2013 Annual Report for the Year Ending December 31, 2013

ILLINOIS COMPREHENSIVE HEALTH INSURANCE PLAN 2013 ANNUAL REPORT FOR THE YEAR ENDING DECEMBER 31, 2013

Lisa Madigan, Attorney General

Andrew Boron, Chairman of the Board

Melissa Hansen, Executive Director ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH TABLE OF CONTENTS MISSION AND HISTORY 1

MISSION2013 EXECUTIVE AND HISTORY SUMMARY 2

APPLICATIONS FOR COVERAGE 4

ENROLLEE PROFILE 5

RATE AREA DISTRIBUTION 7

ENROLLMENT DISTRIBUTION AND ACTIVITY 8

FINANCIAL HIGHLIGHTS 13

ASSESSMENTS AND PREMIUMS 16

6 CLAIMS 17

CHIP HIGHLIGHTS FROM 1989 TO PRESENT 21

ADMINISTRATION 24

ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH THE MISSION AND HISTORY OF CHIP

The Comprehensive Health Insurance Plan (CHIP) has a two-fold mission. One is to provide health coverage for Illinois residents who cannot obtain health insurance due to health reasons or have substantially similar coverage that cost more than the individual Traditional rate. The second is to provide coverage to Illinois residents that have recently lost group coverage and have exhausted COBRA or other continuation coverage.

The CHIP Act became law in 1987 with first coverage being provided on May 1, 1989. Illinois was the fifteenth state to enact such a mechanism, known as a “high risk pool,” and the first to use state general revenue funds.

The original purpose of the CHIP program was to provide coverage to individuals who were “uninsurable”. This part of CHIP is known as the Traditional CHIP pool. There are two plans available under the Traditional pool. The Traditional Non Medicare Plan is for individuals who are either unable to obtain private coverage because of a medical condition or able to find coverage but at a rate exceeding the applicable CHIP rate. The Traditional Medicare Plan was for individuals under age 65 who are covered by Medicare Parts A and B because of end-stage renal disease or other disability. In 2013 the Board made the decision to discontinue the Traditional Medicare Plan effective December 31, 2013.

Following the passage of the federal Health Insurance Portability and Accountability Act (HIPAA) in 1996, CHIP also became responsible for providing health coverage to individuals who have had, but subsequently lost, group insurance. On the state level, legislation was enacted creating the HIPAA-CHIP Pool, and coverage in it was first provided to eligible individuals on July 1, 1997. The pool is funded primarily by an assessment on health insurers and enrollees’ premiums.

Additional responsibility came in 2003 with the designation of CHIP as a “qualified health plan” as established in the federal Trade Act of 2002. Qualified Illinois residents could use coverage in the HIPAA-CHIP pool to claim the Health Coverage Tax Credit (HCTC) if they are Trade Adjustment Act (TAA) certified or receiving a pension from the Pension Benefit Guaranty Corporation (PBGC). Pursuant to federal law, the HCTC ended December 31, 2013.

In 2008 coverage changes were implemented in response to the Medicare Reform Act to provide High Deductible Health Plan (HDHP) options to CHIP enrollees in either the Traditional or the HIPAA pool. HDHP plans can be used in conjunction with Health Savings Accounts to allow enrollees to take advantage of federal income tax provisions that allow payment for out-of-pocket medical expenses from pretax dollars.

On March 23, 2010 the President signed into law the Patient Protection and Affordable Care Act commonly called the ACA, that in part prohibits health insurers from denying coverage due to pre-existing conditions. In 2013, plans were developed and implemented in preparation for CHIP enrollees who would be transitioning to other coverage through the new health insurance exchange or in the marketplace as a result of the ACA.

PAGE 1 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH 2013 EXECUTIVE SUMMARY

AFFORDABLE CARE ACT

A significant portion of 2013 involved preparation for CHIP members to transition to other coverage through the ACA with the start of open enrollment on October 1, 2013. Committee members, Board, and staff worked on the following rate changes, communications, and CHIP’s transition plan:

 In an effort to wind down the Traditional pool, the Board decided that effective January 1, 2014, the Traditional pool would not accept applications during the ACA open enrollment period, since other coverage would be available in the private market that would not discriminate against pre-existing conditions.

 A proposal to revise CHIP’s rate-setting methodology in order to conform to the rates of the ACA was deliberated upon and implemented by the Actuarial/Finance committee. The committee recommended and the Board approved not to change rates in August 2013, maintaining instead the February 2013 rates until January 1, 2014. The new rates would become effective for all in-force enrollees irrespective of their renewal dates.

 Changes were made to CHIP’s rate structure that would conform to the rate structure of the ACA that would go into effect January 1, 2014. Pursuant to the CHIP Act, CHIP’s rates would be a multiple, known as the “multiplier,” of the 2014 private market rates. The rationale for making CHIP’s rates a multiple of the 2014 private market rates enabled CHIP to assure applicants and enrollees that, in terms of cost and benefits, coverage purchased through or off an Exchange would be a better value than CHIP coverage. The committee moved to increase the percentage of the HIPAA pool’s multiplier from 125% to 150% as allowed by the Act.

 The Board adopted the rate-setting mechanism specified by the ACA that includes unisex rating, 13 geographical rating areas, age and tobacco use limitations. CHIP’s 2014 rate would be equal to the average rate charged by health insurance issuers multiplied by the multiplier in effect for CHIP. This rate-setting mechanism would be effective January 1, 2014.

 CHIP eliminated the quarterly and semi-annual modes of premium payment requiring everyone to pay monthly.

 ACA related communication plans were implemented. Letters were sent to insurance agents informing them that the $50 stipend for assisting with the enrollment of an applicant would be discontinued on July 1, 2013.

 Another communications effort was to survey enrollees in order to ascertain their main concerns pertaining to transitioning from CHIP to new coverage. Of the active enrollees 1,756 or 8.5% responded to the surveys. The survey results were posted on the CHIP website. Informational letters to enrollees regarding the ACA and CHIP’s future were sent throughout the remainder of the year. The letters encouraged enrollees to access coverage through the federal Marketplace website to obtain coverage that would go into effect on January 1, 2014. CHIP’s communication efforts were coordinated as part of a statewide effort with the Department of Insurance (DOI), Healthcare and Family Services (HFS) and the Governor’s Office encouraging individuals to visit the marketplace website, “GetCovered Illinois”.

 A key component in CHIP’s transition plan was to encourage enrollees to purchase ACA coverage. Board staff attended training classes to become designated by the federal government as “Certified Application Counselors”. A workstation was setup at the Board office for the specific purpose of assisting enrollees with their ACA applications. PAGE 2 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH 2013 EXECUTIVE SUMMARY

APPLICATIONS

 Applications received in 2013 decreased by 42% compared to 2012. In the last half of 2013 CHIP applications declined by 67% with 1,268 applications received compared to the same six month period in 2012 when 3,796 applications were received. The decrease is likely attributed to the ACA’s open enrollment period that went into effect October 1, 2013 and the Traditional pool’s six-month pre-existing conditions exclusion.

TERMINATIONS

 Termination activity increased during the later part of 2013 due to the ACA’s open enrollment period that started on October 1, 2013 and rate increase letters mailed to members in November 2013. Overall, there were 8,290 terminations in 2013 with 59% of members terminating due to other coverage, non-payment, and premium too high.

CONTRACTUAL OVERVIEW

Catamaran

 Catamaran, the Plan’s pharmacy benefits manager, transitioned CHIP enrollees’ specialty drug needs from Walgreens Specialty Pharmacy to BriovaRx in March 2013. The transition resulted from SXC Health Solutions acquisition of Catalyst Health Solutions’. The transfer is expected to enhance specialty drug services with a minimum amount of enrollee disruption.

 Specialty drug cost increased 22%, representing 43% of Total Plan Costs and 2% of Total Claims. Generic Dispensing Rate increased 5.4 points over 2012 to 73.1%.

Blue Cross Blue Shield of Illinois (BCBSIL)

 BCBSIL, the Plans medical benefits manager reported 2013 year to date total paid expenses of $183,550,808. Out of this paid expense High Cost Claimants (HCC) accounted for $95,925,243 in paid expenses. During 2013 HCC represented 3.8% of total claimants and accounted for 52.3% of total paid expenses. The average paid expense per claimant was $8,767 while the average paid cost per HCC was $116,414. Amongst HCC paid expenses, inpatient facility accounted for 44% of total HCC paid expenses, outpatient facility accounted for 30.7% and professional services accounted for 25.3%. Out of the $95,925,243 in paid expenses for HCC, Neoplasms accounted for 21.8%, Circulatory accounted for 14.3% and Musculoskeletal and Connective Tissue accounted for 11.5%.

PAGE 3 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH APPLICATIONS FOR COVERAGE

The total number of applications received in 2013 declined by 42% over 2012. Overall, total applications received for 2013 is the lowest compared to the last five years. In the last half of 2013 there were 1,268 applications received representing a decline of 67% compared to the same six month period in 2012 when 3,796 applications were received. The decrease in applications is likely attributed to the ACA’s open enrollment period that went into effect October 1, 2013.

HIPAA Traditional Total % Change

2009 4,559 1,819 6,378 18.8%

2010 6,533 2,499 9,032 41.6%

2011 6,972 2,416 9,388 3.9%

2012 5,755 2,230 7,985 -14.9%

2013 3,344 1,286 4,630 -42.0%

Five-year average 5,433 2,050 7,483

7/1/12 - 12/31/12 2,711 1,085 3,796

7/1/13 - 12/31/13 926 342 1,268 -67.0%

Applications 10,000 9,000 8,000 7,000 6,000 Total 5,000 HIPAA 4,000 3,000 Traditional 2,000 1,000 - 2009 2010 2011 2012 2013

PAGE 4 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH

ENROLLEE PROFILE

Enrollment declined over the previous calendar year by 3,277 or 15.7% of change. The months of October, November, and December showed a decline in enrollment coinciding with the ACA’s open enrollment period. CHIP ending enrollment for 2013 was 17,572.

Total Enrollment 2009 - 2013

Total Plan HIPAA Traditional

Year Enrollees % Change Enrollees % Change Enrollees % Change

2009 16,085 -3.7% 11,520 6.2% 4,565 -22.1%

2010 18,098 12.5% 13,516 17.3% 4,582 0.4%

2011 19,998 10.5% 15,329 13.4% 4,669 1.9%

2012 20,849 4.3% 16,159 5.4% 4,690 0.4%

2013 17,572 -15.7% 13,704 -15.2% 3,868 -17.5%

Enrollment 2009 - 2013 25,000

20,000

15,000 Total HIPAA 10,000 Traditional

5,000

0 2009 2010 2011 2012 2013

PAGE 5 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH ENROLLEE PROFILE

The following charts show the largest number of participants in the age distribution are in the 60+ age bracket. Distribution by Gender show males outnumbered females in the Traditional Plan at 51%. When combining the two plans the chart reveals a higher number of females enrolled at a total of 9,548 or 54% compared to males at 8,024 or 46%.

Age Distribution

60+

55-59 50-54 45-49 40-44 35-39 30-34 <30

<30 30-34 35-39 40-44 45-49 50-54 55-59 60+ HIPAA 1,521 607 632 834 1,313 1,973 2,909 3,915 Traditional 551 266 254 319 398 563 709 808

PAGE 6 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH RATE AREA DISTRIBUTION

For rating purposes, the state is divided into four geographic rate areas that reflect the relative differences in the cost of medical care in those areas. The basis for area rating is the enrollee’s county of residence, except for the City of Chicago.

Rate Area A The City of Chicago.

Rate Area B Suburban Cook, and all of DuPage, Kane, Lake, McHenry, and Will Counties. Rate Area C All of Boone, Champaign, DeKalb, Grundy, Kankakee, Kendall, Madison, Peoria, Rock Island, Sangamon, St. Clair, Tazewell, and Winnebago Counties. Rate Area D All counties not included in A, B or C.

Number of Enrollees Percentage of Enrollees

Rate Area A 2,401 14% Rate Area B 9,733 55% Rate Area C 2,392 14% Rate Area D 3,046 17%

Totals 17,572 100%

Enrollment by Rate Area

RATE AREA D RATE AREA A 17% 14%

RATE AREA C 14%

RATE AREA B 55%

PAGE 7 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH ENROLLMENT DISTRIBUTION

DISTRIBUTION BY COUNTY DISTRIBUTION BY PLAN DEDUCTIBLE

As of 12/31/2013 As of 12/31/2013

County Total Percentage Traditional Total Percentage Deductible Cook 6,614 37.6%

500 673 17% DuPage 2,049 11.7% Lake 1,664 9.5% 1,000 556 14% Kane 639 3.6% 1,300 60 2% Will 621 3.5%

Winnebago 605 3.4% 1,500 424 11%

Mc Henry 514 2.9% 2,000 203 5% Madison 280 1.6% 2,500 813 21% Peoria 217 1.2% 5,000 684 18% Sangamon 194 1.1%

De Kalb 192 1.1% 5,200 455 12% St Clair 172 1.0% Total 3,868 100% La Salle 164 0.9% HIPAA Total Percentage Kendall 140 0.8% Deductible Champaign 137 0.8% 500 2,315 17% Kankakee 134 0.8% Mc Lean 124 0.7% 1,000 2,109 15%

Macon 115 0.7% 1,300 550 4% Rock Island 111 0.6% 1,500 1,754 13% Whiteside 100 0.6% 2,000 872 6% Jefferson 98 0.6% Tazewell 96 0.5% 2,500 2,768 20%

Adams 95 0.5% 5,000 1,984 14% Ogle 94 0.5% 5,200 1,352 11% All Other Counties 2,403 13.7% Total 17,572 100% Total 13,704 100% PAGE 8 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH 2013 MONTHLY ENROLLMENT ACTIVITY

The decline in monthly enrollment numbers starting in September may be attributed to the ACA’s open enrollment period that started October 1, 2013.

Month New Enrollees January 629 February 483 March 443 April 442 May 400 June 412 July 417 August 306 September 261 October 262 November 141 December 55

Total 4,251

PAGE 9 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH YEARLY ENROLLMENT ACTIVITY

New Enrollees by Enrollment Members in Active Status on 12/31 Percentage in Active Status Enrollment Total Years Year HIPAA Traditional Total Enrollees HIPAA Traditional Active Active HIPAA Traditional Combined

1989 4,542 4,542 40 40 24 0.9% 0.9%

1990 1,345 1,345 13 13 23 1.0% 1.0%

1991 1,016 1,016 17 17 22 1.7% 1.7%

1992 971 971 21 21 21 2.1% 2.1%

1993 1,250 1,250 28 28 20 2.2% 2.2%

1994 1,073 1,073 17 17 19 1.6% 1.6%

1995 1,110 1,110 34 34 18 3.0% 3.0%

1996 1,225 1,225 38 38 17 3.1% 3.1%

1997 445 1,253 1,698 14 43 57 16 3.1% 3.4% 3.3%

1998 1,405 1,046 2,451 44 40 84 15 3.1% 3.8% 3.4%

1999 1,671 1,210 2,881 64 43 107 14 3.8% 3.6% 3.7%

2000 2,983 1,328 4,311 137 56 193 13 4.6% 4.2% 4.5%

2001 3,018 1,486 4,504 179 109 288 12 5.9% 7.4% 6.4%

2002 3,705 1,445 5,150 247 133 380 11 6.7% 9.2% 7.4%

2003 4,070 1,138 5,208 324 92 416 10 7.9% 8.1% 8.0%

2004 3,292 1,202 4,494 298 114 412 9 9.1% 9.5% 9.2%

2005 3,072 1,181 4,253 279 142 421 8 9.1% 12.1% 9.9%

2006 2,871 1,172 4,043 396 161 557 7 13.8% 13.7% 13.8%

2007 2,914 1,091 4,005 499 187 686 6 17.1% 17.2% 17.1%

2008 3,016 948 3,964 614 200 814 5 20.4% 21.1% 20.5%

2009 3,733 918 4,651 1,002 300 1,302 4 26.8% 32.7% 28.0%

2010 5,193 988 6,181 1,577 377 1,954 3 30.4% 38.1% 31.6%

2011 5,555 1,057 6,612 2,443 512 2,955 2 44.0% 48.5% 44.7%

2012 4,976 1,066 6,042 3,086 673 3,759 1 62.0% 63.1% 62.2%

2013 3,569 682 4,251 2,501 478 2,979 0 70.1% 70.1% 70.1%

Grand Totals 55,488 31,743 87,231 13,704 3,868 17,572 24.7% 12.2% 20.1%

PAGE 10 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH 2013 ENROLLMENT ACTIVITY

The following charts show the number of new and active enrollees by enrollment year. From CHIP’s inception in 1989 through 1996, the lines for the total number of new enrollees in the plan and in the Traditional pool have converged. With the establishment of the HIPAA pool in 1997, the plan’s lines sharply diverged, with the Traditional pool proceeding horizontally and the HIPAA pool and total enrollment rising and falling in tandem. In 2013 enrollment started to decline in both pools with the advent of the ACA.

New Enrollees by Enrollment Year 7,000

6,000

5,000

4,000 Total 3,000 HIPAA 2,000 Traditional

1,000

Active Members by Enrollment Year 4,000 3,500 3,000 2,500 2,000 Total HIPAA 1,500 Traditional 1,000 500 -

PAGE 11 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH 2013 TERMINATION ACTIVITY

Termination activity increased in 2013 due in part to the ACA’s open enrollment period that started on October 1, 2013 and rate increase notification letters mailed to members in November 2013 effective January 1, 2014. Overall, the second chart shows that termination reasons “other coverage, non-payment, and premium too high” accounted for 4,874 or 59% of the 8,290 terminations for 2013.

MAJOR REASONS FOR TERMINATIONS Reason Count Percentage Other Coverage 3,158 38% Age 65 1,340 16% Medicare 383 5% Non-Payment 996 12% Insured's Request 482 6% Non-Resident 625 7% Premium too High 720 9% NSF 332 4% Death 103 1% Medical Assistance 144 2% 10-day Free Look 7 0% Total Terminations 8,290 100% TERMINATIONS BY MONTH

Other Non Insured's Non Premium Medical 10-day Coverage Age 65 Medicare Payment Request Resident too High NSF Death Assistance Free Look Total

January 202 138 47 47 28 44 32 23 6 8 1 576 February 142 111 30 40 11 43 19 34 6 11 0 447 March 152 113 43 53 4 73 27 30 14 5 3 517 April 186 105 43 63 12 28 26 18 13 10 1 505 May 125 150 36 33 15 41 16 17 11 8 0 452 June 112 111 30 47 11 24 25 21 10 5 1 397 July 152 154 26 41 26 38 29 24 11 8 0 509 August 158 89 33 48 24 46 29 23 6 12 0 468 September 163 72 25 65 25 81 23 40 6 11 1 512 October 151 139 42 135 18 47 34 19 8 9 0 602 November 206 88 19 193 69 72 40 36 7 23 0 753 December 1,409 70 9 231 239 88 420 47 5 34 0 2,552 Total 3,158 1,340 383 996 482 625 720 332 103 144 7 8,290

PAGE 12 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH FINANCIAL HIGHLIGHTS

Total Plan

The following is a summary of the Plan’s income and expenses for calendar years 2013 and 2012. Premiums, net of refunds, increased $5.3 million, or 4.1%, from the prior year as a result of a 3.8% increase in the premium rates charged and a 0.3% increase in total average enrollment in 2013. Total incurred losses increased $21.1 million, or 8.9%. This increase is due to a 8.6% average increase in health care costs per member in 2013 and the 0.3% increase in total average enrollment. Nonoperating revenues decreased $28.7 million, or 22.5%, due to an decrease in earned assessments of $16.2 million and a decrease in earned appropriations of $12.3 million. The change in net position was $44.8 million lower in 2013 primarily due to decreased nonoperating revenues of $28.7 million and increased incurred losses of $21.1 million offset by increased premium income of $5.3 million.

Illinois Comprehensive Health Insurance Plan Financial Summary Data (unaudited) Total Plan Year Ended December 31

2013 2012 Plan Income

Premiums, Net of Refunds $ 133,221,748 $ 127,949,368 Investment Income $ 218,602 $ 178,283 Total Plan Income $ 133,440,350 $ 128,127,651

Plan Expenses

Incurred Losses $ 256,937,255 $ 235,876,203 Agent Referral Fees $ 40,150 $ 108,800 Administrator Fees $ 8,573,615 $ 8,222,587 CHIP Board Office Expenses $ 3,291,173 $ 3,203,358 Total Plan Expenses $ 268,842,193 $ 247,410,948

Plan Surplus (Deficit) $ (135,401,843) $ (119,283,297)

Nonoperating Revenues Earned Appropriations $ 12,315,250 $ 24,630,500 Earned Assessments $ 83,981,400 $ 100,136,209 Federal Grants $ 2,599,441 $ 2,788,626 Total Nonoperating Revenues $ 98,896,091 $ 127,555,335

Change in Net Position $ (36,505,752) $ 8,272,038

PAGE 13 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH FINANCIAL HIGHLIGHTS

Traditional Pool

Below is a summary of the income and expenses for the Traditional pool for calendar years 2013 and 2012. Premiums, net of refunds, increased slightly from the prior year. Incurred losses increased $6.4 million, or 12.8%. This increase is due to a 15.7% average increase in health care costs per member in 2013 offset by a 2.6% decrease in average enrollment. Earned appropriations decreased $12.3 million, or 50.0%, due to no general revenue funds appropriated for the last six months of 2013. The change in net position was $18.8 million lower in 2013 primarily due to decreased earned appropriations of $12.3 million and increased incurred losses of $6.4 million.

Illinois Comprehensive Health Insurance Plan Financial Summary Data (unaudited) Traditional Pool Year Ended December 31

2013 2012 Plan Income Premiums, Net of Refunds $ 31,233,121 $ 31,231,553 Investment Income $ 7,698 $ 26,739 Total Plan Income $ 31,240,819 $ 31,258,292

Plan Expenses Incurred Losses $ 56,401,184 $ 50,020,225 Agent Referral Fees $ 6,450 $ 17,450 Administrator Fees $ 1,872,924 $ 1,828,639 CHIP Board Office Expenses $ 973,182 $ 942,886 Total Plan Expenses $ 59,253,740 $ 52,809,200

Plan Surplus (Deficit) $ (28,012,921) $ (21,550,908)

Nonoperating Revenues Earned Appropriations $ 12,315,250 $ 24,630,500 Earned Assessments $ - $ - Federal Grants $ - $ - Total Nonoperating Revenues $ 12,315,250 $ 24,630,500

Change in Net Position $ (15,697,671) $ 3,079,592

PAGE 14 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH FINANCIAL HIGHLIGHTS

HIPAA Pool

Below is a summary of the income and expenses for the HIPAA pool for calendar years 2013 and 2012. Premiums, net of refunds, increased $5.3 million, or 5.4%, from the prior year as a result of a 1.2% increase in average enrollment in the HIPAA pool and a 4.2% increase in the premium rates charged. Incurred losses increased $14.7 million, or 7.9%. This increase is due to a 6.7% average increase in health care costs per member in 2013 and the 1.2% increase in average enrollment. Earned assessments decreased $16.2 million, or 16.1%, as a result of a lower assessment to cover a projected lower deficit for the last six months of 2013. The change in net position was $26.0 million lower in 2013 primarily due to decreased earned assessments of $16.2 million and increased incurred losses of $14.7 million offset by increased premium income of $5.3 million.

Illinois Comprehensive Health Insurance Plan Financial Summary Data (unaudited) HIPAA Pool Year Ended December 31

2013 2012 Plan Income Premiums, Net of Refunds $ 101,988,627 $ 96,717,815 Investment Income $ 210,904 $ 151,544 Total Plan Income $ 102,199,531 $ 96,869,359

Plan Expenses Incurred Losses $ 200,536,071 $ 185,855,978 Agent Referral Fees $ 33,700 $ 91,350 Administrator Fees $ 6,700,691 $ 6,393,948 CHIP Board Office Expenses $ 2,317,991 $ 2,260,472 Total Plan Expenses $ 209,588,453 $ 194,601,748

Plan Surplus (Deficit) $ (107,388,922) $ (97,732,389)

Nonoperating Revenues Earned Appropriations $ - $ - Earned Assessments $ 83,981,400 $ 100,136,209 Federal Grants $ 2,599,441 $ 2,788,626 Total Nonoperating Revenues $ 86,580,841 $ 102,924,835

Change in Net Position $ (20,808,081) $ 5,192,446

PAGE 15| ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH FISCAL YEAR (FY) ASSESSMENTS AND PREMIUMS

The assessment amount for FY’14 declined over the past three years. FY’14 assessment amount reflects decrease in enrollment.

Fiscal Year Assessment Amount FY09 $43,371,000 FY10 $54,503,000 FY11 $61,154,000 FY12 $81,713,009 FY13 $103,311,000 FY14 $ 54,987,000

Fiscal Year Assessments $120.00 $100.00 $80.00

$60.00 Millions $40.00 $20.00 $0.00 FY09 FY10 FY11 FY12 FY13 FY14

Premiums paid by CHIP enrollees vary depending on age, sex, area of residence in the state, the deductible amount, Tobacco/Non-Tobacco use, and the benefit plan for which they are eligible.

The following chart reflects a decrease in annual premiums starting in 2011. In October 2010 the Board reduced the multiplier of the HIPAA pool to the statutory minimum of 125%. The reduction became effective February 2011. In April 2013 the Board increased the multiplier of the HIPAA pool from 125% to the statutory maximum of 150%. The increase became effective January 1, 2014.

Average Annual Premium $8,000

$7,000

$6,000

$5,000

$4,000

$3,000

$2,000 2008 2009 2010 2011 2012 2013 Average Annual Premium $7,153 $7,211 $7,048 $6,201 $6,163 6,397

PAGE 16 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH CLAIMS

2013 2012 Description Traditional HIPAA Grand Total Grand Total Inpatient $ 14,647,725 $ 44,288,666 $ 58,936,392 $ 51,438,675 Outpatient $ 14,686,789 $ 47,053,605 $ 61,740,394 $ 58,763,452 ECF/SNF $ 404,050 $ 715,686 $ 1,119,736 $ 1,155,195 Coordinated Home Care $ 172,113 $ 862,224 $ 1,034,337 $ 1,012,858 Medicare Deductible $ 13,835 $ 2,335 $ 16,170 $ 25,380 Physician Services $ 12,972,320 $ 47,620,776 $ 60,593,096 $ 56,203,073 Major Medical $ 85,293 $ 614,991 $ 700,284 $ 471,261 Subtotal $ 42,982,125 $ 141,158,283 $ 184,140,408 $ 169,069,894 Adjustments* $ (33,180) $ (556,420) $ (589,600) $ (437,207) Total Blue Cross Medical $ 42,948,945 $ 140,601,863 $ 183,550,808 $ 168,632,687

Total Prescriptions $ 14,074,153 $ 62,559,985 $ 76,634,138 $ 69,776,703

Total Paid Claims $ 57,023,098 $ 203,161,848 $ 260,184,946 $ 238,409,390 Prescription Rebates $ (463,336) $ (1,802,596) $ (2,265,932) $ (2,807,498) Claim Refunds $ (58,578) $ (223,181) $ (281,759) $ (325,689) Change in Claim Reservies $ (100,000) $ (600,000) $ (700,000) $ 600,000 Net Incurred Losses $ 56,401,184 $ 200,536,071 $ 256,937,255 $ 235,876,203

* Examples include Rebates, Subrogation Reimbursements, Discount Offsets

Plan Claim Cost Per Member Traditional HIPAA Combined Average Enrollment 4,597 16,228 20,825 Average Prescription Cost $ 2,961 $ 3,744 $ 3,571 Average Non-Prescription Cost $ 9,308 $ 8,613 $ 8,767 Average Plan Claim Cost $ 12,269 $ 12,357 $ 12,338

AVERAGE ANNUAL PLAN CLAIM COST PER MEMBER $14,000 $12,000 $10,000 $8,000 $6,000 $4,000 $2,000 2008 2009 2010 2011 2012 2013 Traditional $9,311 $11,140 $10,939 $10,731 $10,600 $12,269 HIPAA $10,363 $10,875 $10,837 $11,227 $11,586 $12,357

PAGE 17 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH PRESCRIPTION DRUG CLAIMS

TOP DRUGS BY TOTAL PLAN PAID IN 2013 RANK DRUG LABEL TOTAL PLAN COST 1 HUMIRA PEN $3,592,477

2 ABILIFY $1,629,986 3 ATRIPLA $1,421,396 4 COPAXONE $1,387,523 5 ENBREL SURECLICK $1,385,853 6 BERINERT $1,345,398 7 CYMBALTA $1,341,879 8 GLEEVEC $1,207,613 9 CRESTOR $1,164,839 10 NEXIUM $1,038,837 11 AVONEX $1,030,318 12 LANTUS SOLOSTAR $973,948

13 ENBREL $960,196 14 AVONEX PEN $937,072 15 TRUVADA $932,691 16 HUMIRA $845,467

17 BETASERON $789,656 18 REBIF $726,251 19 GILENYA $716,711 20 TECFIDERA $675,042

TOP DRUGS BY AVERAGE PLAN COST IN 2013 RANK DRUG LABEL AVERAGE PLAN COST 1 KOGENATE FS INJ $282,021.46 2 BERINERT INJ $103,492.12 3 ILARIS INJ $28,140.48 4 SYPRINE $14,147.62 5 FERRIPROX $12,368.44 6 XALKORI $11,638.23 7 FIRAZYR INJ $10,669.12 8 ACTHAR HP INJ $9,441.35 9 PROLASTIN-C INJ $8,218.48 10 NEXAVAR $7,362.40 11 SABRIL POW $7,272.37 12 FABRAZYME INJ $7,087.45 13 XYREM SOL $7,021.90 14 KALYDECO $6,810.73 15 TRACLEER $5,957.55 16 COMETRIQ KIT $5,548.77 17 SAMSCA $5,295.08 18 INCIVEK $5,019.52 19 POMALYST $4,719.32 20 TYSABRI INJ $4,484.03

PAGE 18 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH MEDICAL AND PROVIDER CLAIMS

TOP 15 INPATIENT MEDICAL PAID EXPENSES IN 2013

RANK NAME TOTAL PLAN PAID 1 CIRCULATORY $10,439,119 2 MUSCULOSKELETAL AND CONNECTIVE TISSUE $9,427,661 3 DIGESTIVE $6,178,950 4 INJURY & POISONING $5,941,477 5 NEOPLASMS $5,736,018 6 RESPIRATORY $3,084,149 7 HEALTH SERVICES $2,902,215 8 INFECTIOUS AND PARASITIC $2,590,938 9 ENDOCRINE, NUTRITIONAL AND METABOLIC DISEASES $2,393,688 10 NERVOUS SYSTEM $2,033,406 11 MENTAL HEALTH $1,941,571 12 GENITOURINARY $1,638,047 13 SYMPTOMS, SIGNS & ILL-DEFINED CONDITIONS $1,334,952 14 SUBSTANCE ABUSE $1,046,781 15 SKIN AND SUBCUTANEOUS TISSUE $973,306

ALL OTHER $1,892,303 TOP 15 OUTPATIENT MEDICAL PAID EXPENSES IN 2013

RANK NAME TOTAL PLAN PAID 1 NEOPLASMS $10,088,263 2 SYMPTOMS, SIGNS & ILL-DEFINED CONDITIONS $7,223,369 3 HEALTH SERVICES $7,015,602 4 MUSCULOSKELETAL AND CONNECTIVE TISSUE $6,735,939 5 DIGESTIVE $4,774,375 6 CIRCULATORY $4,519,944 7 GENITOURINARY $4,111,224 8 ENDOCRINE, NUTRITIONAL AND METABOLIC DISEASES $3,622,922 9 INJURY & POISONING $3,095,654 10 NERVOUS SYSTEM $2,850,527 11 BLOOD AND BLOOD-FORMING ORGANS $1,504,815 12 WITHOUT REPORTED DIAGNOSIS $1,388,512 13 RESPIRATORY $1,320,899 14 EYES $957,742 15 MENTAL HEALTH $951,510

ALL OTHER $3,280,841 PAGE 19| ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH MEDICAL AND PROVIDER CLAIMS

TOP 10 INPATIENT FACILITY PROVIDERS IN 2013 BY TOTAL PLAN PAID RANK NAME TOTAL PLAN PAID 1 ADVOCATE HEALTH AND HOSPITAL $6,132,775

2 NORTHWESTERN MEMORIAL HOSPITAL $5,395,686 3 BARNES JEWISH HOSPITAL - MO $3,075,823 4 ST FRANCIS HOSPITAL MEDICAL $2,626,580 5 NORTHSHORE UNIVERSITY $2,430,092 6 LOYOLA UNIVERSITY MEDICAL CENTER $2,181,309 7 RUSH UNIVERSITY MEDICAL CENTER $1,888,989 8 CENTRAL DUPAGE HOSPITAL $1,633,256 9 UNIVERSITY OF CHICAGO $1,464,883 10 UNIVERSITY OF WISCONSIN $1,335,463

ALL OTHER $29,713,682

TOP 10 OUTPATIENT FACILITY PROVIDERS IN 2013 BY TOTAL PLAN PAID RANK NAME TOTAL PLAN PAID

1 NORTHSHORE UNIVERSITY $4,724,881

2 ADVOCATE HEALTH AND HOSPITAL $3,759,090

3 NORTHWESTERN MEMORIAL HOSPITAL $3,670,408

4 CENTRAL DUPAGE HOSPITAL $3,213,462

5 UNIVERSITY OF CHICAGO $3,154,350

6 RUSH UNIVERSITY MEDICAL CENTER $2,423,751

7 LOYOLA UNIVERSITY MEDICAL CENTER $1,668,594

8 MIDWESTERN REGIONAL MEDICAL CENTER $1,605,466

9 ST FRANCIS HOSPITAL MEDICAL $1,181,951

10 BARNES JEWISH HOSPITAL - MO $1,044,346

ALL OTHER $36,468,924

PAGE 20 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH CHIP HIGHLIGHTS FROM 1989—2012

We would like to take this opportunity to reflect back on significant milestones over the past 25 years that made the CHIP program an important vehicle for those individuals who could not obtain healthcare coverage due to pre-existing conditions. As we transition into a new era that will now allow the uninsured to obtain affordable healthcare coverage through the ACA, we would like to thank the Legislature, Board of Directors and employees for their contributions and efforts in making CHIP the best program of its time for the citizens of Illinois. 1989 The CHIP Act became law in 1987; with first coverage being provided on May 1, 1989, Illinois was the fifteenth state to enact such a mechanism, known as “high risk pool.”

1990 In 1990, the average premium was $3,150 a year. Expenses that CHIP incurred during 1990 surpassed what the plan earned in premiums and investments by nearly $11.9 million. Membership was limited to 4,500.

1991 The number of uninsurable in Illinois was estimated from 75,000 to 150,000. Through December 31, 1991, nearly 7,000 Illinois citizens had at one time or another, availed themselves of coverage through CHIP. The plan had paid out benefits in excess of $50 million.

1992 At year’s end, all but three counties in Illinois had at least one CHIP enrollee. By 1992, $75 million in benefits had been paid out with nearly nine hundred on waiting list.

1993 During 1993 the Board of Directors increased its existing enrollment limitation from 4,500 to 4,750. Benefits paid for CHIP’s insured surpassed $100 million.

1994 1994 marked CHIPs fifth year of providing health insurance to Illinois uninsurable. At the federal level, two healthcare issues received much attention, portability and uninsurability.

1995 Beginning August 1, 1995, CHIP began making available a hospital-only Preferred Provider Option (PPO) for which premiums averaged 14% less than the standard plan. At the end of the year, 44% of those eligible (i.e., those not eligible for Medicare) had enrolled in the PPO plan; and 60% of new applicants selected the PPO option. For 1995, CHIP had an enrollment capacity of 5,000 and virtually no waiting list.

1996 The President signed into law HIPAA. Senate Bill 802 implemented HIPAA in Illinois and qualified CHIP as an “acceptable alternative mechanism” for the state’s individual insurance market as authorized by this new federal law.

1997 Illinois legislation provides for a new HIPAA-CHIP program is to be funded by an assessment of all health insurers, health maintenance organizations and voluntary health service plans, and that there can be no limitation on enrollment or exclusion for preexisting conditions for federally eligible individuals. Lifetime maximum in benefits increased from $500,000 to $1 million.

PAGE 21 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH CHIP HIGHLIGHTS FROM 1989—2012

1998 In 1998, 1,915 applications were received for the HIPAA-CHIP program. The average annualized premium paid by participants in the CHIP program during 1998 was $3,726—slightly below the previous year.

1999 Total benefits paid on behalf of CHIP participants in the Traditional Pool exceeded $348 million by the end of 1999. The number of Traditional Pool applications received during 1999 increased by 17% and HIPAA-CHIP increased 21% over the previous year. 2000 HIPAA-CHIP became the larger of the two programs offered by CHIP with an increase of 81% higher applications received over the previous year.

2001 In 2001, CHIP received a supplemental appropriation of $10 million for the first time in its history. Allowing the CHIP Board to reopen enrollment in the Traditional CHIP program. Existing PPO options were expanded to include both hospitals and physi- cians; the previous standard “indemnity” options were discontinued; and a prescription drug card program was implemented with the new administrative agreement.

2002 Illinois General Assembly passed H.B. 3298 and H.B. 707 which amended the CHIP Act to allow HIPAA-CHIP to become a “qualified health plan” in response to the Trade Act of 2002 that created a federal tax credit, administered by the IRS. The Health Coverage Tax Credit (HCTC) paid 65% of the cost of qualified private health insurance for displaced workers and certain individuals who receive benefits from the Pension Benefit Guaranty Corporation (PBGC).

2003 On June 23, 2003, legislation amended the CHIP Act to create a special category of participants who qualify for coverage because they are Trade Act (TAA) certified or receive PBGC.

2004 CHIP added $5,000 deductible to the program and a separate $2,500 out-of-pocket maximum for prescription drugs effective January 1, 2004.

2005 Public Act 94-0017, provided eligibility requirements with respect to third party liability claims. Multi-million dollar premium relief was secured from the U.S. Depart of Health and Human Services. Preparation for Medicare Part D commenced during 2005. On-line applications began in 2005.

2006 The ICHIP Act had, since 1992, deemed persons ineligible for the program if they have in excess of $100,000 remaining from a structured settlement. Public Act 94-0017 changed this amount to in excess of $300,000 effective January 1, 2006. Medicare Part D went into effect. Lifetime maximum increased form $1 million to $1.5 million. Premium relief for federally eligible individuals went into effect during 2006.

PAGE 22| ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH CHIP HIGHLIGHTS FROM 1989—2012

2007 Procedures were developed in 2007 by CHIP staff, the TPA and PBM to implement a High Deductible Health Plan (HDHP). HDHP’s which meet the federal guidelines to be used in conjunction with Health Saving Account will go into effect January 1, 2008.

2008 HDHP became operational pursuant to Board direction. New under-age-20 premium rates were developed and implemented. Legislation became effective so that an insurer may not deny coverage to a person who applies for Medicare Supplement policy within six months after enrolling in Medicare Part B. CHIP notified its Plan 2 participants of the availability of the policies. At the time the law became effective, CHIP had 1,080 individuals enrolled in Medicare Plan 2. Because of the availability of Medicare Supple- ment plans, as of December 31, 2008 the total enrollment was 589.

2009 The CHIP Board changed significantly its maternity benefit structure on August 1. CHIP began payment of maternity benefits under the major medical provisions of the plan the “same as any other sickness”. The Board established tobacco user/non-user rates for new enrollees effective February 2010 and for in-force participants effective February 2011. Enrollees and participants using tobacco will be charged higher rates than non- users.

2010 Passage of the Affordable Care Act (ACA) on March 23, 2010 had minimal effect on current CHIP operations. CHIP provided technical support and expertise in the State’s implementation and establishment of the federally funded temporary high risk pool referred to as the IL Preexisting Condition Insurance Plan. Tobacco user/non-user rates for new enrollees effective 2010. The number of applications for enrollment in CHIP during 2010 increased dramatically, particularly in the HIPAA pool. The monthly average increased by 42%. The increase in enrollment was attributed to the economic recession and resultant expiration of COBRA coverage.

2011 CHIP applied tobacco user/non-user rates to in-force enrollees beginning in February 2011. The Board endorsed legislation that provides access to CHIP coverage to children under 19 years of age who are unable to access it because of the unavailability of private sector coverage. The legislation became law and effective on January 13, 2012.

2012 CHIP achieved a record high level of enrollment of more than 20,800. Specialty drug utilization increased. Board decided to increase the $1,200 deductible to $1,300. When the Supreme Court validated the ACA in June 2012, interest in the new law intensified. At a special meeting in October the Board discussed and made decisions regarding CHIP’s transition in 2013 to coverage under the ACA.

PAGE 23| ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH BOARD OF DIRECTORS STATUTORY MEMBERS

Lisa Madigan, Attorney General Attorney General of Illinois; State Senator, serving as Minority Spokesperson on Senate Education Committee; litigator with Sachnoff & Weaver, Ltd., specializing in employment law; Assistant Dean for Adult and Continuing Education at Wright College, Chicago; volunteer school teacher of Zulu women in apartheid South Africa; graduate of Loyola University Law School and Georgetown University.

Raymond Threlkeld Representative for the Attorney General. Andrew Boron, Director, Andrew Boron was appointed Director of the Illinois Department of Insurance Department of Insurance, Board January 27, 2012, by Illinois Governor, Pat Quinn. Boron brings a career of Chair insurance, government and private sector experience to the department. He returned to state government after working as vice president and counsel at the ACE Group, where he served as primary liaison to the departments of insurance in nine states, including Illinois. He also served as Deputy Chief of

Staff at the Illinois Toll Highway Authority between 2009 and 2010.

Boron began his career at CNA Financial, serving as counsel and then director

of state government relations. He holds a bachelor’s degree from the University of Wisconsin and a juris doctorate from the Chicago-Kent College of Law. Boron was admitted to the Illinois Bar in 1998. He is married and has two children.

Jerry Stermer, Acting Director, At GOMB, Stermer leads the administration’s budget negotiations with the Governor’s Office of Manage- General Assembly. He joined Governor Quinn’s administration as chief of ment and Budget (GOMB) staff in 2009 after spending several years working for numerous public interest groups that focused on state policy and state budgeting. During his tenure with the administration, Stermer has played a leading role in negotiations with the General Assembly and legislative leaders. He led the Governor’s pension working group and developed legislation to address the pension crisis that has resulted from decades of fiscal mismanagement in Illinois. Since joining Governor Quinn, Stermer has helped pass major legislation including bills to stabilize pensions and restructure the state’s Medicaid program.

Stermer holds a master’s degree in political science from the University of IL at Chicago, and he studied at the Divine World Seminary, where he completed his bachelor’s degree in liberal arts. He has been an adjunct professor at Northwestern University School of Education and Social Policy since 2002.

Michael Moss, Deputy Director Representative for Governor’s Office of Management and Budget (GOMB).

PAGE 24| ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH LEGISLATIVE MEMBERS

Bill Brady, Bloomington, IL Republican spokesperson on the Senate Insurance Committee; Member, Senate State Senator 44th District Agriculture & Conservation, State Government & Veterans Affairs, and Transpor- tation Committees. Active in workers' compensation and tort reform and financial and insurance reform; Member Illinois House of Representatives, 88th District, 1988-2000; Chairman House Insurance and Pensions Committee; member of Financial Institutions, Energy and Environment, Child Support Enforcement, Judicial Reappointment, Labor and Commerce, and Prison Reform Management Committees, as well as the Economic and Fiscal Commission; Owner of ReMax Choice Real Estate Bloomington and Champaign; civic involvement includes Chamber of Commerce, Catholic Charities, St. Joseph Medical Center, and United Way; B. A., Illinois Wesleyan University, Bloomington, Illinois. Don Harmon, Oak Park, IL Senator Don Harmon is a graduate of St. Ignatius High School on Chicago’s near State Senator 39th District, west side and Knox College in Galesburg, Illinois. Harmon worked his way Assistant Majority Leader through the University of Chicago, where he received both his law degree and MBA.

Senator Harmon is currently serving his third term in the Illinois Senate. In January of 2009, incoming Senate President John Cullerton appointed Harmon Assistant Majority Leader. Senator Harmon serves as Vice-Chair of the Judiciary Committee, and on the Assignments, Environment, Executive, Executive Appointments, Redistricting, and Telecommunications and Technology Commit- tees. He and his wife, live in Oak Park with their three young children. David Leitch, Peoria, IL Member, House Committee on Human Services Appropriations, Accountability rd IL State Representative 73 and Administrative Review, Financial Institutions, Labor & Commerce, and District, Deputy Republican Minority Spokesman for Housing National City Bank, vice president (retired); B.A., Leader History, Kalamazoo College, Kalamazoo, MI; American Medical Association Nathan Davis Award as State Legislator of the Year in the U.S.; numerous awards for mental health advocacy and “Legislator of the Year” awards; Guardian of Small Business Award; Champion of Free Enterprise; numerous Farm Bureau Activator Awards. Current board service: Susan G. Komen for the Cure; has three children.

Frank J. Mautino, Illinois State University-Bachelor of Science Degree, 1984; Major: Marketing: Minor Spring Valley, IL Administration. Illinois Valley Community College, Oglesby, IL—Associate of Arts State Representative 76th Degree, 1982 Western Illinois University. House Committees: Agriculture & Conserva- District, Deputy Majority tion; Insurance; Revenue & Finance House Terms: Appointed 1991—present; Leader Currently serving—11th Elected Term Deputy Majority Leader—2011; Assistant Majority Leader—2009; Awards: Environmental Leadership Award-IL Environmental Council-2012: “Legislator of the Year”-IL Assoc of Wholesale Distributors-2012; Friend of Conservation-Northwest Central Land Use Council 2—2011; “Statesmen of the Year” Local 150 Northern IL Union Contractors-2010; IL Victims Org—Legislator Hero Award 2008-2009; Legislator of the Year-IL Assoc. of County Officials-2009; Legislator of the Year-IL HealthCare Assoc.-2007; Excellence Award in Government * Business-2006; IL State Crime Commission-2005; Legislator of the Year-IL County Board-2005; Friend of Agriculture-IL Farm Bureau-2002, 04, 06, 08, 10,11, 12; Friend of Municipalities-2002; Legislature Advocacy Award for Developmental Disabilities- 2002; Outstanding Contributor towards a Non-Violent World Freedom House 2001- 2002. Married with three children. PAGE 25 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH PUBLIC MEMBERS

Howard J. Bolnick, F.S.A., Former Chair, Finance Committee. Actuarial and strategic consultant to health Chicago, IL insurance companies and wellness plans. Former Chairman, InFocus Financial Group; former Adjunct Professor, Kellogg Graduate School of Management, Northwestern University; former President, Celtic Life Insurance Company; former Partner, Coopers & Lybrand; Fellow of the Society of Actuaries; Past-President, Society of Actuaries; Member of the American Academy of Actuaries; Honorary

Fellow, Institute of Actuaries (U. K.); Honorary Member of the Actuarial Society of South Africa; M. B. A., University of Chicago. Ronald S Eaker, MDIV, Former Consumer Advocate on Illinois Health Facilities and Services Review Board; Urbana, IL member Champaign County Health Care Consumers; member Illinois Comprehen- sive Health Insurance Program Board; former United Methodist Clergy; former member Chaddock Board of Trustees; former Chairman Epworth Springs Board of Trustees; former member of Sunset Home Board of Trustees; MDIV, Eden Theologi- cal Seminary, St. Louis, MO.

Brent Hanfling, Chicago, IL General Counsel of Allied Benefit Systems, Inc., a third party administrator of group health plans. Brent oversees all legal matters involving Allied, as well as leads all areas of legal compliance governing Allied and its client group health plans, including consulting with respect to the Affordable Care Act, ERISA, COBRA, HIPAA and healthcare law generally. Brent joined Allied in April 2006. Graduated from Northwestern University in 1991 and Northwestern University School of Law in 1994. Immediately following law school, Brent clerked for the Honorable David Sentelle of the United States Court of Appeals for the District of Columbia Circuit. He subsequently practiced complex commercial litigation for several years in Chicago, Illinois. Brent is admitted to the Illinois Bar and the United States District Court, Northern District of Illinois. He is a member of the Chicago Bar Association.

David Hill, Evanston, IL Chief State Affairs Officer for Assurant Legal Department; prior to joining Assurant in 1997, served as Associate General Counsel for the Chicago Housing Authority Legal Department and as Senior Attorney for the City of Chicago, Office of the Corporation Counsel. Alyssa Knobel, Highland Elected Office—Councilman (2013-2017); Appointed Offices-Business and Park, IL Economic Development Commission (BEDC), Chair; Downtown Business Alliance; Ravinia Business District Alliance; Briergate Business Association District; ICHIP (IL Comprehensive Health Insurance Plan), Governor Appointed.

Education: Boston University, Bachelor of Science, Communication; Occupation- Marketing/Communications Consultant; State Representative Karen May; BBDO; McCann-Erickson; Activities, Clubs and Organizations; League of Women Voters; Boston University Alumni Admissions Volunteer; Summer Camp Opportunity Provides Education (SCOPE); Highland Park Historical Society; Joint Action Committee for Political Affairs (JACPAC); Jewish Council for Youth Services; NSSD 112 Strategic Plan Curriculum Committee; Small Business Advocacy Council (SBAC). Married, with two children.

PAGE 26 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH PUBLIC MEMBERS

Carrie McAteer, Chicago, IL Manages the University Internship Program at DePaul University where she has worked for over 12 years. She has a BA in communication from the University of Dayton and an MS in public service administration from DePaul University. She is a board member of the Danny Did Foundation, an organization which supports epilepsy research and awareness. Her involvement with the foundation is very personal because she has lived with epilepsy for more than 25 years. Carrie also serves on the board of directors for Personal PAC and is serving her 7th year as a board member for the Lincoln Park Chamber of Commerce where she holds the role of Director of External Affairs for the organization's executive committee. Managing a chronic illness for most of her life, while being fortunate to receive excellent medical care to live a normal life, has led to her passion and commitment as a member of the CHIP Board of Directors.

Thomas L. McLeary, CLU, President of ENDOW, INC. Former National Trustee, National Association of Chicago, IL Insurance and Financial Advisors, past President, IL and Chicago Association of Life Underwriters. Current 1st Vice Chair, Board of Trustees Lincoln Park Zoo. Asst. Treasurer, Chicago Minority Business Development Council. Member, Alliance of Business Leaders and Entrepreneurs. BS, University of Illinois.

Nasir Rana, MD, MPH, Member CHIP Board. Board certified Reproductive Endocrinologist and Infertility FACOG, FACS, Oak Brook, IL Physician. Medical Director Reproductive Medicine Institute; Fellow American College Of Obstetricians and Gynecologists; Fellow American College Of Surgeons; Retired Colonel USAF Reserve; Veteran Gulf War. Former Commander 440 MDS, 440th Air Lift Wing; Chief flight Surgeon 64 TAS and 95 TAS; Graduate Squadron Officers School, School Of Aerospace Medicine, Top Knife Fighter Surgeons School; Graduate Squadron Commander’s School; former, Director OB/GYN Ambulatory Health Care, Cook County Hospital Mem- ber CHIP Board. Health Care, Cook County Hospital

Eva Serrano, Ed.D., Aurora, IL Assistant Professor, Aurora University; former Executive Director, Girl Scouts of the USA (Whispering Oaks Council); former Vice President, El Valor; former Board Member of Voices for Illinois Children; Fellow of National Hispana Leadership Institute, ENLACE Leadership Institute, and Leadership Greater Chicago; Faculty Fellow of American Association of Hispanics in Higher Education.

Stephen Stabile, M.D. Associate Chief Medical Officer, Ambulatory and Community Health Network, Chicago, IL Cook County Health and Hospitals System. Dr. Stabile is a family physician with focusing on caring for underserved urban communities. He is on staff at Stroger, Provident and St. Mary and Elizabeth Hospitals. He has an interest in global health issues and has provided care in Latin America, Africa and Australia. He speaks fluent Spanish.

PAGE 27 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH PUBLIC MEMBERS

Melissa Hansen, Executive Director, IL Melissa Hansen became the Executive Director of the Illinois Comprehensive Health Insurance Plan, January 3, 2014. Hansen’s Comprehensive Health Insurance Plan sixteen years of government experience encompass budget analysis, financial reporting of local governments and crafting legislation. During her ten years as a legislative liaison she has worked

legislation ranging from health coverage for young adults to reducing predatory lending. Prior to joining ICHIP, Hansen was the Legislative Director at the Department of Insurance. While there Hansen passed legislation to provide insurance coverage for Autism, Habilitative services, substance abuse and young adults up to age 26. In addition, Hansen passed legislation to ensure that insured individuals have a proper appeal process when insurance claims are denied.

Previously, Hansen worked for Illinois House of Representatives, Illinois Comptroller, Healthcare and Family Services, Central Management Services and Financial and Professional Regulation. John Stevens, General Counsel, John Stevens is a Springfield-based Partner in the Government and Freeborn & Peters LLP Regulatory Law Practice Group.

John has more than 30 years of experience in assisting clients with

legislative, regulatory, government procurement and public employee collective bargaining issues. John’s experience includes developing and implementing comprehensive government relations programs, drafting complex legislation, lobbying the legislative and executive branches of government, negotiating and administering public employee collective bargaining agreements, and counseling clients on asset privatizations, public pension issues, public finance issues and municipal bond sales.

He previously served as General Counsel to the IL Attorney General and two IL Comptrollers. His past experience also includes serving as Chief Counsel to the Governor’s GOMB (formerly known as the IL Bureau of the Budget), Deputy Counsel to the Governor and legal advisor to the Governor and legal advisor to the Procurement Policy Board. Plan Administrators Blue Cross and Blue Shield of Illinois Catamaran Rx (PBM Administrator) The CHIP Board of Directors wishes to thank the following members of the Actuarial Advisory Committee

Actuaries Charles J. Sherfey, Chairman Dan Goodman Gerald Lucht Richard Ruppel Nicole Styka

PAGE 28 | ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH ICHIP 2013 ANNUAL REPORT ILLINOIS COMPREHENSIVE HEALTH