Date of pilot launch: October 1st, 2009
|
Coverage Indicator |
Oct 2009 |
Jan 2010 |
July 2010 |
May 2011 |
|
Number of policies |
NA |
413 |
1,192 |
2,201 |
|
Number of covered lives |
NA |
1,723 |
5,055 |
9,133 |
|
Growth Rate |
NA |
NA |
NA |
NA |
|
Coverage Ratio |
NA |
1% |
2.2% |
7-9% |
|
Renewal Rate |
NA |
NA |
NA |
~25% |
|
Percent policies BPL |
NA |
44% |
44% |
~52% |
|
ClientService Indicators |
Oct 2009 |
Jan 2010 |
July 2010 |
May 2011 |
|
Time to create a policy |
NA |
30 |
30 |
30 |
|
Number of claims settled – cashless |
NA |
6 |
117 |
697 |
|
Number of claims settled – reimbursement |
NA |
2 |
NA |
40 |
|
Number of claims rejected – cashless |
NA |
NA |
22.5% by insurer & 2.5% by CHF |
15.5% by insurer & 2.1 % by CHF |
|
Number of claims rejected- reimbursement |
NA |
0 |
2 |
NA |
|
Days to pay out of network claims |
NA |
NA |
60 |
NA |
|
Per cent Out Of Pocket cost |
NA |
14% |
NA |
36% |
|
HealthIndicators |
Oct 2009 |
Jan 2010 |
July 2010 |
May 2011 |
|
Claims incidence ratio |
NA |
3.2% |
7.5% |
8.90% |
|
Claims frequency by age category |
NA |
Not evaluated |
Not evaluated |
Not evaluated |
|
Length of Stay (days) |
NA |
3.8 |
3.8 |
4.6 |
|
Average claim amount |
NA |
90 USD |
108 USD |
96 USD |
|
Number of members with OPD visit/year |
NA |
106 |
715 |
6,026 |
|
Number of non-members with OPD visit/year |
NA |
418 |
463 |
Not evaluated |
|
Average pharmacy cost pmpy |
NA |
0.91 USD |
0.58 USD |
0.6 USD |
|
Average savings OPD |
NA |
0.40 USD |
0.47 USD |
0.8 USD |
|
Financial |
Oct 2009 |
Jan 2010 |
July 2010 |
May 2011 |
|
Earned premium |
NA |
0.40 USD |
4,175 USD |
53,332 USD |
|
Net Income Ratio |
NA |
Not evaluated |
- 660% |
Not evaluated |
|
Incurred Expense Ratio |
NA |
Not evaluated |
217.9% |
Not evaluated |
|
Claim ratio (from insurer partner for hospitalization policy) |
NA |
102% |
206% |
118% (settled claims only) |
|
Claim ratio CHF |
NA |
Not evaluated |
248% |
141% |
|
Value of rejected claims |
NA |
Not evaluated |
5,174 USD |
pending |
|
Operating Expense, CHF (per life) |
NA |
Not evaluated |
4.78 USD |
Not evaluated |
|
Pharmacy distribution expense (per life) |
NA |
Not evaluated |
1.62 USD |
Not evaluated |
|
Total Rx value |
NA |
US$483 |
908 USD |
US$ 7,860 |
|
Total Savings for members |
NA |
US$44 |
457 USD |
US$ 10,481 |
Date of last Learning Journey update: November 2011
