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City Of Decatur <br /> ASO Projection <br /> for the period <br /> January 1,2019-December 31,2019 <br /> 1/1/2019 ASO Medical Renewal <br /> FEE COMPARISON(BY PRODUCT) <br /> Please refer to the ACA Disclaimer regarding benefits and final pricing. <br /> Mature PPO PPO <br /> Curren; Renewal Change FINAL 8/27/2018 <br /> Projected Enrollment 599 561 -6.3% <br /> Single 183 <br /> Family 378 <br /> Illinois Access Fee 1.57% 1.57% 0.0% N/C <br /> Administration Fee $59.02 $59.02 0.0% N/C <br /> Virtual Visits $0.52 <br /> Prescription Drug Rebate Credit ($37.02) ($49.36) 33.3% N/C <br /> Additional Services PCPM Fees $2.00 $2.00 0.0% N/C <br /> Net Administration Fee PCPM $24.00 $11.66 -51.4% $12.18 <br /> Individual Stop Loss$200,000 Level $69.78 $822.64 48-4 $ 76.06 9.00% <br /> Aggregate Stop Loss 125%Aft.Pt. $12,723 $13,698 N/C <br /> Total Fixed Costs PCPM $95.55 $96.33 0.8% $90.27 -5.50% <br /> Projected Average Claim Value PCPM $1,152.65 $1,271.67 10.3% N/C <br /> Projected Aggregate Limit PCPM $1,440.81 $1,589.59 10.3% N/C <br /> Total Projected Costs PCPM $1,248.20 $1,368.00 9.6% $1,361.94 9.00% <br /> A Division of Health Care Service Corporation,a Mutual Legal Reserve Company, <br /> an Independent Licensee of the Blue Cross and Blue Shield Association <br />