EPIC Program Annual Report 2009-2010 Appendix: Tables IV-A and IV-B

Table IV-A
Claims, Expenditures and Revenue by Program Year^*

Description	Category	Twenty-first (2007-2008)	Twenty-second (2008-2009)	Twenty-third (2009-2010)
Net State Cost= (Expenditures+Premiums-Revenue)		$190,861,688	$187,283,107	$120,576,619
Number of Claims	Co-payment	9,192,928	8,541,283	8,070,456
	Deductible	1,477,951	1,587,704	1,607,887
	Total Claims	10,670,879	10,128,987	9,678,343
Expenditures	Total Cost of Drugs	$1,090,587,079	$956,536,482	$930,616,380
	less Third Party Payments**	$518,118,379	$468,037,216	$496,553,983
	less Participant Co-payments	$77,150,989	$64,758,593	$58,652,524
	less Deductible Payments	$44,412,254	$43,836,044	$41,851,962
	Total EPIC Expenditures	$450,905,457	$379,904,629	$333,557,911
Plus Premium	Payments***	$25,924,547	$27,466,913	$26,976,400
Less Revenue	Manufacturers' Rebates	$226,262,168	$169,494,340	$209,301,480
	plus Participant Fees	$18,746,354	$17,117,037	$17,563,017
	plus Benefit Recovery****	$40,959,794	$33,477,058	$13,093,195
	Total Revenue	$285,968,316	$220,088,435	$239,957,682

^* Table IV-A represents Claims, Expenditures and Revenue by Program Year up to October 2009-September 2010.
^** Estimated Third Party Payments from Medicare Part D coverage and other insurers.
^*** Premium Payments reflects a 1.1% Federal Medical Assistance Percentage reduction for August and September 2010.
^**** Retroactive Third Party Benefit recoveries from Medicare and other insurers as well as plan recoveries.

Table IV-B
Payment and Utilization by Program Year^*

Paid Claims	Twenty-first (2007-2008)	Twenty-second (2008-2009)	Twenty-third (2009-2010)
Average EPIC Payment per Claim	$42.26	$37.51	$34.46
Average Deductible Payment per Deductible Claim	$30.05	$27.61	$26.03
Average Participant Co-payment per Co-payment Claim	$8.39	$7.58	$7.27
Average Third Party Payment** per Claim	$48.55	$46.21	$51.31
Average Total Cost per Claim	$102.20	$94.44	$96.15
Number of Participants Reaching Deductible	67,301	67,162	70,596
Number of Participants Reaching Copay limit	12,189	6,091	4,218

^* Table IV-B represents Payment and Utilization by program year up to October 2009-September 2010.
^** Estimated Third Party Payments from Medicare Part D coverage and other insurers.