.3% | 381.95 | 18.2% |
| 1990 (2) | 403.75 | 5.3% | 380.15 | -0.5% |
| 1991 (3) | 464.39 | 15.0% | 417.36 | 9.8% |
| 1992 | 445.64 | -4.0% | 407.76 | -2.3% |
| 1993 | 479.37 | 7.6% | 426.35 | 4.6% |
| 1994 | 484.69 | 1.1% | 446.94 | 4.8% |
| 1995 | 486.99 | 0.5% | 440.35 | -1.5% |
| 1996 (4) | 491.07 | 0.8% | 428.27 | -2.7% |
| 1997 | 495.81 | 1.0% | 447.22 | 4.4% |
| 1998 | 514.28 | 3.7% | 463.62 | 3.7% |
| 1999 | 539.14 | 4.8% | 499.75 | 7.8% |
| 2000 | 578.26 | 7.3% | 563.03 | 12.7% |
| 2001 (projected) | 657.09 | 13.6% | 638.99 | 13.5% |
Family Average Percent Increase
| Gross Rate % Changes | Net Rate % Change | |
|---|---|---|
| From Inception | 8.1% | 8.2% |
| Most Recent 10 Years | 3.6% | 4.5% |
| Most Recent 5 Years | 6.1% | 8.4% |
* Statewide Plan Premium Rates
(1) 1988 rates represent the effective amounts of the 1/88 and 8/88 rate changes.
(2) No change in effective net rate over 1989.
(3) Represents rates effective 1/1/91 - 6/30/91.
(4) Represents 2 tier Empire Plan rates; 5 tier rate schedule effective 1/1/96.
EMPIRE PLAN
PA 5 TIER GROUP RATES
1995-2001 Monthly Rates
Core Plus Medical & Psychiatric Enhancement
Individual Planprime
| Year | Gross Rate (1) | % Changes | Net Rate (2) | % Change |
|---|---|---|---|---|
| 1995 | 214.70 | | 193.54 | |
| 1996 (3) | 234.59 | 9.3% | 207.66 | 7.3% |
| 1997 | 261.80 | 11.6% | 240.22 | 15.7% |
| 1998 | 267.89 | 2.3% | 246.07 | 2.4% |
| 1999 | 279.56 | 4.4% | 261.18 | 6.1% |
| 2000 | 294.94 | 5.5% | 286.53 | 9.7% |
| 2001 (projected) | 332.11 | 12.6% | 322.44 | 12.5% |
Individual Planprime Average Percent Increase
| Gross Rate % Changes | Net Rate % Change | |
|---|---|---|
| From Inception of 5 Tier Structure | 7.6% | 9.0% |
Family Planprime
| Year | Gross Rate (1) | % Changes | Net Rate (2) | % Change |
|---|---|---|---|---|
| 1995 | 486.99 | | 440.35 | |
| 1996 (3) | 521.96 | 7.2% | 459.16 | 4.3% |
| 1997 | 537.96 | 3.1% | 489.22 | 6.5% |
| 1998 | 552.00 | 2.6% | 503.78 | 3.0% |
| 1999 | 573.33 | 3.9% | 531.89 | 5.6% |
| 2000 | 607.33 | 5.9% | 590.16 | 11.0% |
| 2001 (projected) | 683.20 | 12.5% | 663.34 | 12.4% |
Family Planprime Average Percent Increase
| Gross Rate % Changes | Net Rate % Change | |
|---|---|---|
| From Inception of 5 Tier Structure | 5.9% | 7.1% |
Individual Medprime
| Year | Gross Rate (1) | % Changes | Net Rate (2) | % Change |
|---|---|---|---|---|
| 1995 | 214.70 | 193.54 | ||
| 1996 (3) | 158.65 | -26.1% | 131.72 | -31.9% |
| 1997 | 150.53 | -5.1% | 129.28 | -1.9% |
| 1998 | 167.91 | 11.5% | 151.34 | 17.1% |
| 1999 | 186.46 | 11.0% | 175.61 | 16.0% |
| 2000 | 217.94 | 16.9% | 214.25 | 22.0% |
| 2001 (projected) | 258.54 | 18.6% | 253.58 | 18.4% |
Individual Medprime Average Percent Increase
| Gross Rate % Changes | Net Rate % Change | |
|---|---|---|
| From Inception of 5 Tier Structure | 4.5% | 6.6% |
Family - 1 Medprime
| Year | Gross Rate (1) | % Changes | Net Rate (2) | % Change |
|---|---|---|---|---|
| 1995 | 486.99 | 440.35 | ||
| 1996 (3) | 446.03 | -8.4% | 383.23 | -13.0% |
| 1997 | 427.23 | -4.2% | 378.82 | -1.2% |
| 1998 | 452.73 | 6.0% | 409.76 | 8.2% |
| 1999 | 480.95 | 6.2% | 447.05 | 9.1% |
| 2000 | 530.97 | 10.4% | 518.52 | 16.0% |
| 2001 (projected) | 610.09 | 14.9% | 594.93 | 14.7% |
Family - 1 Medprime Average Percent Increase
| Gross Rate % Changes | Net Rate % Change | |
|---|---|---|
| From Inception of 5 Tier Structure | 4.1% | 5.6 |
Family - 2 or More Medprime
| Year | Gross Rate (1) | % Changes | Net Rate (2) | % Change |
|---|---|---|---|---|
| 1995 | 486.99 | 440.35 | ||
| 1996 | 369.87 | -24.0% | 307.07 | -30.3% |
| 1997 | 315.24 | -14.8% | 267.15 | -13.0% |
| 1998 | 351.98 | 11.7% | 314.25 | 17.6% |
| 1999 | 387.05 | 10.0% | 360.66 | 14.8% |
| 2000 | 453.22 | 17.1% | 445.51 | 23.5% |
| 2001 (projected) | 536.02 | 18.3% | 525.29 | 18.0% |
Family - 2 or More Medprime Average Percent Increase
| Gross Rate % Changes | Net Rate % Change | |
|---|---|---|
| From Inception of 5 Tier Structure | 3.0% | 5.1% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
(3) Inception of Medprime Rate Structure.