PINNACLE - New York State Department of Health · 2019. 10. 17. · Pinnacle Actuarial Resources,...
Transcript of PINNACLE - New York State Department of Health · 2019. 10. 17. · Pinnacle Actuarial Resources,...
Report to the New York Department of Financial Services
New York State Medical Indemnity Fund
3rd Quarter 2017 Actuarial Analysis
As of September 30 2017
February 2018
~ PINN ACLE ACTUARIAL RESOURCES INC
3109 Cornelius Drive
Bloomington IL 61704
309807 2300 pinnacleactuariescom
Commitment Beyond Numbers
TABLE OF CONTENTS
Section
Purpose amp Scope 1
Executive Summary 2
Background 4
Data Methods amp Assumptions 5
Discussion and Analysis 7
Number of Qualifying Participants 7
Mortality ExperienceLife Expectancy 8
Actuarial Ca lculation of Estimated Fund Liabilities 9
Amount of Benefits Paid 11
Patterns of Utilization 11
Benefit Payments and Injury Type 13
Inflationary Patterns of Types of Services 16
Administrative Expenses 17
Impact of Available Health Insurance 17
Investment Earnings 17
Distribution amp Use 18
Reliances amp Limitations 19
EXHIBITS
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund 3rd Quarter 2017 Actuarial Analysis
As of September 30 2017
Purpose amp Scope
Pinnacle Actuarial Resources Inc (Pinnacle) had been retained by the New York State Department of
Financial Services (NYS DFS or the Department) to provide quarterly actuaria l reports regard ing the
experience of the New York State Medical Indemnity Fund (MIF or the Fund) This analysis eva luates
data for the Fund as of September 30 2017
sect69-1019 of the New York State Department of Health Regulation states that the quarterly reports
should include a review of the various elements contributing to the amount of benefits paid by the
Fund and to the expenses of administration of the Fund including
bull The number of qualifying plaintiffs
bull The mortality experience of the qualified plaintiffs
bull The amount of benefits paid by the Fund
bull The patterns of utilization of types of services provided
bull Inflationary patterns by types of services provided
bull The expenses of administration of the Fund
bull The impact of avai lable health insurance on benefits paid by the Fund and
bull Investment earnings of the Fund
sect69-1020 of the New York State Department of Health Regulation also requires an actuaria l
calcu lation of the estimated liabi lities of the Fund for the coming year resu lting from the qualified
plaintiffs enrolled in the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 2 February 21 2018
Executive Summary
Based on our review of available information regarding the New York State Medical Indemnity Fund as
of September 30 2017 Pinnacle has arrived at a number of key conclusions
bull As of September 30 2017 the Fund had accepted 505 participants (500 living) with expected
future benefit payments of approximately $7271 mi ll ion and future administrative expenses of
$1240 million assuming a discount rate of 25 With a Fund balance as of September 30
2017 of approximately $2445 mi ll ion this results in an unfunded liability for the Fund of
approximately $6067 million
o Tota l future lifetime benefits for the 500 living Fund participants without discounting is
estimated to be $1756 bil lion
o The current present va lue of future benefit payments of $7271 million does not
consider any additional enrollees that may be admitted to the Fund in the future
o Prior to the passing of recent legislation each new participant admitted to the Fund
after June 30 2017 would increase the Funds future benefits payment liabilities by
$335 mi llion on a nominal basis or a present value of $132 million increasing at
approximately the medical inflation rate annually from March 31 2017
o Earlier this year new legislation was passed expanding eligibi lity for the Fund to nonshy
hospital births and significantly raising reimbursement rates for the period from July 1
2017 through December 31 2019 For new participants admitted during this period a
priori estimates of future lifetime benefits payment liabilities increased to $362 million
on a nominal basis or a present va lue of $152 million These liabilities vary depending
on the amount of an individual participants benefits that are paid during the period of
higher reimbursement rates
bull Prior to the beginning of the fisca l year the Fund was expected to have almost
one hundred three (10292) additional participants accepted between March 31
2017 and March 31 2018 These new participants were expected to add future
discounted benefits liabi lities of about $1550 million
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 3 February 21 2018
bull There were seventeen (17) new participants to the Fund in the second quarter of
fisca l year 2017-18 approximately nine (9) less than expected for this period
Quarterly new participant counts have varied between fifteen (15) and thirty-five
(35 ) in the last two years
bull The number of eligible participants is expected to continue increasing for at least
thirty years as more eligible participants are admitted to the Fund each year
bull Note that the Fund ba lance increased from approximately $1989 million at June
30 2017 to $2445 million at September 30 2017 due to the application of the
2016-17 year budget allocation of $52 m illion between the two dates
bull Actual benefit payments in the second quarter of the 2017-18 fiscal year (7 1 17-9 30 17) as of
930 17 were $603 million for a total of $13729 million paid so far in the 2017-18 fiscal year
There were no claims payments processed in September Expected benefit payments in the
remainder of the 2017-18 fiscal year are $38448 million Estimated tota l benefit payments for
the 2017-18 fisca l year (4 117- 331 18) are therefore $52177 million It is important to
recognize that these amounts can vary significantly each quarter
bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting
Group (PCG) instead of Alicare The impact of this change on the administrative expenses of
the Fund has not been provided to us but we expect future administrative costs to be
somewhat lower based on this change Based on the prior Alicare costs and expected number
of participants we estimated that the Fund would incur approximately $497 million in
administrative expenses during the 2017-18 fiscal year
bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012
Compared to Virginia the Fund is having a substantial ly higher percentage of overa ll costs in
medical and hospital costs medical equipment and prescription drug costs and corresponding
lower percentages in nursing and long term care costs
bull As of September 30 2017 the number of participants that have received more than $1 million
in benefits payments is fourteen (14) Based on current annual severities by individual
member we expect six (6) more members to cross this threshold in the next twelve months
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 4 February 21 2018
Background
The Medical Indemnity Fund was established in 2011 to provide a funding source for future health
care costs associated w ith birth-related neurological injuries Enrollees of the Fund are plaintiffs in
medical malpractice actions who have received either court-approved settlements or judgments
deeming the plaintiffs neurological impairments to be birth-related1 More specifically a birthshy
related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of
labor delivery or resuscitation or by the provision or non-provision of other medical services during
the delivery admission 2 These injuries must result in a physical impairment a developmental
disability or both
Benefits provided by the Fund include
bull Medical Denta l Surgical and Hospital Care
bull Nursing and Custodia l Care
bull Prescription and Non-Prescription Drugs
bull Rehabilitation Services
bull Durable Medical Equipment and Assistive Technology
bull Certain Home and Vehicle Modifications
bull Other Health Care Costs for Medical Services and Supplies for Participants
The New York State Department of Financial Services (NYS DFS) serves as the administrator of the
Fund For the first year of the MlFs operations Sedgwick CMS served as the Funds third party
administrators (TPA) For the second year of operations they were replaced by Alicare As of
September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues
to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the
Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related
Neurological Injury Compensation Fund and the Florida Neurologica l Injury Compensation Association
1 Provided by NY DFS 2 http wwwdfsnygovinsurancemif mif _faqshtm
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 5 February 21 2018
The Fund currently is financed through a budget allocation from the state of New York Any party to a
medical professiona l liability claim can request for the j udgment to reflect eligibi lity for participation in
the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund
Data Methods amp Assumptions
Given that the Fund has been in operation for on ly six years a number of sources of information are
still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Public
Consu lting Group to ensure that their claims databases are sufficient to support these ongoing
quarterly reports and to enhance the ongoing management of the Fund As a result we have
introduced more analysis by benefit category (ie nursing medical hospital prescription drugs etc)
and inj ury type
Early in the Funds operations some health care benefits that should have been paid by the Fund were
erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment
information on these costs by the New York Department of Health (DOH) and they are reflected in the
exhibits
Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for
the birth injury funds in Virginia and Florida as wel l as medical professional liability insurers in the
state of New York These have been significantly modified based on data from the Fund as it becomes
more credible
One significant area of ongoing review of assumptions relates to the expected number of claims per
10000 live births Initia lly 110 participants per 10000 births were assumed based on data from
Virginia and Florida After the first year the frequency rate was increased to 290 participants per
10000 births In the first quarter 2014 report the expected number of eligible Fund participants was
increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal
years of experience and present more rea listic financial projections for the next five years In late
2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing
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New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 6 February 21 2018
frequency data It should be recognized that this is over four times the number of participants per
10000 live births experienced by the birth funds in Florida and Virginia
As we are accumulating more credible amounts of benefit payments data several differences are
emerging For example the annual benefit payments during 2016 to Fund participants that were
admitted to the program prior to 2016 (ie participants that have a full year of benefit payments
during 2016) are shown in the following graph and compared to data from Virginia Additional severity
information is conta ined in Exhibit 1 Page 2 and Exhibit 6
600
500
400
300
200o
100
I I I I 1 I 100 11 bullbull -bull VA Data bull NY Data
There are at least three key issues
1) The Fund has significantly more participants with $0 of benefit payments Will these
participants have benefit payments at some point
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New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 7 February 21 2018
2) The Fund has substantially more participants with less than $25000 in annual benefit
payments Is there something about the Fund s enabling legislation that is causing this or will
their costs increase over time
3) The Fund had five participants with annual benefits costs over $400000 Virginia has no
participants that breached this threshold Admittedly there are sample size issues but will this
phenomenon persist
We are continuing to monitor these phenomenon
In response to this information changes to the assumptions regarding the expected frequency and
severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016
The assumptions will be detai led later in this report
Discussion and Analysis
Number of Qualifying Participants
Based on the loss runs provided by Sedgwick CMS Alicare and OOH valued as of September 30 2017
there are five hundred five (505) participants that have qualified for the Program as of this date five
hundred (500) were still living as of September 30 2017 This information is summarized in Exhibit 2
There were seventeen (17) new participants to the Fund in the second quarter of fiscal 2017
approximately nine (9) fewer than expected for that portion of the quarter
The number of Fund participants and the distribution of participants by age warrants continued
monitoring The average age of a Fund participant at the time of admission is about 87 which is
approximately four years older than the age of a Virginia Birth Fund participant at admission
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
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6349
12620
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17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
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2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
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Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
m~ tim
traderu
m~ m~ wm ~mumtrade
tradern mm~~
mm mm ~ m ~trade mootrade~
mm Mm m~
mm s~=~
l 9 ll2 25 350
210266
39312 2S 350
2102
l9JU 25 350
110266
40418 26064
21618
40418
2606 216183
40418
2606 216 183
40418
2064 216183
1893
27015 224069
41 393
27015 224 069
4 1893 2701S
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41893
27015 224 069
44037
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laquo on 28397
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20UQ1 2012(14 201lQl 201l(U
2S lO
ru~ ru~ m~ m~ ~~ 2mm2mm2mm2rnm2mffl
bull~ trade~ -trade trade~ nw wm ~m ww wm m-
~~
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m = illtrade nm m-
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m~
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166 796 6171S9 69513
114 S37
16S 196 617 1S9 69SU
UA Sl7
165 796 6171S9 69SU
114 531
170-461 63-02
11469 117760
17046gt 634 526 71469
117 760
170462 634S26
71469 111160
170462 6WS26
71 469 117 NO
11680 6576n
74076 lll OSS
116680 657671
74076 1210SS
176680 6S76n
74016 1220SS
17668() 657 672 7076
122oss
1SS721 691 326 n861
12a301
185 721 691 326
11861 128101
1asn1 91326
121301
18S 721 691326 77867
uuo
194 936 72S626 81730 134~
19036 72S 626 81 uo
13667 201CU 2lt)1)(14
27 ~m trade~
~m laquo~
mlli laquo ~
mm laquo rn
mm ~-
mm bullm
mm am
mm bullm
m ~ ~m
187 OU 431316
111 OU 43136
1870W bulll 736
192 307 44 967
192 )07
44967 192307 44967
192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
237049 15J22S
2881ll 160821
248 810~ 2015Ql 20150
27
~~
~~
~~
~~
~~~= ~~ ~~
wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
nm mtrade ~w mm
u= mm~trade rn~
~rn ~m v~ m~
sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
s11u 102 6l4 9010amp
134 7Sl
57136 102634 ~10S
t34 7Sl
57 U6 10263 90 108
U 4 7Sl
57 ll6 102amp14 90 108
134 753
S9 220 1deg)78 93ffl
U9669
S9 220 106311 93 39S
139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
TABLE OF CONTENTS
Section
Purpose amp Scope 1
Executive Summary 2
Background 4
Data Methods amp Assumptions 5
Discussion and Analysis 7
Number of Qualifying Participants 7
Mortality ExperienceLife Expectancy 8
Actuarial Ca lculation of Estimated Fund Liabilities 9
Amount of Benefits Paid 11
Patterns of Utilization 11
Benefit Payments and Injury Type 13
Inflationary Patterns of Types of Services 16
Administrative Expenses 17
Impact of Available Health Insurance 17
Investment Earnings 17
Distribution amp Use 18
Reliances amp Limitations 19
EXHIBITS
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund 3rd Quarter 2017 Actuarial Analysis
As of September 30 2017
Purpose amp Scope
Pinnacle Actuarial Resources Inc (Pinnacle) had been retained by the New York State Department of
Financial Services (NYS DFS or the Department) to provide quarterly actuaria l reports regard ing the
experience of the New York State Medical Indemnity Fund (MIF or the Fund) This analysis eva luates
data for the Fund as of September 30 2017
sect69-1019 of the New York State Department of Health Regulation states that the quarterly reports
should include a review of the various elements contributing to the amount of benefits paid by the
Fund and to the expenses of administration of the Fund including
bull The number of qualifying plaintiffs
bull The mortality experience of the qualified plaintiffs
bull The amount of benefits paid by the Fund
bull The patterns of utilization of types of services provided
bull Inflationary patterns by types of services provided
bull The expenses of administration of the Fund
bull The impact of avai lable health insurance on benefits paid by the Fund and
bull Investment earnings of the Fund
sect69-1020 of the New York State Department of Health Regulation also requires an actuaria l
calcu lation of the estimated liabi lities of the Fund for the coming year resu lting from the qualified
plaintiffs enrolled in the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 2 February 21 2018
Executive Summary
Based on our review of available information regarding the New York State Medical Indemnity Fund as
of September 30 2017 Pinnacle has arrived at a number of key conclusions
bull As of September 30 2017 the Fund had accepted 505 participants (500 living) with expected
future benefit payments of approximately $7271 mi ll ion and future administrative expenses of
$1240 million assuming a discount rate of 25 With a Fund balance as of September 30
2017 of approximately $2445 mi ll ion this results in an unfunded liability for the Fund of
approximately $6067 million
o Tota l future lifetime benefits for the 500 living Fund participants without discounting is
estimated to be $1756 bil lion
o The current present va lue of future benefit payments of $7271 million does not
consider any additional enrollees that may be admitted to the Fund in the future
o Prior to the passing of recent legislation each new participant admitted to the Fund
after June 30 2017 would increase the Funds future benefits payment liabilities by
$335 mi llion on a nominal basis or a present value of $132 million increasing at
approximately the medical inflation rate annually from March 31 2017
o Earlier this year new legislation was passed expanding eligibi lity for the Fund to nonshy
hospital births and significantly raising reimbursement rates for the period from July 1
2017 through December 31 2019 For new participants admitted during this period a
priori estimates of future lifetime benefits payment liabilities increased to $362 million
on a nominal basis or a present va lue of $152 million These liabilities vary depending
on the amount of an individual participants benefits that are paid during the period of
higher reimbursement rates
bull Prior to the beginning of the fisca l year the Fund was expected to have almost
one hundred three (10292) additional participants accepted between March 31
2017 and March 31 2018 These new participants were expected to add future
discounted benefits liabi lities of about $1550 million
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 3 February 21 2018
bull There were seventeen (17) new participants to the Fund in the second quarter of
fisca l year 2017-18 approximately nine (9) less than expected for this period
Quarterly new participant counts have varied between fifteen (15) and thirty-five
(35 ) in the last two years
bull The number of eligible participants is expected to continue increasing for at least
thirty years as more eligible participants are admitted to the Fund each year
bull Note that the Fund ba lance increased from approximately $1989 million at June
30 2017 to $2445 million at September 30 2017 due to the application of the
2016-17 year budget allocation of $52 m illion between the two dates
bull Actual benefit payments in the second quarter of the 2017-18 fiscal year (7 1 17-9 30 17) as of
930 17 were $603 million for a total of $13729 million paid so far in the 2017-18 fiscal year
There were no claims payments processed in September Expected benefit payments in the
remainder of the 2017-18 fiscal year are $38448 million Estimated tota l benefit payments for
the 2017-18 fisca l year (4 117- 331 18) are therefore $52177 million It is important to
recognize that these amounts can vary significantly each quarter
bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting
Group (PCG) instead of Alicare The impact of this change on the administrative expenses of
the Fund has not been provided to us but we expect future administrative costs to be
somewhat lower based on this change Based on the prior Alicare costs and expected number
of participants we estimated that the Fund would incur approximately $497 million in
administrative expenses during the 2017-18 fiscal year
bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012
Compared to Virginia the Fund is having a substantial ly higher percentage of overa ll costs in
medical and hospital costs medical equipment and prescription drug costs and corresponding
lower percentages in nursing and long term care costs
bull As of September 30 2017 the number of participants that have received more than $1 million
in benefits payments is fourteen (14) Based on current annual severities by individual
member we expect six (6) more members to cross this threshold in the next twelve months
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 4 February 21 2018
Background
The Medical Indemnity Fund was established in 2011 to provide a funding source for future health
care costs associated w ith birth-related neurological injuries Enrollees of the Fund are plaintiffs in
medical malpractice actions who have received either court-approved settlements or judgments
deeming the plaintiffs neurological impairments to be birth-related1 More specifically a birthshy
related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of
labor delivery or resuscitation or by the provision or non-provision of other medical services during
the delivery admission 2 These injuries must result in a physical impairment a developmental
disability or both
Benefits provided by the Fund include
bull Medical Denta l Surgical and Hospital Care
bull Nursing and Custodia l Care
bull Prescription and Non-Prescription Drugs
bull Rehabilitation Services
bull Durable Medical Equipment and Assistive Technology
bull Certain Home and Vehicle Modifications
bull Other Health Care Costs for Medical Services and Supplies for Participants
The New York State Department of Financial Services (NYS DFS) serves as the administrator of the
Fund For the first year of the MlFs operations Sedgwick CMS served as the Funds third party
administrators (TPA) For the second year of operations they were replaced by Alicare As of
September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues
to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the
Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related
Neurological Injury Compensation Fund and the Florida Neurologica l Injury Compensation Association
1 Provided by NY DFS 2 http wwwdfsnygovinsurancemif mif _faqshtm
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 5 February 21 2018
The Fund currently is financed through a budget allocation from the state of New York Any party to a
medical professiona l liability claim can request for the j udgment to reflect eligibi lity for participation in
the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund
Data Methods amp Assumptions
Given that the Fund has been in operation for on ly six years a number of sources of information are
still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Public
Consu lting Group to ensure that their claims databases are sufficient to support these ongoing
quarterly reports and to enhance the ongoing management of the Fund As a result we have
introduced more analysis by benefit category (ie nursing medical hospital prescription drugs etc)
and inj ury type
Early in the Funds operations some health care benefits that should have been paid by the Fund were
erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment
information on these costs by the New York Department of Health (DOH) and they are reflected in the
exhibits
Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for
the birth injury funds in Virginia and Florida as wel l as medical professional liability insurers in the
state of New York These have been significantly modified based on data from the Fund as it becomes
more credible
One significant area of ongoing review of assumptions relates to the expected number of claims per
10000 live births Initia lly 110 participants per 10000 births were assumed based on data from
Virginia and Florida After the first year the frequency rate was increased to 290 participants per
10000 births In the first quarter 2014 report the expected number of eligible Fund participants was
increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal
years of experience and present more rea listic financial projections for the next five years In late
2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 6 February 21 2018
frequency data It should be recognized that this is over four times the number of participants per
10000 live births experienced by the birth funds in Florida and Virginia
As we are accumulating more credible amounts of benefit payments data several differences are
emerging For example the annual benefit payments during 2016 to Fund participants that were
admitted to the program prior to 2016 (ie participants that have a full year of benefit payments
during 2016) are shown in the following graph and compared to data from Virginia Additional severity
information is conta ined in Exhibit 1 Page 2 and Exhibit 6
600
500
400
300
200o
100
I I I I 1 I 100 11 bullbull -bull VA Data bull NY Data
There are at least three key issues
1) The Fund has significantly more participants with $0 of benefit payments Will these
participants have benefit payments at some point
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 7 February 21 2018
2) The Fund has substantially more participants with less than $25000 in annual benefit
payments Is there something about the Fund s enabling legislation that is causing this or will
their costs increase over time
3) The Fund had five participants with annual benefits costs over $400000 Virginia has no
participants that breached this threshold Admittedly there are sample size issues but will this
phenomenon persist
We are continuing to monitor these phenomenon
In response to this information changes to the assumptions regarding the expected frequency and
severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016
The assumptions will be detai led later in this report
Discussion and Analysis
Number of Qualifying Participants
Based on the loss runs provided by Sedgwick CMS Alicare and OOH valued as of September 30 2017
there are five hundred five (505) participants that have qualified for the Program as of this date five
hundred (500) were still living as of September 30 2017 This information is summarized in Exhibit 2
There were seventeen (17) new participants to the Fund in the second quarter of fiscal 2017
approximately nine (9) fewer than expected for that portion of the quarter
The number of Fund participants and the distribution of participants by age warrants continued
monitoring The average age of a Fund participant at the time of admission is about 87 which is
approximately four years older than the age of a Virginia Birth Fund participant at admission
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
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4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
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167131
56231
27783 184912
60561 205461
63067
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228S70
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317058
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338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
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3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
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98871 lll316
203563
52078
110970
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246076
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275891
73957
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80334
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89851
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bull 19
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2112 _ 6S06
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7389 14764 38728
degmiddotdeg 11287
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128891
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140 125 104 169
190383
142782
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207451
162620
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167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
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l 18800 136890 115 157 966bull26
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ll ll ll 91 2827 S4SU 47626 21564
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1218933 97820 927 SJ 119313 117497 114918 197 202 2S6 410 16702l 273 7bull3 JU 761 270692 303320 120 264 10S891 31801 25466S
1219804 2573M
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1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
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10620 12856 111 l7l
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Ill ssm
6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
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201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
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2U617 1367
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l SS 836 295 078
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10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund 3rd Quarter 2017 Actuarial Analysis
As of September 30 2017
Purpose amp Scope
Pinnacle Actuarial Resources Inc (Pinnacle) had been retained by the New York State Department of
Financial Services (NYS DFS or the Department) to provide quarterly actuaria l reports regard ing the
experience of the New York State Medical Indemnity Fund (MIF or the Fund) This analysis eva luates
data for the Fund as of September 30 2017
sect69-1019 of the New York State Department of Health Regulation states that the quarterly reports
should include a review of the various elements contributing to the amount of benefits paid by the
Fund and to the expenses of administration of the Fund including
bull The number of qualifying plaintiffs
bull The mortality experience of the qualified plaintiffs
bull The amount of benefits paid by the Fund
bull The patterns of utilization of types of services provided
bull Inflationary patterns by types of services provided
bull The expenses of administration of the Fund
bull The impact of avai lable health insurance on benefits paid by the Fund and
bull Investment earnings of the Fund
sect69-1020 of the New York State Department of Health Regulation also requires an actuaria l
calcu lation of the estimated liabi lities of the Fund for the coming year resu lting from the qualified
plaintiffs enrolled in the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 2 February 21 2018
Executive Summary
Based on our review of available information regarding the New York State Medical Indemnity Fund as
of September 30 2017 Pinnacle has arrived at a number of key conclusions
bull As of September 30 2017 the Fund had accepted 505 participants (500 living) with expected
future benefit payments of approximately $7271 mi ll ion and future administrative expenses of
$1240 million assuming a discount rate of 25 With a Fund balance as of September 30
2017 of approximately $2445 mi ll ion this results in an unfunded liability for the Fund of
approximately $6067 million
o Tota l future lifetime benefits for the 500 living Fund participants without discounting is
estimated to be $1756 bil lion
o The current present va lue of future benefit payments of $7271 million does not
consider any additional enrollees that may be admitted to the Fund in the future
o Prior to the passing of recent legislation each new participant admitted to the Fund
after June 30 2017 would increase the Funds future benefits payment liabilities by
$335 mi llion on a nominal basis or a present value of $132 million increasing at
approximately the medical inflation rate annually from March 31 2017
o Earlier this year new legislation was passed expanding eligibi lity for the Fund to nonshy
hospital births and significantly raising reimbursement rates for the period from July 1
2017 through December 31 2019 For new participants admitted during this period a
priori estimates of future lifetime benefits payment liabilities increased to $362 million
on a nominal basis or a present va lue of $152 million These liabilities vary depending
on the amount of an individual participants benefits that are paid during the period of
higher reimbursement rates
bull Prior to the beginning of the fisca l year the Fund was expected to have almost
one hundred three (10292) additional participants accepted between March 31
2017 and March 31 2018 These new participants were expected to add future
discounted benefits liabi lities of about $1550 million
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 3 February 21 2018
bull There were seventeen (17) new participants to the Fund in the second quarter of
fisca l year 2017-18 approximately nine (9) less than expected for this period
Quarterly new participant counts have varied between fifteen (15) and thirty-five
(35 ) in the last two years
bull The number of eligible participants is expected to continue increasing for at least
thirty years as more eligible participants are admitted to the Fund each year
bull Note that the Fund ba lance increased from approximately $1989 million at June
30 2017 to $2445 million at September 30 2017 due to the application of the
2016-17 year budget allocation of $52 m illion between the two dates
bull Actual benefit payments in the second quarter of the 2017-18 fiscal year (7 1 17-9 30 17) as of
930 17 were $603 million for a total of $13729 million paid so far in the 2017-18 fiscal year
There were no claims payments processed in September Expected benefit payments in the
remainder of the 2017-18 fiscal year are $38448 million Estimated tota l benefit payments for
the 2017-18 fisca l year (4 117- 331 18) are therefore $52177 million It is important to
recognize that these amounts can vary significantly each quarter
bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting
Group (PCG) instead of Alicare The impact of this change on the administrative expenses of
the Fund has not been provided to us but we expect future administrative costs to be
somewhat lower based on this change Based on the prior Alicare costs and expected number
of participants we estimated that the Fund would incur approximately $497 million in
administrative expenses during the 2017-18 fiscal year
bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012
Compared to Virginia the Fund is having a substantial ly higher percentage of overa ll costs in
medical and hospital costs medical equipment and prescription drug costs and corresponding
lower percentages in nursing and long term care costs
bull As of September 30 2017 the number of participants that have received more than $1 million
in benefits payments is fourteen (14) Based on current annual severities by individual
member we expect six (6) more members to cross this threshold in the next twelve months
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 4 February 21 2018
Background
The Medical Indemnity Fund was established in 2011 to provide a funding source for future health
care costs associated w ith birth-related neurological injuries Enrollees of the Fund are plaintiffs in
medical malpractice actions who have received either court-approved settlements or judgments
deeming the plaintiffs neurological impairments to be birth-related1 More specifically a birthshy
related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of
labor delivery or resuscitation or by the provision or non-provision of other medical services during
the delivery admission 2 These injuries must result in a physical impairment a developmental
disability or both
Benefits provided by the Fund include
bull Medical Denta l Surgical and Hospital Care
bull Nursing and Custodia l Care
bull Prescription and Non-Prescription Drugs
bull Rehabilitation Services
bull Durable Medical Equipment and Assistive Technology
bull Certain Home and Vehicle Modifications
bull Other Health Care Costs for Medical Services and Supplies for Participants
The New York State Department of Financial Services (NYS DFS) serves as the administrator of the
Fund For the first year of the MlFs operations Sedgwick CMS served as the Funds third party
administrators (TPA) For the second year of operations they were replaced by Alicare As of
September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues
to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the
Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related
Neurological Injury Compensation Fund and the Florida Neurologica l Injury Compensation Association
1 Provided by NY DFS 2 http wwwdfsnygovinsurancemif mif _faqshtm
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 5 February 21 2018
The Fund currently is financed through a budget allocation from the state of New York Any party to a
medical professiona l liability claim can request for the j udgment to reflect eligibi lity for participation in
the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund
Data Methods amp Assumptions
Given that the Fund has been in operation for on ly six years a number of sources of information are
still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Public
Consu lting Group to ensure that their claims databases are sufficient to support these ongoing
quarterly reports and to enhance the ongoing management of the Fund As a result we have
introduced more analysis by benefit category (ie nursing medical hospital prescription drugs etc)
and inj ury type
Early in the Funds operations some health care benefits that should have been paid by the Fund were
erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment
information on these costs by the New York Department of Health (DOH) and they are reflected in the
exhibits
Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for
the birth injury funds in Virginia and Florida as wel l as medical professional liability insurers in the
state of New York These have been significantly modified based on data from the Fund as it becomes
more credible
One significant area of ongoing review of assumptions relates to the expected number of claims per
10000 live births Initia lly 110 participants per 10000 births were assumed based on data from
Virginia and Florida After the first year the frequency rate was increased to 290 participants per
10000 births In the first quarter 2014 report the expected number of eligible Fund participants was
increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal
years of experience and present more rea listic financial projections for the next five years In late
2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 6 February 21 2018
frequency data It should be recognized that this is over four times the number of participants per
10000 live births experienced by the birth funds in Florida and Virginia
As we are accumulating more credible amounts of benefit payments data several differences are
emerging For example the annual benefit payments during 2016 to Fund participants that were
admitted to the program prior to 2016 (ie participants that have a full year of benefit payments
during 2016) are shown in the following graph and compared to data from Virginia Additional severity
information is conta ined in Exhibit 1 Page 2 and Exhibit 6
600
500
400
300
200o
100
I I I I 1 I 100 11 bullbull -bull VA Data bull NY Data
There are at least three key issues
1) The Fund has significantly more participants with $0 of benefit payments Will these
participants have benefit payments at some point
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 7 February 21 2018
2) The Fund has substantially more participants with less than $25000 in annual benefit
payments Is there something about the Fund s enabling legislation that is causing this or will
their costs increase over time
3) The Fund had five participants with annual benefits costs over $400000 Virginia has no
participants that breached this threshold Admittedly there are sample size issues but will this
phenomenon persist
We are continuing to monitor these phenomenon
In response to this information changes to the assumptions regarding the expected frequency and
severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016
The assumptions will be detai led later in this report
Discussion and Analysis
Number of Qualifying Participants
Based on the loss runs provided by Sedgwick CMS Alicare and OOH valued as of September 30 2017
there are five hundred five (505) participants that have qualified for the Program as of this date five
hundred (500) were still living as of September 30 2017 This information is summarized in Exhibit 2
There were seventeen (17) new participants to the Fund in the second quarter of fiscal 2017
approximately nine (9) fewer than expected for that portion of the quarter
The number of Fund participants and the distribution of participants by age warrants continued
monitoring The average age of a Fund participant at the time of admission is about 87 which is
approximately four years older than the age of a Virginia Birth Fund participant at admission
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
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2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
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2017Q1 19 6- 14278 2017Q2 29 328 S618
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New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
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201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
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2U617 1367
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122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 2 February 21 2018
Executive Summary
Based on our review of available information regarding the New York State Medical Indemnity Fund as
of September 30 2017 Pinnacle has arrived at a number of key conclusions
bull As of September 30 2017 the Fund had accepted 505 participants (500 living) with expected
future benefit payments of approximately $7271 mi ll ion and future administrative expenses of
$1240 million assuming a discount rate of 25 With a Fund balance as of September 30
2017 of approximately $2445 mi ll ion this results in an unfunded liability for the Fund of
approximately $6067 million
o Tota l future lifetime benefits for the 500 living Fund participants without discounting is
estimated to be $1756 bil lion
o The current present va lue of future benefit payments of $7271 million does not
consider any additional enrollees that may be admitted to the Fund in the future
o Prior to the passing of recent legislation each new participant admitted to the Fund
after June 30 2017 would increase the Funds future benefits payment liabilities by
$335 mi llion on a nominal basis or a present value of $132 million increasing at
approximately the medical inflation rate annually from March 31 2017
o Earlier this year new legislation was passed expanding eligibi lity for the Fund to nonshy
hospital births and significantly raising reimbursement rates for the period from July 1
2017 through December 31 2019 For new participants admitted during this period a
priori estimates of future lifetime benefits payment liabilities increased to $362 million
on a nominal basis or a present va lue of $152 million These liabilities vary depending
on the amount of an individual participants benefits that are paid during the period of
higher reimbursement rates
bull Prior to the beginning of the fisca l year the Fund was expected to have almost
one hundred three (10292) additional participants accepted between March 31
2017 and March 31 2018 These new participants were expected to add future
discounted benefits liabi lities of about $1550 million
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 3 February 21 2018
bull There were seventeen (17) new participants to the Fund in the second quarter of
fisca l year 2017-18 approximately nine (9) less than expected for this period
Quarterly new participant counts have varied between fifteen (15) and thirty-five
(35 ) in the last two years
bull The number of eligible participants is expected to continue increasing for at least
thirty years as more eligible participants are admitted to the Fund each year
bull Note that the Fund ba lance increased from approximately $1989 million at June
30 2017 to $2445 million at September 30 2017 due to the application of the
2016-17 year budget allocation of $52 m illion between the two dates
bull Actual benefit payments in the second quarter of the 2017-18 fiscal year (7 1 17-9 30 17) as of
930 17 were $603 million for a total of $13729 million paid so far in the 2017-18 fiscal year
There were no claims payments processed in September Expected benefit payments in the
remainder of the 2017-18 fiscal year are $38448 million Estimated tota l benefit payments for
the 2017-18 fisca l year (4 117- 331 18) are therefore $52177 million It is important to
recognize that these amounts can vary significantly each quarter
bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting
Group (PCG) instead of Alicare The impact of this change on the administrative expenses of
the Fund has not been provided to us but we expect future administrative costs to be
somewhat lower based on this change Based on the prior Alicare costs and expected number
of participants we estimated that the Fund would incur approximately $497 million in
administrative expenses during the 2017-18 fiscal year
bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012
Compared to Virginia the Fund is having a substantial ly higher percentage of overa ll costs in
medical and hospital costs medical equipment and prescription drug costs and corresponding
lower percentages in nursing and long term care costs
bull As of September 30 2017 the number of participants that have received more than $1 million
in benefits payments is fourteen (14) Based on current annual severities by individual
member we expect six (6) more members to cross this threshold in the next twelve months
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 4 February 21 2018
Background
The Medical Indemnity Fund was established in 2011 to provide a funding source for future health
care costs associated w ith birth-related neurological injuries Enrollees of the Fund are plaintiffs in
medical malpractice actions who have received either court-approved settlements or judgments
deeming the plaintiffs neurological impairments to be birth-related1 More specifically a birthshy
related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of
labor delivery or resuscitation or by the provision or non-provision of other medical services during
the delivery admission 2 These injuries must result in a physical impairment a developmental
disability or both
Benefits provided by the Fund include
bull Medical Denta l Surgical and Hospital Care
bull Nursing and Custodia l Care
bull Prescription and Non-Prescription Drugs
bull Rehabilitation Services
bull Durable Medical Equipment and Assistive Technology
bull Certain Home and Vehicle Modifications
bull Other Health Care Costs for Medical Services and Supplies for Participants
The New York State Department of Financial Services (NYS DFS) serves as the administrator of the
Fund For the first year of the MlFs operations Sedgwick CMS served as the Funds third party
administrators (TPA) For the second year of operations they were replaced by Alicare As of
September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues
to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the
Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related
Neurological Injury Compensation Fund and the Florida Neurologica l Injury Compensation Association
1 Provided by NY DFS 2 http wwwdfsnygovinsurancemif mif _faqshtm
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 5 February 21 2018
The Fund currently is financed through a budget allocation from the state of New York Any party to a
medical professiona l liability claim can request for the j udgment to reflect eligibi lity for participation in
the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund
Data Methods amp Assumptions
Given that the Fund has been in operation for on ly six years a number of sources of information are
still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Public
Consu lting Group to ensure that their claims databases are sufficient to support these ongoing
quarterly reports and to enhance the ongoing management of the Fund As a result we have
introduced more analysis by benefit category (ie nursing medical hospital prescription drugs etc)
and inj ury type
Early in the Funds operations some health care benefits that should have been paid by the Fund were
erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment
information on these costs by the New York Department of Health (DOH) and they are reflected in the
exhibits
Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for
the birth injury funds in Virginia and Florida as wel l as medical professional liability insurers in the
state of New York These have been significantly modified based on data from the Fund as it becomes
more credible
One significant area of ongoing review of assumptions relates to the expected number of claims per
10000 live births Initia lly 110 participants per 10000 births were assumed based on data from
Virginia and Florida After the first year the frequency rate was increased to 290 participants per
10000 births In the first quarter 2014 report the expected number of eligible Fund participants was
increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal
years of experience and present more rea listic financial projections for the next five years In late
2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 6 February 21 2018
frequency data It should be recognized that this is over four times the number of participants per
10000 live births experienced by the birth funds in Florida and Virginia
As we are accumulating more credible amounts of benefit payments data several differences are
emerging For example the annual benefit payments during 2016 to Fund participants that were
admitted to the program prior to 2016 (ie participants that have a full year of benefit payments
during 2016) are shown in the following graph and compared to data from Virginia Additional severity
information is conta ined in Exhibit 1 Page 2 and Exhibit 6
600
500
400
300
200o
100
I I I I 1 I 100 11 bullbull -bull VA Data bull NY Data
There are at least three key issues
1) The Fund has significantly more participants with $0 of benefit payments Will these
participants have benefit payments at some point
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 7 February 21 2018
2) The Fund has substantially more participants with less than $25000 in annual benefit
payments Is there something about the Fund s enabling legislation that is causing this or will
their costs increase over time
3) The Fund had five participants with annual benefits costs over $400000 Virginia has no
participants that breached this threshold Admittedly there are sample size issues but will this
phenomenon persist
We are continuing to monitor these phenomenon
In response to this information changes to the assumptions regarding the expected frequency and
severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016
The assumptions will be detai led later in this report
Discussion and Analysis
Number of Qualifying Participants
Based on the loss runs provided by Sedgwick CMS Alicare and OOH valued as of September 30 2017
there are five hundred five (505) participants that have qualified for the Program as of this date five
hundred (500) were still living as of September 30 2017 This information is summarized in Exhibit 2
There were seventeen (17) new participants to the Fund in the second quarter of fiscal 2017
approximately nine (9) fewer than expected for that portion of the quarter
The number of Fund participants and the distribution of participants by age warrants continued
monitoring The average age of a Fund participant at the time of admission is about 87 which is
approximately four years older than the age of a Virginia Birth Fund participant at admission
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
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5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
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228S70
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n3so 37502
81060
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295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
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9897
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3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
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203563
52078
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73957
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80334
152339 344850 324486
89851
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385819
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degmiddotdeg 11287
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140 125 104 169
190383
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167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
284 456
211213 1045 294
1708 21776 401 St 1S2 406
2amp2 S92 350374 296N3 193 955 288099
91 llll 433 287128
1
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372 bullu 2496 25ltU
212 728
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41 285
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l 18800 136890 115 157 966bull26
68386
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ll ll ll 91 2827 S4SU 47626 21564
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1218933 97820 927 SJ 119313 117497 114918 197 202 2S6 410 16702l 273 7bull3 JU 761 270692 303320 120 264 10S891 31801 25466S
1219804 2573M
SU396 462 2SO 462 250 4S07Jt 4S0738 6834
9 190CM
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1219804 2SHl4 622SO
9 9 S148l 800
31812 9
321808 301643 90654
8119S1 782 976
91219 91219 61amp758 618758
1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
811951 7amp2 976 941 219 608390
618158 1171 631
10620 12856 111 l7l
919 S0087
8119S1 712 976 941219 60890 6187i8 ll4 7S2
70620 126856 111 tl
Ill ssm
6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
SI
24A S11 402980 6-S8086 642289 619368 137 S04 139847 2pound4803 S864
Ul0343 88101
9 9
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2laquoS71 244S71 402980 402980 153880 1S3 880 642289 619 168 176961 212727 2U717 1375deg 137 S04 09847 ll9S47 264803 1008 88101 88 101
2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
496bull56 S9002S 72 993
066sooa 53914 673 S94
674 066 S39U 673 59-C
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166 SS6 166 SS6 Ut212 1112U 132173 U217 166439 16609
166 556 111 212 12113 166 439
166S56 111212 112 171 166439
U17S3 81973
1045S4 131 660
131 7S3 87973
10amp SS4 131660
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131660 131660 2017Ql 1~330 1 058 330 1osa130 1 0S8330 959 477 9S9bulln 9S9477 274 136 24682fi 246126 26826 246126 237071 237078 137 078 23707t 1815~ 17S39 187 S39 lt7S39 17Ql 17 578133 607807 607 807 607907 f1)1801 SSl 015 ss1 oas 157 4l8 1S7 431 11s 141 7S4 14115 14175-4 1316156 136 1S6 1316156 U6 1S6 10770S 1077()6 107705 107 70S
so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
m~ tim
traderu
m~ m~ wm ~mumtrade
tradern mm~~
mm mm ~ m ~trade mootrade~
mm Mm m~
mm s~=~
l 9 ll2 25 350
210266
39312 2S 350
2102
l9JU 25 350
110266
40418 26064
21618
40418
2606 216183
40418
2606 216 183
40418
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41 393
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2S lO
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bull~ trade~ -trade trade~ nw wm ~m ww wm m-
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m = illtrade nm m-
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166 796 6171S9 69513
114 S37
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165 796 6171S9 69SU
114 531
170-461 63-02
11469 117760
17046gt 634 526 71469
117 760
170462 634S26
71469 111160
170462 6WS26
71 469 117 NO
11680 6576n
74076 lll OSS
116680 657671
74076 1210SS
176680 6S76n
74016 1220SS
17668() 657 672 7076
122oss
1SS721 691 326 n861
12a301
185 721 691 326
11861 128101
1asn1 91326
121301
18S 721 691326 77867
uuo
194 936 72S626 81730 134~
19036 72S 626 81 uo
13667 201CU 2lt)1)(14
27 ~m trade~
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mlli laquo ~
mm laquo rn
mm ~-
mm bullm
mm am
mm bullm
m ~ ~m
187 OU 431316
111 OU 43136
1870W bulll 736
192 307 44 967
192 )07
44967 192307 44967
192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
237049 15J22S
2881ll 160821
248 810~ 2015Ql 20150
27
~~
~~
~~
~~
~~~= ~~ ~~
wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
nm mtrade ~w mm
u= mm~trade rn~
~rn ~m v~ m~
sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
s11u 102 6l4 9010amp
134 7Sl
57136 102634 ~10S
t34 7Sl
57 U6 10263 90 108
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57 ll6 102amp14 90 108
134 753
S9 220 1deg)78 93ffl
U9669
S9 220 106311 93 39S
139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 3 February 21 2018
bull There were seventeen (17) new participants to the Fund in the second quarter of
fisca l year 2017-18 approximately nine (9) less than expected for this period
Quarterly new participant counts have varied between fifteen (15) and thirty-five
(35 ) in the last two years
bull The number of eligible participants is expected to continue increasing for at least
thirty years as more eligible participants are admitted to the Fund each year
bull Note that the Fund ba lance increased from approximately $1989 million at June
30 2017 to $2445 million at September 30 2017 due to the application of the
2016-17 year budget allocation of $52 m illion between the two dates
bull Actual benefit payments in the second quarter of the 2017-18 fiscal year (7 1 17-9 30 17) as of
930 17 were $603 million for a total of $13729 million paid so far in the 2017-18 fiscal year
There were no claims payments processed in September Expected benefit payments in the
remainder of the 2017-18 fiscal year are $38448 million Estimated tota l benefit payments for
the 2017-18 fisca l year (4 117- 331 18) are therefore $52177 million It is important to
recognize that these amounts can vary significantly each quarter
bull As of September 1 2017 the Funds claims handling is now performed by Public Consulting
Group (PCG) instead of Alicare The impact of this change on the administrative expenses of
the Fund has not been provided to us but we expect future administrative costs to be
somewhat lower based on this change Based on the prior Alicare costs and expected number
of participants we estimated that the Fund would incur approximately $497 million in
administrative expenses during the 2017-18 fiscal year
bull Exhibit 1 summarizes Fund payments by benefit type since 4th quarter of 2012
Compared to Virginia the Fund is having a substantial ly higher percentage of overa ll costs in
medical and hospital costs medical equipment and prescription drug costs and corresponding
lower percentages in nursing and long term care costs
bull As of September 30 2017 the number of participants that have received more than $1 million
in benefits payments is fourteen (14) Based on current annual severities by individual
member we expect six (6) more members to cross this threshold in the next twelve months
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 4 February 21 2018
Background
The Medical Indemnity Fund was established in 2011 to provide a funding source for future health
care costs associated w ith birth-related neurological injuries Enrollees of the Fund are plaintiffs in
medical malpractice actions who have received either court-approved settlements or judgments
deeming the plaintiffs neurological impairments to be birth-related1 More specifically a birthshy
related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of
labor delivery or resuscitation or by the provision or non-provision of other medical services during
the delivery admission 2 These injuries must result in a physical impairment a developmental
disability or both
Benefits provided by the Fund include
bull Medical Denta l Surgical and Hospital Care
bull Nursing and Custodia l Care
bull Prescription and Non-Prescription Drugs
bull Rehabilitation Services
bull Durable Medical Equipment and Assistive Technology
bull Certain Home and Vehicle Modifications
bull Other Health Care Costs for Medical Services and Supplies for Participants
The New York State Department of Financial Services (NYS DFS) serves as the administrator of the
Fund For the first year of the MlFs operations Sedgwick CMS served as the Funds third party
administrators (TPA) For the second year of operations they were replaced by Alicare As of
September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues
to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the
Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related
Neurological Injury Compensation Fund and the Florida Neurologica l Injury Compensation Association
1 Provided by NY DFS 2 http wwwdfsnygovinsurancemif mif _faqshtm
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 5 February 21 2018
The Fund currently is financed through a budget allocation from the state of New York Any party to a
medical professiona l liability claim can request for the j udgment to reflect eligibi lity for participation in
the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund
Data Methods amp Assumptions
Given that the Fund has been in operation for on ly six years a number of sources of information are
still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Public
Consu lting Group to ensure that their claims databases are sufficient to support these ongoing
quarterly reports and to enhance the ongoing management of the Fund As a result we have
introduced more analysis by benefit category (ie nursing medical hospital prescription drugs etc)
and inj ury type
Early in the Funds operations some health care benefits that should have been paid by the Fund were
erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment
information on these costs by the New York Department of Health (DOH) and they are reflected in the
exhibits
Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for
the birth injury funds in Virginia and Florida as wel l as medical professional liability insurers in the
state of New York These have been significantly modified based on data from the Fund as it becomes
more credible
One significant area of ongoing review of assumptions relates to the expected number of claims per
10000 live births Initia lly 110 participants per 10000 births were assumed based on data from
Virginia and Florida After the first year the frequency rate was increased to 290 participants per
10000 births In the first quarter 2014 report the expected number of eligible Fund participants was
increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal
years of experience and present more rea listic financial projections for the next five years In late
2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 6 February 21 2018
frequency data It should be recognized that this is over four times the number of participants per
10000 live births experienced by the birth funds in Florida and Virginia
As we are accumulating more credible amounts of benefit payments data several differences are
emerging For example the annual benefit payments during 2016 to Fund participants that were
admitted to the program prior to 2016 (ie participants that have a full year of benefit payments
during 2016) are shown in the following graph and compared to data from Virginia Additional severity
information is conta ined in Exhibit 1 Page 2 and Exhibit 6
600
500
400
300
200o
100
I I I I 1 I 100 11 bullbull -bull VA Data bull NY Data
There are at least three key issues
1) The Fund has significantly more participants with $0 of benefit payments Will these
participants have benefit payments at some point
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 7 February 21 2018
2) The Fund has substantially more participants with less than $25000 in annual benefit
payments Is there something about the Fund s enabling legislation that is causing this or will
their costs increase over time
3) The Fund had five participants with annual benefits costs over $400000 Virginia has no
participants that breached this threshold Admittedly there are sample size issues but will this
phenomenon persist
We are continuing to monitor these phenomenon
In response to this information changes to the assumptions regarding the expected frequency and
severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016
The assumptions will be detai led later in this report
Discussion and Analysis
Number of Qualifying Participants
Based on the loss runs provided by Sedgwick CMS Alicare and OOH valued as of September 30 2017
there are five hundred five (505) participants that have qualified for the Program as of this date five
hundred (500) were still living as of September 30 2017 This information is summarized in Exhibit 2
There were seventeen (17) new participants to the Fund in the second quarter of fiscal 2017
approximately nine (9) fewer than expected for that portion of the quarter
The number of Fund participants and the distribution of participants by age warrants continued
monitoring The average age of a Fund participant at the time of admission is about 87 which is
approximately four years older than the age of a Virginia Birth Fund participant at admission
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
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4330 2506
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2614
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3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
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21195
147720
5 1248
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167131
56231
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63067
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81060
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317058
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338117
93743
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361616
98814
49917
389135
104246
59470
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110595
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115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
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7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
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3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
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203563
52078
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degmiddotdeg 11287
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190383
142782
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167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
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l 18800 136890 115 157 966bull26
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1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
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201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
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2U617 1367
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110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 4 February 21 2018
Background
The Medical Indemnity Fund was established in 2011 to provide a funding source for future health
care costs associated w ith birth-related neurological injuries Enrollees of the Fund are plaintiffs in
medical malpractice actions who have received either court-approved settlements or judgments
deeming the plaintiffs neurological impairments to be birth-related1 More specifically a birthshy
related neurological injury is an inj ury to the brain or spinal cord that occurred in the course of
labor delivery or resuscitation or by the provision or non-provision of other medical services during
the delivery admission 2 These injuries must result in a physical impairment a developmental
disability or both
Benefits provided by the Fund include
bull Medical Denta l Surgical and Hospital Care
bull Nursing and Custodia l Care
bull Prescription and Non-Prescription Drugs
bull Rehabilitation Services
bull Durable Medical Equipment and Assistive Technology
bull Certain Home and Vehicle Modifications
bull Other Health Care Costs for Medical Services and Supplies for Participants
The New York State Department of Financial Services (NYS DFS) serves as the administrator of the
Fund For the first year of the MlFs operations Sedgwick CMS served as the Funds third party
administrators (TPA) For the second year of operations they were replaced by Alicare As of
September 1 2017 claims are now handled by Public Consulting Group (PCG) while Alicare continues
to work with Fund enrollment and case management Pinnacle serves as the actuarial advisors to the
Fund as well as the on ly other two state-run birth injury funds in the US the Virginia Birth Related
Neurological Injury Compensation Fund and the Florida Neurologica l Injury Compensation Association
1 Provided by NY DFS 2 http wwwdfsnygovinsurancemif mif _faqshtm
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 5 February 21 2018
The Fund currently is financed through a budget allocation from the state of New York Any party to a
medical professiona l liability claim can request for the j udgment to reflect eligibi lity for participation in
the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund
Data Methods amp Assumptions
Given that the Fund has been in operation for on ly six years a number of sources of information are
still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Public
Consu lting Group to ensure that their claims databases are sufficient to support these ongoing
quarterly reports and to enhance the ongoing management of the Fund As a result we have
introduced more analysis by benefit category (ie nursing medical hospital prescription drugs etc)
and inj ury type
Early in the Funds operations some health care benefits that should have been paid by the Fund were
erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment
information on these costs by the New York Department of Health (DOH) and they are reflected in the
exhibits
Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for
the birth injury funds in Virginia and Florida as wel l as medical professional liability insurers in the
state of New York These have been significantly modified based on data from the Fund as it becomes
more credible
One significant area of ongoing review of assumptions relates to the expected number of claims per
10000 live births Initia lly 110 participants per 10000 births were assumed based on data from
Virginia and Florida After the first year the frequency rate was increased to 290 participants per
10000 births In the first quarter 2014 report the expected number of eligible Fund participants was
increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal
years of experience and present more rea listic financial projections for the next five years In late
2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 6 February 21 2018
frequency data It should be recognized that this is over four times the number of participants per
10000 live births experienced by the birth funds in Florida and Virginia
As we are accumulating more credible amounts of benefit payments data several differences are
emerging For example the annual benefit payments during 2016 to Fund participants that were
admitted to the program prior to 2016 (ie participants that have a full year of benefit payments
during 2016) are shown in the following graph and compared to data from Virginia Additional severity
information is conta ined in Exhibit 1 Page 2 and Exhibit 6
600
500
400
300
200o
100
I I I I 1 I 100 11 bullbull -bull VA Data bull NY Data
There are at least three key issues
1) The Fund has significantly more participants with $0 of benefit payments Will these
participants have benefit payments at some point
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 7 February 21 2018
2) The Fund has substantially more participants with less than $25000 in annual benefit
payments Is there something about the Fund s enabling legislation that is causing this or will
their costs increase over time
3) The Fund had five participants with annual benefits costs over $400000 Virginia has no
participants that breached this threshold Admittedly there are sample size issues but will this
phenomenon persist
We are continuing to monitor these phenomenon
In response to this information changes to the assumptions regarding the expected frequency and
severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016
The assumptions will be detai led later in this report
Discussion and Analysis
Number of Qualifying Participants
Based on the loss runs provided by Sedgwick CMS Alicare and OOH valued as of September 30 2017
there are five hundred five (505) participants that have qualified for the Program as of this date five
hundred (500) were still living as of September 30 2017 This information is summarized in Exhibit 2
There were seventeen (17) new participants to the Fund in the second quarter of fiscal 2017
approximately nine (9) fewer than expected for that portion of the quarter
The number of Fund participants and the distribution of participants by age warrants continued
monitoring The average age of a Fund participant at the time of admission is about 87 which is
approximately four years older than the age of a Virginia Birth Fund participant at admission
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
OAl 111 ltQgt 22 1S t S)ZS() deglS736 2011Ql 19 122431 14US4 9506 1Slc22
I 1441n 21oc U71SS 431112111 71441
112 $201()
2309 17276amp 1amp4 US JS2 1no19 t64 SS9 264142
119295 2213amp
9 10148 deg 348Ji9
143414 mno 4102$7 ruu t7G7 202010
deg
9 42 11
21940 1480U 161013
29659 222W )052t
159-203 52345191
211 106
222 lll uosu
It 21111a
1 0r4S294 moa 21714 4013Sl 212592 3$03)4
111714 252349
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9 101 43 deg 11SOS08 124 1116
41129 m 31243l
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12742 221$3
31991 264ltil 160051
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91 IY 91 I 9ll S48U Camp2S 38157 19 004 iwsn 2844-97 deg 3M 414bullm 27$2$ 3024ampgt
121ampm ll9-t490 91820 t27ampS7 l lS4514 11931 117497 124918 U9 01S 191202 25amp410 2n10 21S
111 761 deg 10U91 n 131801 )64447 3Jts2 SSOQO 4S amp24
3St669 4211-SS lSS~
ll
1174113
110923 191 25
I ampOSO
906524 mos 2ampsS07 11HU
ll
34929(
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9l 1436amp
lJ69S4 t 793SS
147~
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deg40 610 31M7
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40301 3Uli9
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I
TdegI sstit S00098t
17917099 290amp23 45144 10009amp 3 941$9 1S69SSS 4 01) lS6
l 4ll 1Cl
22S4l02 414608
a211s 132019amp 10040
1019229 S8t9U $419$2
162928
Toul sos 6241amp99
Note ltd(ltr 2011di~11ld11ta onlvindJditsthroti amp3117
2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
1163 deg 201c)2 30 109114 18sss 201(J 27 939lt 2nsz1 90300deg201401 19 OlJl 2012 201lt3 0 130117 l 110SS
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New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
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201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
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2U617 1367
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10t0Cl9 130974
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122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
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168A09 39137
103126
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104721
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1deg082
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103442
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1028()5
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lOS900
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104600
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107935
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40710
107271
11100 40459
106611
173029 40210
111212
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4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
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161929
1970U
163914
195829
162905
194624
156556
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185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
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156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
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n956
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5079S 90682
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7186
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47041
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74874
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7441bull
1n 84758
73956
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73500
48605 86772
75713
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8008 85707
74784
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49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
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24930
205509
24984
20595-
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204687
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24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 5 February 21 2018
The Fund currently is financed through a budget allocation from the state of New York Any party to a
medical professiona l liability claim can request for the j udgment to reflect eligibi lity for participation in
the Fund Upon this judgment the participant is eligible to receive covered benefits from the Fund
Data Methods amp Assumptions
Given that the Fund has been in operation for on ly six years a number of sources of information are
still in the formative stages Pinnacle has worked with Alicare and wi ll be working with Public
Consu lting Group to ensure that their claims databases are sufficient to support these ongoing
quarterly reports and to enhance the ongoing management of the Fund As a result we have
introduced more analysis by benefit category (ie nursing medical hospital prescription drugs etc)
and inj ury type
Early in the Funds operations some health care benefits that should have been paid by the Fund were
erroneously paid by New York Medicaid Pinnacle has been provided detailed benefits payment
information on these costs by the New York Department of Health (DOH) and they are reflected in the
exhibits
Some of the long term forecasts and industry benchmarks used in the ana lysis are based on data for
the birth injury funds in Virginia and Florida as wel l as medical professional liability insurers in the
state of New York These have been significantly modified based on data from the Fund as it becomes
more credible
One significant area of ongoing review of assumptions relates to the expected number of claims per
10000 live births Initia lly 110 participants per 10000 births were assumed based on data from
Virginia and Florida After the first year the frequency rate was increased to 290 participants per
10000 births In the first quarter 2014 report the expected number of eligible Fund participants was
increased from 290 per 10000 live births to 348 to be more consistent with the first two fu ll fiscal
years of experience and present more rea listic financial projections for the next five years In late
2016 we increased the assumption to 450 participants per 10000 births to better reflect ongoing
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 6 February 21 2018
frequency data It should be recognized that this is over four times the number of participants per
10000 live births experienced by the birth funds in Florida and Virginia
As we are accumulating more credible amounts of benefit payments data several differences are
emerging For example the annual benefit payments during 2016 to Fund participants that were
admitted to the program prior to 2016 (ie participants that have a full year of benefit payments
during 2016) are shown in the following graph and compared to data from Virginia Additional severity
information is conta ined in Exhibit 1 Page 2 and Exhibit 6
600
500
400
300
200o
100
I I I I 1 I 100 11 bullbull -bull VA Data bull NY Data
There are at least three key issues
1) The Fund has significantly more participants with $0 of benefit payments Will these
participants have benefit payments at some point
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 7 February 21 2018
2) The Fund has substantially more participants with less than $25000 in annual benefit
payments Is there something about the Fund s enabling legislation that is causing this or will
their costs increase over time
3) The Fund had five participants with annual benefits costs over $400000 Virginia has no
participants that breached this threshold Admittedly there are sample size issues but will this
phenomenon persist
We are continuing to monitor these phenomenon
In response to this information changes to the assumptions regarding the expected frequency and
severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016
The assumptions will be detai led later in this report
Discussion and Analysis
Number of Qualifying Participants
Based on the loss runs provided by Sedgwick CMS Alicare and OOH valued as of September 30 2017
there are five hundred five (505) participants that have qualified for the Program as of this date five
hundred (500) were still living as of September 30 2017 This information is summarized in Exhibit 2
There were seventeen (17) new participants to the Fund in the second quarter of fiscal 2017
approximately nine (9) fewer than expected for that portion of the quarter
The number of Fund participants and the distribution of participants by age warrants continued
monitoring The average age of a Fund participant at the time of admission is about 87 which is
approximately four years older than the age of a Virginia Birth Fund participant at admission
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
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4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
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39625
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15273
126623
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21195
147720
5 1248
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167131
56231
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63067
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317058
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338117
93743
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361616
98814
49917
389135
104246
59470
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110595
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115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
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15265
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69907
22523
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102417
28579
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190383
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167283
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2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
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l 18800 136890 115 157 966bull26
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
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t34 7Sl
57 U6 10263 90 108
U 4 7Sl
57 ll6 102amp14 90 108
134 753
S9 220 1deg)78 93ffl
U9669
S9 220 106311 93 39S
139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 6 February 21 2018
frequency data It should be recognized that this is over four times the number of participants per
10000 live births experienced by the birth funds in Florida and Virginia
As we are accumulating more credible amounts of benefit payments data several differences are
emerging For example the annual benefit payments during 2016 to Fund participants that were
admitted to the program prior to 2016 (ie participants that have a full year of benefit payments
during 2016) are shown in the following graph and compared to data from Virginia Additional severity
information is conta ined in Exhibit 1 Page 2 and Exhibit 6
600
500
400
300
200o
100
I I I I 1 I 100 11 bullbull -bull VA Data bull NY Data
There are at least three key issues
1) The Fund has significantly more participants with $0 of benefit payments Will these
participants have benefit payments at some point
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 7 February 21 2018
2) The Fund has substantially more participants with less than $25000 in annual benefit
payments Is there something about the Fund s enabling legislation that is causing this or will
their costs increase over time
3) The Fund had five participants with annual benefits costs over $400000 Virginia has no
participants that breached this threshold Admittedly there are sample size issues but will this
phenomenon persist
We are continuing to monitor these phenomenon
In response to this information changes to the assumptions regarding the expected frequency and
severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016
The assumptions will be detai led later in this report
Discussion and Analysis
Number of Qualifying Participants
Based on the loss runs provided by Sedgwick CMS Alicare and OOH valued as of September 30 2017
there are five hundred five (505) participants that have qualified for the Program as of this date five
hundred (500) were still living as of September 30 2017 This information is summarized in Exhibit 2
There were seventeen (17) new participants to the Fund in the second quarter of fiscal 2017
approximately nine (9) fewer than expected for that portion of the quarter
The number of Fund participants and the distribution of participants by age warrants continued
monitoring The average age of a Fund participant at the time of admission is about 87 which is
approximately four years older than the age of a Virginia Birth Fund participant at admission
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
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5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
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2014Ql
201402 201Q3
27
bull 19
2S 20
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1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
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87758
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41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
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133980
94708
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105634
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147207
10625-4
75983
123097
10S693 164791
116280
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128891
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134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
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167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
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209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
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2U617 1367
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t u 11 11678
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22S S09 14$ 766
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U9U7 263 4ll
139117 263 422
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18 2SO 280 11bull
l SS 836 295 078
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2015Q1 2015(14 2015Ql 20160
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sssn 998lS 87641
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146816
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2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
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10t0Cl9 130974
186561
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186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
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191810
110836 139571
198808
110amp16 139 571
198808
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116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 7 February 21 2018
2) The Fund has substantially more participants with less than $25000 in annual benefit
payments Is there something about the Fund s enabling legislation that is causing this or will
their costs increase over time
3) The Fund had five participants with annual benefits costs over $400000 Virginia has no
participants that breached this threshold Admittedly there are sample size issues but will this
phenomenon persist
We are continuing to monitor these phenomenon
In response to this information changes to the assumptions regarding the expected frequency and
severity of claims were made to the 4th quarter 2014 analysis and again in the second quarter of 2016
The assumptions will be detai led later in this report
Discussion and Analysis
Number of Qualifying Participants
Based on the loss runs provided by Sedgwick CMS Alicare and OOH valued as of September 30 2017
there are five hundred five (505) participants that have qualified for the Program as of this date five
hundred (500) were still living as of September 30 2017 This information is summarized in Exhibit 2
There were seventeen (17) new participants to the Fund in the second quarter of fiscal 2017
approximately nine (9) fewer than expected for that portion of the quarter
The number of Fund participants and the distribution of participants by age warrants continued
monitoring The average age of a Fund participant at the time of admission is about 87 which is
approximately four years older than the age of a Virginia Birth Fund participant at admission
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
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New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
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New Yorilt Department of FIMnelal SMllces amptlibit 4
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New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 8 February 21 2018
Average Entry Age
120
110
100
90
80
70
60
ml
50
40
Mortality ExperienceLife Expectancy
It is reasonable to expect that average life expectancies for Fund participants w ill average in the high
twenties as a group unless the different admission standards materially changes life expectancies
relative to the Virginia and Florida birth funds The current life expectancies of the Virginia birth fund
are 284 years from birth and 292 years for participants that reach the age of three (3) As of the
current analysis the Fund has experienced the death of only five of its participants The following
graph compares the age of current participants with the expected age distribution based on the
Virginia Birth Fund data
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
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26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
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2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
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Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
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6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
SI
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9 9
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2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
496bull56 S9002S 72 993
066sooa 53914 673 S94
674 066 S39U 673 59-C
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166 556 111 212 12113 166 439
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131 7S3 87973
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
m~ tim
traderu
m~ m~ wm ~mumtrade
tradern mm~~
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mm Mm m~
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l 9 ll2 25 350
210266
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110266
40418 26064
21618
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166 796 6171S9 69513
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165 796 6171S9 69SU
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17046gt 634 526 71469
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11680 6576n
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17668() 657 672 7076
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12a301
185 721 691 326
11861 128101
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uuo
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19036 72S 626 81 uo
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m ~ ~m
187 OU 431316
111 OU 43136
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192 307 44 967
192 )07
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192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
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248 810~ 2015Ql 20150
27
~~
~~
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~~
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wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
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u= mm~trade rn~
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sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
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t34 7Sl
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139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 9
February 21 2018
Participant Distribution by Age 80
70
60
C 50 -
f -0 40
0
E 30 z
20
10
-
- - - I- - -
- - - - - - -
- t- - - - - - - -
lJ T IT T
I I I I I bull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Current Age
bull Actual II of Participants bull Expected If of Participants
Actuarial Ca lculation of Estimated Fund Liabilities
We have been asked to project expected fund liabilities for the next ten fiscal years of the M IF To do
this we have estimated the ultimate benefit payments for the participants admitted to the Fund each
quarter on both a nominal and discounted basis Three methods were used to estimate ult imate
benefit payments by the year in which a participant was accepted to the fund A loss development
method was used in which actua l benefit payments to date were divided by the expected percentage
of ultimate benefits as of each participant-quarters maturity These percentages were developed
based on information for the Virginia Birth Fund and modified to reflect the older average age of the
Fund participants upon admittance An expected loss method was also used in which expected
ult imate benefit payments by quarter were also estimated using a weighted average of expected
average ultimate benefit payments per Fund participant overall and by quarter of eligibility Finally a
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
OAl 111 ltQgt 22 1S t S)ZS() deglS736 2011Ql 19 122431 14US4 9506 1Slc22
I 1441n 21oc U71SS 431112111 71441
112 $201()
2309 17276amp 1amp4 US JS2 1no19 t64 SS9 264142
119295 2213amp
9 10148 deg 348Ji9
143414 mno 4102$7 ruu t7G7 202010
deg
9 42 11
21940 1480U 161013
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New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
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New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
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Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 10 February 21 2018
Bornhuetter-Ferguson (B-F) technique estimates ultimate losses using a combination of expected
losses and loss development techniques
These ultimate benefits amounts are then allocated to future payment quarter based on the benefits
payment patterns described previously To state future payments on a discounted basis a discount
rate of 25 was used This is based on discount rates for other medical professiona l liability insurance
programs in New York Prior to the recent legislative change average lifetime benefit payments were
estimated to average $335 million per participant on a nominal basis and $132 million on a
discounted basis using a 25 discount rate This amount increases annually to account for medical
inflation For new participants admitted subsequent to the law change an a priori estimate of future
lifetime benefits payment liabilities increases to an average of $362 million on a nominal basis or a
present va lue of $152 million These liabi lities will vary depending on the amount of an individual
participants benefits that are paid during the period of higher reimbursement rates The timing of the
payments used in our severity estimates also reflect the amount of time a participant is expected to
live so that these severities take participant mortality into account
Based on this approach and the new law we estimate that the 505 admitted Fund participants wi ll
ultimately receive benefits on the order of $1824 billion Adjusting for the time value of money at a
25 discount rate resu lts in a present value for these benefits of $7923 million
Actual benefit payments in the second quarter of the 2017-18 fiscal year were $603 million Based on
updated severity and payment timing estimates the expected 5165 additiona l participants increased
payments in the third quarter to account for the lack of September payments and the impacts of the
recent legislation estimated benefit payments for the 2017-18 fiscal year will be $52177 million It is
important to recognize that these amounts can vary significantly each quarter We will continue to
monitor this estimation methodology closely as they are quite sensitive to several key assumptions
The number of eligible participants is expected to continue increasing for at least 30 years as more
eligible participants are admitted to the Fund each year
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
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4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
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ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
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200()39
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201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
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87758
Sl760
41967 S279S
60317 102596
67 733
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71531 U S080
81136
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133980
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147207
10625-4
75983
123097
10S693 164791
116280
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1A2279
116307 186149
128891
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134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
284 456
211213 1045 294
1708 21776 401 St 1S2 406
2amp2 S92 350374 296N3 193 955 288099
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1
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1l2023 116 207 361 amp86
41 285
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~ 29173 65 141
l 18800 136890 115 157 966bull26
68386
404028 317022
ll ll ll 91 2827 S4SU 47626 21564
33607 38S7 227Ul 17639 gt10S77 2S4C97 28190 369 7J8 3494S8 26762S
1218933 97820 927 SJ 119313 117497 114918 197 202 2S6 410 16702l 273 7bull3 JU 761 270692 303320 120 264 10S891 31801 25466S
1219804 2573M
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9 190CM
3S5bull1c 226106
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9 9 S148l 800
31812 9
321808 301643 90654
8119S1 782 976
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1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
811951 7amp2 976 941 219 608390
618158 1171 631
10620 12856 111 l7l
919 S0087
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70620 126856 111 tl
Ill ssm
6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
SI
24A S11 402980 6-S8086 642289 619368 137 S04 139847 2pound4803 S864
Ul0343 88101
9 9
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2laquoS71 244S71 402980 402980 153880 1S3 880 642289 619 168 176961 212727 2U717 1375deg 137 S04 09847 ll9S47 264803 1008 88101 88 101
2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
496bull56 S9002S 72 993
066sooa 53914 673 S94
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606913 11578lt U7607 171282
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166 SS6 166 SS6 Ut212 1112U 132173 U217 166439 16609
166 556 111 212 12113 166 439
166S56 111212 112 171 166439
U17S3 81973
1045S4 131 660
131 7S3 87973
10amp SS4 131660
Ul7U 1l1 75l 87971 amp79tl U)4 SS4
131660 131660 2017Ql 1~330 1 058 330 1osa130 1 0S8330 959 477 9S9bulln 9S9477 274 136 24682fi 246126 26826 246126 237071 237078 137 078 23707t 1815~ 17S39 187 S39 lt7S39 17Ql 17 578133 607807 607 807 607907 f1)1801 SSl 015 ss1 oas 157 4l8 1S7 431 11s 141 7S4 14115 14175-4 1316156 136 1S6 1316156 U6 1S6 10770S 1077()6 107705 107 70S
so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
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mm mm ~ m ~trade mootrade~
mm Mm m~
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l 9 ll2 25 350
210266
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110266
40418 26064
21618
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2606 216183
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166 796 6171S9 69513
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170-461 63-02
11469 117760
17046gt 634 526 71469
117 760
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11680 6576n
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187 OU 431316
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192 307 44 967
192 )07
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192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
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m~ m m
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2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
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217 S72 140 S5
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22S S09 14$ 766
22S S09 14S 766
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1432SO 280711
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18 2SO 280 11bull
l SS 836 295 078
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2015Q1 2015(14 2015Ql 20160
16
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sssn 998lS 87641
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146816
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16816
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146 816
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2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
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10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 11 February 21 2018
Amount of Benefits Paid
As shown in Exhibit 1 $603 mil lion has been paid to Fund participants during the second quarter of
the 2017-18 fisca l year (7117-930 17) based on the payment data provided by Alicare Due to the
transition of claims handling to PCG no claims were paid during the 91 17-930 17 period We
therefore expect to see proportionally higher payments in the third quarter of the 2017-18 fiscal year
as claim payments resume In addition we are continuing to investigate to see if there are materia l
differences in the types of inj uries experienced by participants in the New York Fund versus those in
Virginia and Florida that may explain some of the differences we are seeing between actual and
expected payments
Patterns of Utilization
It is too early in the life of the Fund to provide any credible conclusions regarding patterns of
utilization However Pinnacle is working with Alicare and wi ll continue to work with PCG to develop
the data capabi lities to provide this type of ana lysis in the future Specifically we are developing
detai led benefit payment information by participant Fund fiscal year and benefit type The benefit
types being captured are intended to reflect the benefits provided by the Funds legislation and follow
form with existing databases in Florida and Virginia
Exhibit 1 shows Alicare payment detail (provided through 930 17) grouped into the following
categories
bull Medical Treatment
bull Hospita l Based Care
bull Surgical Care
bull Nursing Care
bull Denta l Care
bull Rehabilitation Care
bull Custodial Care
bull Durable Medical Equipment
bull Home Modifications
Vehicle Modificationsbull Prescription and Non-Prescriptive Drugs bull
bull Other Health Care Costs
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
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26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
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2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
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so
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
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27015 224 069
4 1893 2701S
22bull 069
41893
27015 224 069
44037
28197 lliS35
44037
2897 215 S35
44011
28397 235535
laquo on 28397
23SS3S
46221 29806
27221
46221 2bull 7121
20UQ1 2012(14 201lQl 201l(U
2S lO
ru~ ru~ m~ m~ ~~ 2mm2mm2mm2rnm2mffl
bull~ trade~ -trade trade~ nw wm ~m ww wm m-
~~
~lli
n w m-
m~~trade nw m~
m = illtrade nm m-
~~
m~
~m ~m
166 796 6171S9 69513
114 S37
16S 196 617 1S9 69SU
UA Sl7
165 796 6171S9 69SU
114 531
170-461 63-02
11469 117760
17046gt 634 526 71469
117 760
170462 634S26
71469 111160
170462 6WS26
71 469 117 NO
11680 6576n
74076 lll OSS
116680 657671
74076 1210SS
176680 6S76n
74016 1220SS
17668() 657 672 7076
122oss
1SS721 691 326 n861
12a301
185 721 691 326
11861 128101
1asn1 91326
121301
18S 721 691326 77867
uuo
194 936 72S626 81730 134~
19036 72S 626 81 uo
13667 201CU 2lt)1)(14
27 ~m trade~
~m laquo~
mlli laquo ~
mm laquo rn
mm ~-
mm bullm
mm am
mm bullm
m ~ ~m
187 OU 431316
111 OU 43136
1870W bulll 736
192 307 44 967
192 )07
44967 192307 44967
192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
237049 15J22S
2881ll 160821
248 810~ 2015Ql 20150
27
~~
~~
~~
~~
~~~= ~~ ~~
wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
nm mtrade ~w mm
u= mm~trade rn~
~rn ~m v~ m~
sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
s11u 102 6l4 9010amp
134 7Sl
57136 102634 ~10S
t34 7Sl
57 U6 10263 90 108
U 4 7Sl
57 ll6 102amp14 90 108
134 753
S9 220 1deg)78 93ffl
U9669
S9 220 106311 93 39S
139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 12 February 21 2018
bull Assistive Technology bull Other Payments
Our analysis suggests benefits patterns that are showing some differences from the Virginia data To
date t he Fund is having a substantia lly higher percentage of overall costs in medical and hospita l costs
medical equipment and prescription drug costs and correspondi ng lower percentages in nursing and
long-term care costs The prescription drug costs merit continued monitoring and potentially a more
detailed investigation Th is data is summarized in Exhibit 1 and shown graphically below Exhibit 1 also
compares New York data to benefit payments in Virgin ia Nursing costs are t he majority of total
payments in both states
Benefits Payments 1012 - 9 17
bull Medical Treatment 529
bull Hospital Based Care 1151
bull Surgical Care 068
bull Nursing care 5123
bull Dental Care 023
bull Rehabi lit ation Care 521
bull Custodial Care 371
Durable Med Equip 517
bull Hom e M odif ications 504
Vehicle Modifications 121
bull Rx and Non-Rx Drugs 1028
bull Other Health Care Costs 024
Assistive Technology 000
Other Paym ent s 019
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
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2614
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5070
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6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
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13416
8855
3648
27333
21962
5052
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54635
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104246
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2012Ql 2012Q4
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102417
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2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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212 728
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41 285
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~ 29173 65 141
l 18800 136890 115 157 966bull26
68386
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ll ll ll 91 2827 S4SU 47626 21564
33607 38S7 227Ul 17639 gt10S77 2S4C97 28190 369 7J8 3494S8 26762S
1218933 97820 927 SJ 119313 117497 114918 197 202 2S6 410 16702l 273 7bull3 JU 761 270692 303320 120 264 10S891 31801 25466S
1219804 2573M
SU396 462 2SO 462 250 4S07Jt 4S0738 6834
9 190CM
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1 35451t
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644 200 121980C
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1174 22)
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1219804 2SHl4 622SO
9 9 S148l 800
31812 9
321808 301643 90654
8119S1 782 976
91219 91219 61amp758 618758
1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
811951 7amp2 976 941 219 608390
618158 1171 631
10620 12856 111 l7l
919 S0087
8119S1 712 976 941219 60890 6187i8 ll4 7S2
70620 126856 111 tl
Ill ssm
6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
SI
24A S11 402980 6-S8086 642289 619368 137 S04 139847 2pound4803 S864
Ul0343 88101
9 9
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2laquoS71 244S71 402980 402980 153880 1S3 880 642289 619 168 176961 212727 2U717 1375deg 137 S04 09847 ll9S47 264803 1008 88101 88 101
2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
496bull56 S9002S 72 993
066sooa 53914 673 S94
674 066 S39U 673 59-C
674066 67C 066 6069U 606 913 bullS0084 4S0084 406246 534914 48162C 131607 6n 594 673 S94 1732amp2 171282
606913 11578lt U7607 171282
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166 SS6 166 SS6 Ut212 1112U 132173 U217 166439 16609
166 556 111 212 12113 166 439
166S56 111212 112 171 166439
U17S3 81973
1045S4 131 660
131 7S3 87973
10amp SS4 131660
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131660 131660 2017Ql 1~330 1 058 330 1osa130 1 0S8330 959 477 9S9bulln 9S9477 274 136 24682fi 246126 26826 246126 237071 237078 137 078 23707t 1815~ 17S39 187 S39 lt7S39 17Ql 17 578133 607807 607 807 607907 f1)1801 SSl 015 ss1 oas 157 4l8 1S7 431 11s 141 7S4 14115 14175-4 1316156 136 1S6 1316156 U6 1S6 10770S 1077()6 107705 107 70S
so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
m~ tim
traderu
m~ m~ wm ~mumtrade
tradern mm~~
mm mm ~ m ~trade mootrade~
mm Mm m~
mm s~=~
l 9 ll2 25 350
210266
39312 2S 350
2102
l9JU 25 350
110266
40418 26064
21618
40418
2606 216183
40418
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40418
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27015 224 069
44037
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laquo on 28397
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20UQ1 2012(14 201lQl 201l(U
2S lO
ru~ ru~ m~ m~ ~~ 2mm2mm2mm2rnm2mffl
bull~ trade~ -trade trade~ nw wm ~m ww wm m-
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m = illtrade nm m-
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166 796 6171S9 69513
114 S37
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165 796 6171S9 69SU
114 531
170-461 63-02
11469 117760
17046gt 634 526 71469
117 760
170462 634S26
71469 111160
170462 6WS26
71 469 117 NO
11680 6576n
74076 lll OSS
116680 657671
74076 1210SS
176680 6S76n
74016 1220SS
17668() 657 672 7076
122oss
1SS721 691 326 n861
12a301
185 721 691 326
11861 128101
1asn1 91326
121301
18S 721 691326 77867
uuo
194 936 72S626 81730 134~
19036 72S 626 81 uo
13667 201CU 2lt)1)(14
27 ~m trade~
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mlli laquo ~
mm laquo rn
mm ~-
mm bullm
mm am
mm bullm
m ~ ~m
187 OU 431316
111 OU 43136
1870W bulll 736
192 307 44 967
192 )07
44967 192307 44967
192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
237049 15J22S
2881ll 160821
248 810~ 2015Ql 20150
27
~~
~~
~~
~~
~~~= ~~ ~~
wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
nm mtrade ~w mm
u= mm~trade rn~
~rn ~m v~ m~
sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
s11u 102 6l4 9010amp
134 7Sl
57136 102634 ~10S
t34 7Sl
57 U6 10263 90 108
U 4 7Sl
57 ll6 102amp14 90 108
134 753
S9 220 1deg)78 93ffl
U9669
S9 220 106311 93 39S
139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 13 February 21 2018
Another key aspect of the database needed to evaluate patterns of utilization is differences in the
medical and mental condition of the Funds participants To facilitate this dimension of our future
ana lysis Pinnacle worked w ith Alicare to add a number of characteristics for each Fund participant
including
bull Current Age
bull Gender
bull Injury Description
bull Other Insurance (ie whether participant holds other insurance)
bull Ambulatory Status
bull Use of a gastric feeding tube (G-Tube)
bull Abi lity to lift head from the prone position
bull Use of a ventilator
bull Use of a tracheostomy tube (trach tube)
In Virginia several of these characteristics have been shown to influence life expectancies and average
annual benefit payments We expect they will serve equally va luable to the Fund as more benefit
payment data becomes available
Benefit Payments and Injury Type
For nearly all Fund participants the nature of the injury and primary diagnosis permitting entrance into
the Fund has been provided to Pinnacle as part of the quarterly Alicare payment data Although strict
standardization of participant injury types is not provided sufficiently detailed descriptions of the
nature of the injury have allowed us to judgmentally categorize participants into standardized injury
type groups As with the benefit type categorization injury type categorization can aid in identifying
differences in injury types that are relevant to the management of the Fund
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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OAl 111 ltQgt 22 1S t S)ZS() deglS736 2011Ql 19 122431 14US4 9506 1Slc22
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Note ltd(ltr 2011di~11ld11ta onlvindJditsthroti amp3117
2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
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209 S22 48 992
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201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
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2U617 1367
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10t0Cl9 130974
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110836 139571
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116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
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153992
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122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 14 February 21 2018
We have categorized the primary diagnosis for each Fund participant into one of the following injury
types
Brachia Plexus bull bull Cerebra l Palsy
Developmenta l Delays bull bull Encephalopathy
bull Erbs Palsy
bull Hemiplegia
Mental Retardation bull bull Neurological Disabi lities
bull Quadriplegia
bull Spastic Diplegia
Spastic Paraplegia bull bull Spastic Quadriplegia
bull Other
bull Not Ava ilable
The following is a graph of the distribution of participants by injury type group above Spastic
quadriplegia cerebra l palsy and encephalopathy combine to make up over 73 of total benefit
payments
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
OAl 111 ltQgt 22 1S t S)ZS() deglS736 2011Ql 19 122431 14US4 9506 1Slc22
I 1441n 21oc U71SS 431112111 71441
112 $201()
2309 17276amp 1amp4 US JS2 1no19 t64 SS9 264142
119295 2213amp
9 10148 deg 348Ji9
143414 mno 4102$7 ruu t7G7 202010
deg
9 42 11
21940 1480U 161013
29659 222W )052t
159-203 52345191
211 106
222 lll uosu
It 21111a
1 0r4S294 moa 21714 4013Sl 212592 3$03)4
111714 252349
2la77
9 101 43 deg 11SOS08 124 1116
41129 m 31243l
180340
149 2U72t -l3 01
12 bullSOSO
)60amp$ cum
111iS11 U20tl 116207 361886 4128S
12742 221$3
31991 264ltil 160051
912
1 14amp00 u a90
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l~lhM11tshld bo(flldPwtlclpadon(tuwttt
91 IY 91 I 9ll S48U Camp2S 38157 19 004 iwsn 2844-97 deg 3M 414bullm 27$2$ 3024ampgt
121ampm ll9-t490 91820 t27ampS7 l lS4514 11931 117497 124918 U9 01S 191202 25amp410 2n10 21S
111 761 deg 10U91 n 131801 )64447 3Jts2 SSOQO 4S amp24
3St669 4211-SS lSS~
ll
1174113
110923 191 25
I ampOSO
906524 mos 2ampsS07 11HU
ll
34929(
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
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201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
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2U617 1367
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10t0Cl9 130974
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122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 15 February 21 2018
Benefit Payments 1012 - 917
2448
bull Brachia Plexus 008
bull Erbs Palsy 0 20
bull Spast ic Diplegia 036
bull Hemiplegia 040
bull Mental Retardation 220
bull Developmental Delays 691
Neurological Disabilities 796
bull Spastic Paraplegia 024
bull Cerebral Palsy 2922
Encephalopathy 2448
bull Spast ic Quadriplegia 1950
bull Other 560
Quadriplegia 151
Not Available 134
It is clear from t he graph that the Funds participant composition by injury type is varied but also
concentrated in a handful of categories The followi ng graph illustrates the number of participants and
average payment by injury type through the current quarter
_ Pinnacle Act uarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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so
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
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122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 16 February 21 2018
Average To Date Payments per Participant
S-0000000 160
45000000
110
40000000
100)St00000
l 300()(X)00 80c
i ~ 15000000 ~ G 60i 20000000
i 15000000
40
10000000
20
lt000000 I - bull - Nurrbe of Parnc1panrs Avenge Pcltbeioot Seenty
Participants with injury types of Cerebral Palsy Encephalopathy or Spastic Quadriplegia comprise
approximately 52 of the tota l participants but account for approximately 73 of total payments
resulting in relatively large average payments Conversely participants with injury types of Brachia I
Plexus Erbs Palsy Spastic Diplegia Hemiplegia Mental Retardation Developmental Delays or
Neurological Disabilities have relatively low average payments and comprise approximately 40 of the
total participants but account for roughly only 18 of tota l payments The large number of
participants in the Developmental Delays and Neurological Disabi lities categories with relatively low
benefit payments are also noteworthy
Inflationary Patterns of Types of Services
It is far too early in the life of the Fund to provide any credible conclusions regarding inflationary
patterns However based on our experience in Virginia we are confident that the detailed claims
benefits payment database being constructed will prove invaluable once more benefits experience has
been accumulated
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
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New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
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New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
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122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 17 February 21 2018
Administrative Expenses
Pinnacle was provided information in early 2017 on administrative expenses for the Fund Prior to the
change in claims administration at 9 1 17 Alicare was charging the Fund $809 per Fund participant per
month Based on this information we estimated that the Fund would incur approximately $497
million in administrative expenses during the 2017-18 fiscal year or 80 of total fund expenditures
This is comparable to the administrative expenses in Virginia However this percentage is affected by
the significantly higher benefits payments expected due to recent legislation Once the legislation
expires administrative expenses as related to benefit payments were expected to return to previous
levels more on the order of 20 of the Funds tota l expenditures However the new contract with
PCG is expected to result in somewhat lower administrative expenses that will lower this percentage
Impact of Available Health Insurance
It is also far too early in the life of the Fund to provide any credible conclusions regarding the impact of
available health insurance However the detailed benefits payment database described earlier and
summarized in Exhibit 1 wi ll prove invaluable once more benefits experience has been accumulated
One early item of note is the number of participants with Medicaid has been consistently tracking at
more than half of the Funds participants In the current 2017 fiscal year over 70 of the Funds
admitted participants rely on Medicaid
Investment Earnings
We have not had the opportunity to review sign ificant information regarding the Funds investment
returns on the Funds invested assets at th is time We expect that more information will be provided
in upcoming quarterly reports Building up investment income on the Funds balance will be essentia l
to the Funds ongoing financial strength as participants continue to enter the Fund and calendar year
benefit payments continue to grow as the Fund moves toward a steady state over the next twenty or
more years
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
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New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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9ll 49618
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so
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
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219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
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2U617 1367
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2015Q1 2015(14 2015Ql 20160
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2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
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10t0Cl9 130974
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110836 139571
198808
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198808
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116508 146 713 208981
116508 146713 208981
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122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 18 February 21 2018
Distribution amp Use
This Report has been prepared for the use of the NY DFS and for the internal use of the NY DFS only
Permission is granted to share this Report with representatives of M IF under the Departments
standard guidelines for such review Any other distribution of this report is not authorized without the
prior written consent of Pinnacle Th ird parties reviewing the report shou ld recognize that the
furnishing of this report is not a substitute for their own due di ligence and should place no reliance on
this report or the data contained herein that would result in the creation of any duty or liability by
Pinnacle to the third party
Pinnacle consents to reference by the Department to Pinnacles reports opinions advice and firm
name in documents released by or at the direction of the Department concerning such financia l
examination findings In any instances other than the Departments fina l examination report regarding
the review of reserves and solvency analysis of the Fund in which Pinnacle is identified as the source of
a paraphrase quotation or partial quotation the Department shall notify Pinnacle prior to such
publication so that Pinnacle may review said reference(s) Further distribution or use of this Report is
expressly prohibited without the prior written consent of Pinnacle The nature of the materia l
contained in the Report is such that this limitation on distribution shou ld apply to requests made under
any Freedom of Information Act
The exhibits attached in support of our findings are an integral part of this Report These sections have
been prepared so that our actuarial assumptions and j udgments are documented Judgments about
the conclusions drawn in this Report should be made only after considering the Report in its entirety
We remain avai lable to answer any questions that may arise regarding this Report We assume that
the user of this Report will seek such explanation on any matter in question
Our conclusions are predicated on a number of assumptions as to future conditions and events Those
assumptions which are documented in subsequent sections of this report must be understood in
order to place our conclusions in their appropriate context In addition our work is subject to inherent
limitations which are also discussed in this Report
_ Pinnacle Actuarial Resources Inc
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
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New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
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211213 1045 294
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9ll 49618
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
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209 S22 48 992
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219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
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2U617 1367
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t u 11 11678
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2015Q1 2015(14 2015Ql 20160
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16816
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2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
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10t0Cl9 130974
186561
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191810
110836 139571
198808
110amp16 139 571
198808
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116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York State Medical Indemnity Fund Report - 3rd Quarter 2017 Page 19 February 21 2018
Reliances amp Limitations
We have prepared this Report in conformity with its intended use by persons technically competent in
the areas addressed and for the stated purposes only
Throughout our analysis we have without audit or verification relied on historical data and qualitative
information provided by NYS DFS related agencies and MlFs services providers The accuracy of our
results is dependent upon the accuracy and completeness of this underlying data Therefore any
material discrepancies discovered in this data or other information provided by NYS DFS its related
agencies or MlFs other service providers should be reported to us and this Report amended
accordingly
There is a limitation upon the accuracy of these estimates in that there is inherent uncertainty in any
estimate of unpaid claims obligations and benefits This is due to the fact that the ultimate liability for
claims is subject to the outcome of events yet to occur eg future program participant life
expectancies medical cost inflationary trends etc We have employed generally accepted actuarial
techniques and assumptions that we believe are reasonable and appropriate Further the conclusions
presented herein are reasonable and appropriate and supported by our analysis given the information
currently available However it should be recognized that future loss emergence wil l likely deviate
perhaps materially from our estimates
Additiona l uncertainty arises from lack of historical data and use of industry benchmarks Our
projections of future loss emergence and benefit payments are based primari ly on aggregate insurance
industry loss development patterns It is possible that these patterns may not be indicative of future
loss development for MIF
_ Pinnacle Actuarial Resources Inc
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
OAl 111 ltQgt 22 1S t S)ZS() deglS736 2011Ql 19 122431 14US4 9506 1Slc22
I 1441n 21oc U71SS 431112111 71441
112 $201()
2309 17276amp 1amp4 US JS2 1no19 t64 SS9 264142
119295 2213amp
9 10148 deg 348Ji9
143414 mno 4102$7 ruu t7G7 202010
deg
9 42 11
21940 1480U 161013
29659 222W )052t
159-203 52345191
211 106
222 lll uosu
It 21111a
1 0r4S294 moa 21714 4013Sl 212592 3$03)4
111714 252349
2la77
9 101 43 deg 11SOS08 124 1116
41129 m 31243l
180340
149 2U72t -l3 01
12 bullSOSO
)60amp$ cum
111iS11 U20tl 116207 361886 4128S
12742 221$3
31991 264ltil 160051
912
1 14amp00 u a90
40lt 02amp
422
l~lhM11tshld bo(flldPwtlclpadon(tuwttt
91 IY 91 I 9ll S48U Camp2S 38157 19 004 iwsn 2844-97 deg 3M 414bullm 27$2$ 3024ampgt
121ampm ll9-t490 91820 t27ampS7 l lS4514 11931 117497 124918 U9 01S 191202 25amp410 2n10 21S
111 761 deg 10U91 n 131801 )64447 3Jts2 SSOQO 4S amp24
3St669 4211-SS lSS~
ll
1174113
110923 191 25
I ampOSO
906524 mos 2ampsS07 11HU
ll
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New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
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201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
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2U617 1367
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122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
INDEX OF EXHIBITS
Exhibit Description
1 Fund Payments by Benefits and Injury Categories
2 Projected Balance Sheets and Income Statements
3 Actual vs Revised Expected Participant Counts
4 Payments by Admittance Quarter
5 Projected Payments by Admittance Quarter - Nominal and Discounted
6 Estimated Ultimate Benefits Payments by Admittance Year
7 Participant Profile
_ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
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2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
OAl 111 ltQgt 22 1S t S)ZS() deglS736 2011Ql 19 122431 14US4 9506 1Slc22
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
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211213 1045 294
1708 21776 401 St 1S2 406
2amp2 S92 350374 296N3 193 955 288099
91 llll 433 287128
1
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372 bullu 2496 25ltU
212 728
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41 285
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l 18800 136890 115 157 966bull26
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404028 317022
ll ll ll 91 2827 S4SU 47626 21564
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1218933 97820 927 SJ 119313 117497 114918 197 202 2S6 410 16702l 273 7bull3 JU 761 270692 303320 120 264 10S891 31801 25466S
1219804 2573M
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31812 9
321808 301643 90654
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91219 91219 61amp758 618758
1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
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618158 1171 631
10620 12856 111 l7l
919 S0087
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Ill ssm
6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
SI
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9 9
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2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
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066sooa 53914 673 S94
674 066 S39U 673 59-C
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166 556 111 212 12113 166 439
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131 7S3 87973
10amp SS4 131660
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
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tradern mm~~
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l 9 ll2 25 350
210266
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110266
40418 26064
21618
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166 796 6171S9 69513
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11680 6576n
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187 OU 431316
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192 307 44 967
192 )07
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192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
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m~ mm
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mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
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248 810~ 2015Ql 20150
27
~~
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wm mw
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mw mw
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U9U7 263 4ll
139117 263 422
09117 263422
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143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
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16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
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sssn 998lS 87641
13106S
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sssn 9982S 87641 lll 065
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62 2Sl 111 amp21 9811bull
146 816
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146816
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16816
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146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
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10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 1
As of September 30 2017
Fund Payments by Benefits Category
Virampinia Birth Fund Percent
Benefit category lliZQ1 lliZfil FY 1617 FY 1516 FY1415 FY 1314 FY 1213 Total Percent of Total Benefit category ofTotal
Medical Treatment 337504 397605 1111413 868110 573589 263209 35184 3586614 529 Hospital Based Care 754869 1050283 1885043 2092358 1673039 300325 42922 7798840 1151 HospitalPhysician 140
Surgical care 33609 42722 113032 146685 101149 18896 2190 458283 068 Nursing care 2760908 3831353 10627012 8153130 6438280 2345151 552120 34707955 5123 Nursing 6511
Dental Care 16005 14592 43620 43956 28510 8619 586 155887 023 Rehabilitation care 266786 380875 1135719 995410 630482 62821 60191 3532284 521 Physical Therapy 264
Custodial care 428888 391187 1131480 485434 69581 9248 2515817 371 Durable Med Equip 321774 364773 945751 880138 533009 416785 42169 3504399 517 Medical Equipment 187
Home Modifications 271455 263254 1208614 674666 700673 292218 6110 3416990 504 Housing 1242 Vehicle Modifications 56139 145296 249284 153585 180606 37247 822157 121 Vans 523
Prescription and Non-Prescriptive Drugs 751443 784704 2537792 1669450 872352 281662 65176 6962579 1028 Prescription Drugs 099 other Health care Costs 12551 10598 46590 38122 43311 12976 360 164509 024 All Other 1033
Assistive Technology 500 1244 1744 000 Other Payments 14308 25740 64014 14022 7404 (4) 8 125492 019
Total 6026240 7702981 21099865 16216310 11851988 4049151 807015 67753550 10000Ai
Note FY 1213 includes only 4th quarter 2012 and 1st quarter 2013 FY 1213 does not include payments when Sedgwick was TPA
Claim Database thru 2017Q3 11272017~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
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6349
12620
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26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
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2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
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Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
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131660 131660 2017Ql 1~330 1 058 330 1osa130 1 0S8330 959 477 9S9bulln 9S9477 274 136 24682fi 246126 26826 246126 237071 237078 137 078 23707t 1815~ 17S39 187 S39 lt7S39 17Ql 17 578133 607807 607 807 607907 f1)1801 SSl 015 ss1 oas 157 4l8 1S7 431 11s 141 7S4 14115 14175-4 1316156 136 1S6 1316156 U6 1S6 10770S 1077()6 107705 107 70S
so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
m~ tim
traderu
m~ m~ wm ~mumtrade
tradern mm~~
mm mm ~ m ~trade mootrade~
mm Mm m~
mm s~=~
l 9 ll2 25 350
210266
39312 2S 350
2102
l9JU 25 350
110266
40418 26064
21618
40418
2606 216183
40418
2606 216 183
40418
2064 216183
1893
27015 224069
41 393
27015 224 069
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41893
27015 224 069
44037
28197 lliS35
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laquo on 28397
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20UQ1 2012(14 201lQl 201l(U
2S lO
ru~ ru~ m~ m~ ~~ 2mm2mm2mm2rnm2mffl
bull~ trade~ -trade trade~ nw wm ~m ww wm m-
~~
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m = illtrade nm m-
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m~
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166 796 6171S9 69513
114 S37
16S 196 617 1S9 69SU
UA Sl7
165 796 6171S9 69SU
114 531
170-461 63-02
11469 117760
17046gt 634 526 71469
117 760
170462 634S26
71469 111160
170462 6WS26
71 469 117 NO
11680 6576n
74076 lll OSS
116680 657671
74076 1210SS
176680 6S76n
74016 1220SS
17668() 657 672 7076
122oss
1SS721 691 326 n861
12a301
185 721 691 326
11861 128101
1asn1 91326
121301
18S 721 691326 77867
uuo
194 936 72S626 81730 134~
19036 72S 626 81 uo
13667 201CU 2lt)1)(14
27 ~m trade~
~m laquo~
mlli laquo ~
mm laquo rn
mm ~-
mm bullm
mm am
mm bullm
m ~ ~m
187 OU 431316
111 OU 43136
1870W bulll 736
192 307 44 967
192 )07
44967 192307 44967
192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
237049 15J22S
2881ll 160821
248 810~ 2015Ql 20150
27
~~
~~
~~
~~
~~~= ~~ ~~
wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
nm mtrade ~w mm
u= mm~trade rn~
~rn ~m v~ m~
sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
s11u 102 6l4 9010amp
134 7Sl
57136 102634 ~10S
t34 7Sl
57 U6 10263 90 108
U 4 7Sl
57 ll6 102amp14 90 108
134 753
S9 220 1deg)78 93ffl
U9669
S9 220 106311 93 39S
139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Exhibit 1
Quarterly Analysis of New York Medical Indemnity Fund Page 2
As of Septembelt 30 2017
Fund Payments by Injury Category Total Percent Totallnjury Number of Injury category
Total Percent of Numberof of Total category Participant Annualized Injury Category 201703 201702 FY 1617 FY 1516 FY 1415 FY 1314 FY 1213 Payments Total P~ments Participants Panicipants Severity Quarters Severity
Brachial Plexus 9826 6482 10549 11927 8466 2687 49936 008 20 396 249682 203 984 Erbs Palsy 14961 15115 32885 34007 25640 3617 126225 020 36 713 3506 384 1315
Spastic Oiplegia 20418 26137 58214 65865 53702 224336 036 7 139 32048 96 9347 Hemiplegia 10786 21900 86939 18250 52271 53464 4331 247940 040 15 297 16529 197 5034
Mental Retardation 105499 102187 433236 514888 176580 32714 14964 1380069 220 16 317 86254 193 28602 Developmental Delays 323496 393448 1251998 1265010 949237 152790 389 4336368 691 60 1188 72273 729 23794
Neurological Disabilities 611079 699593 1788924 1130909 571830 169875 17260 4989469 796 50 990 99789 603 33098 Spastic Paraplegia 21115 9689 21081 39287 57729 148901 024 040 74450 17 35035
Cerebral Palsy 1533446 2277089 5909418 4116581 3052208 1227845 212024 18328611 2922 116 2297 158005 1422 51557 Encephalopathy 1285153 1662867 4109928 3785684 3244944 1055853 209787 15354217 2448 87 1723 176485 1141 53827
Spastic Quadriplegia 1114592 1460176 3839667 2999106 2096547 675214 45764 12231067 1950 59 1168 207306 602 81270
Other 202861 344133 892244 640451 707892 492737 233864 3514182 560 27 535 130155 301 46700 Quadriplegia 139325 80959 327236 272060 127694 947274 151 040 473637 19 199426 Not Available 62436 31096 351832 128354 149457 46031 68632 837839 134 8 158 104730 151 22194
Total 5454994 7130872 19114151 15022378 11274197 3912827 807015 62716433 505 10000 124191 6058 41411
Note FY 12 13 includes only 4th quarter 2012 and 1st quaner 2013 Medeare invokes for prescriptions also excluded Total Injury category Severity =-Total Payments Number of Participant Total Injury category Atmualized Severity = T oral Payments Number of Participant Quarters x 4
Claim Database thru 201703 ~ Pinnacle Actuarial Resources Inc 11272017
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
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4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
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39625
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15273
126623
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21195
147720
5 1248
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167131
56231
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63067
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317058
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338117
93743
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361616
98814
49917
389135
104246
59470
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110595
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115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
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15265
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69907
22523
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102417
28579
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190383
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167283
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2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
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l 18800 136890 115 157 966bull26
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
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t34 7Sl
57 U6 10263 90 108
U 4 7Sl
57 ll6 102amp14 90 108
134 753
S9 220 1deg)78 93ffl
U9669
S9 220 106311 93 39S
139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Exhibit 2
Quarterly Analysis of New York Medical Indemnity Fund Page 1 Future Fund Balances by Fiscal Year (000s) as of September 30 2017
With 250 Discount
8AlANCESHEpoundT
Projections as of flseal Year At93017 2017-18 ~ ~ ~ ~ ~ ~ ~ 2025middot2 2026-27
Assets
Fund Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
fls Future Benefits for Curent Participants 7270749 7776107 8701866 9628327 11045616 12514740 14042103 15628342 17270280 18962709 20705773
Future Administrative Expenses 1240415 1351661 1617269 1891731 2176462 2471990 2779418 3098796 3429556 3770645 4122039
Surplusf(Unfunded Llabillty [6066503) [6516953) [7994234 (9452416) [10972287) (12603560) (14356457) (16235247) (18241587) (2037493S) (22637737)
INCOME STATEMENT
Projectionbull at of Flsal Year Endlnc At 9(30(17 2017-18 2018-19 2019-20 2020-21 2021middot22 2022-23 2023-24 2024-25 2025middot2 2026-27
lnltial Fund 8alan~ 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419
Annual FuOOing 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000 Investment Income 25()91( 55994 54515 47809 46882 50777 53435 54777 54693 53045 49734
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511
AdmtntSuattve Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final FuM Balance 2444660 2610815 2324901 2067641 2249791 2383170 2465064 2491891 2458249 2358419 2190076
Change In Fund Balance 166154 (285914) (257260) 182150 133379 81894 26827 (33642) (99830) (168343)
Benefit Payments as 6 of lnltlal Fund Balance 157 307 325 146 152 160 172 188 211 240
Number of Participants Initial 500 545 640 734 827 919 1010 1100 1189 1276
Expected N= 52 104 104 104 104 105 105 105 105 105 Expeltted Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 545 640 734 827 919 1010 1100 1189 1276 1362
New York Medical Indemnity Fund as of9-3017 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
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New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
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New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
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New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
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201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
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122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Exhibit2 Quarterly Analysis of New York Medical Indemnity Fund Page 2 Future Fund Balances by Fiscal Year (OOOs) as ofSeptember 30 2017 Undiscounted
BALANCE SHEET
Projections as of Fiscal Year
At93017 l2lZl ~ ~ ~ ~ ~ ~ ~ ~ ~ Assets Fund Balance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 1668414
~ Future 6enefltS for CUrrent Participants 17556013 19368982 22973511 26805393 31414756 36360290 41675939 47381118 53487339 60000133 66935413 Future Administrative Expenses 3347735 3647976 4455702 5320571 6248968 7245491 8316807 9466749 10697728 12010853 13409277
SUrplus(Unfunded Liability (18459088) (20462137) (25214820) (30216641) (35619132) (41478588) (47837094) (S4n0165) (62145700) (70124495) (786762763)
INCOME STATEMENT
Projections as of Fiscel Year Ending
At 93017 2017-18 2018-19 2019-20 202~21 2021-22 2022-23 2023-24 202~25 2025-26 2026-27 Initial Fund Bance 2444660 2554821 2214393 1909324 2044591 2127193 2155652 2127702 2039367 1886491 Annual Funding 520000 520000 520000 520000 520000 520000 520000 520000 520000 520000
Benefit Payments 384481 801902 754810 302130 341797 382240 424209 469401 517999 566511 Administrative Expenses 25358 58526 70259 82602 95601 109301 123741 138934 154876 171567
Final fund Balance 2444660 2554821 2214393 1909324 2044591 2U7193 2155652 2127702 2039367 1886491 1668414
Change in Fund Balance 110161 (340429) (305069) 135268 82602 28459 (27950) (88335) (152876) (218078)
Benefit Payments as of Initial Fund Balance 157 314 341 158 167 180 197 221 254 300oo
Number of Participants Initial S00 54S 640 734 827 919 1010 1100 1189 1276
Expected New 52 104 104 104 104 10S 105 105 105 105 Expected Deceased 7 8 10 11 12 14 15 16 18 19
Final 500 54S 640 734 827 919 1010 1100 1189 1276 1362
New Yorilt Medical Indemnity Fund as of9-30-17v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
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129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
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bull 19
2S 20
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1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
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84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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2laquoS71 244S71 402980 402980 153880 1S3 880 642289 619 168 176961 212727 2U717 1375deg 137 S04 09847 ll9S47 264803 1008 88101 88 101
2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
496bull56 S9002S 72 993
066sooa 53914 673 S94
674 066 S39U 673 59-C
674066 67C 066 6069U 606 913 bullS0084 4S0084 406246 534914 48162C 131607 6n 594 673 S94 1732amp2 171282
606913 11578lt U7607 171282
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166 SS6 166 SS6 Ut212 1112U 132173 U217 166439 16609
166 556 111 212 12113 166 439
166S56 111212 112 171 166439
U17S3 81973
1045S4 131 660
131 7S3 87973
10amp SS4 131660
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
m~ tim
traderu
m~ m~ wm ~mumtrade
tradern mm~~
mm mm ~ m ~trade mootrade~
mm Mm m~
mm s~=~
l 9 ll2 25 350
210266
39312 2S 350
2102
l9JU 25 350
110266
40418 26064
21618
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2606 216183
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bull~ trade~ -trade trade~ nw wm ~m ww wm m-
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166 796 6171S9 69513
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165 796 6171S9 69SU
114 531
170-461 63-02
11469 117760
17046gt 634 526 71469
117 760
170462 634S26
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170462 6WS26
71 469 117 NO
11680 6576n
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116680 657671
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74016 1220SS
17668() 657 672 7076
122oss
1SS721 691 326 n861
12a301
185 721 691 326
11861 128101
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121301
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uuo
194 936 72S626 81730 134~
19036 72S 626 81 uo
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mlli laquo ~
mm laquo rn
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mm am
mm bullm
m ~ ~m
187 OU 431316
111 OU 43136
1870W bulll 736
192 307 44 967
192 )07
44967 192307 44967
192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
237049 15J22S
2881ll 160821
248 810~ 2015Ql 20150
27
~~
~~
~~
~~
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wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
nm mtrade ~w mm
u= mm~trade rn~
~rn ~m v~ m~
sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
s11u 102 6l4 9010amp
134 7Sl
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t34 7Sl
57 U6 10263 90 108
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134 753
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139 669
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59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Exhibit 3
Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017
Actual vs Revised Expected
Fiscal New Participants Total Participants Period Actual Expected Difference Actual Expected Difference
(1) (2a) (2b) (2c) (3a) (3b) (3c)
Fiscal 2011-12 Total 2200 2200 2200 2200 Fiscal 2012-13 Total 8600 8600 10800 10800 Fiscal 2013-14 Total 8400 8400 19200 19200 Fiscal 2014-15 Total 9100 9100 28300 28300 Fiscal 2015-16 Total 8500 8500 36800 36800 Fiscal 2016-17 Total 9100 9680 580 45900 46480 580
2nd Qtr 2017 2900 2544 (356) 48800 49024 224 3rd Qtr 2017 1700 2583 883 50500 51607 1107 4th Qtr 2017 1st Qtr 2018
Fiscal 2017-18 Total to Date 4600 5127 527 51607
Fiscal 2018-19Total 10366 61973 Fiscal 2019-20 Total 10360 72333 Fiscal 2020-21 Total 10386 82719 Fiscal 2021-22 Total 10417 93136 Fiscal 2022-23 Total 10473 103610 Fiscal 2023-24 Total 10518 114128 Fiscal 2024-25 Total 10540 124668 Fiscal 2025-26 Total 10529 135196 Fiscal 2026-27 Total 10500 145696
New York Medical Indemnity Fund as of 9-30-1~ Pinnacle Actuarial Resources Inc 2162018
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
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2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New Yorilt Department of Financial Services Quarterty AnaiSls of New Yortc Medical Indemnity Fund
Incremental Average Payments per Participant by Admittance Quarter AsofSeptember 30 2017
_ ll1 ll1 11 ~ m Qi
2011Q4 11 286 8569 ll107 2539 3833 -2012Ql -11 1003 1565 _ 346 843 2012Q2 16 45 13371 13917 1350lt 13797 13713 2012Ql 25 689 2356 4779 4710 600 5920 2012Q4 40 3658 1079S 1S598 13022 2013Ql s 156 2171 7343 718 11m 2013Q2 30 1380 2257 2615 3646 5367 2013Ql 27 348 3321 6536 12903 13566 2013Q4 8 1973 2805 6501 6885 4744 2014Ql 19 32 20SO s2n 8789 7551 14 193 2014Q2 25 U38 5308 8218 9212 13432 8895 201403 20 ~223 5283 32222 19624 14143 15262 201AQ4 19 85 3861 S473 9093 10454 8379 201SQ1 27 145 S076 7236 8544 2015Q2 3 1 4421 12991 14039 U 387 13234 16886 middot-2015Ql 16 UBS 6469 S03S 4362 S735 2015Q4 20 91 5104 4559 8601 16067 10SSS 201SQl 18 12 931 10298 9142 9815 12341 2016Q2 35 290 2039 4599 7550 S772 105amp6
2016Ql 22 4303 9321 8150 4995
2016Q4 15 10A83 10491 15156
2017Q1 19 6A44 7834
201702 29 32 5290
201703 17
Totgt sos
Note 3td ctv 2017 diagonal data only indudes thtou9h83117
Exhibit4
Pagel
lncmnertt111 Severity per Patlklpant~ P~Qllter
llZ Ill JlI mil lW lW lW WA ~ la IUZ llll IW lUll Im IIU ~ lilt 2065 2267
9226
2670
6332
4095
2610
5922
2621
3DSS
4983 3532
4330 2506
1604
443S
1na 9878
4323
4680
732
2614
m 4516
~306
4SS3
3692
5070
5932 5433 9553
6349
12620
4757
17778 17945 22SS2 2~096 19All 17781 20549 23109 22213 20186 24258 21amp31 21060 23A99 27519 20735 8449 12018 17357 11480 13978 10705 12099 9180 9068 10248 12872 12306 9536 12574 13285
26132 29513 29142 28720 30473 22362 24457 23196 33863 29356 22663 25950 44484 32893
35542 32511 26AOS 27378 23804 23499 17S29 24984 29815 22185 26411 31833 29499
7258 6056 3874 4505 6573 8547 5567 9125 7187 6376 9517 7092 15087 15973 13A03 13571 11547 10026 12611 11234 10430 12065 4663 19051 S278 S161 8548 15033 13236 S734 9_212 124SS 8496
14873 19602 U 973 21265 17A63 19181 191SS 28948 17068
14015 11214 10894 13081 10187 10614 18633 7843 14838 12484 18900 13223 17583 21358 14709
10208 13406 13903 17699 18m 15724 10670 7879 13139 12557 7022
12lll 21351 19941 13632 4299 ll939 10004
12617 8350 13265
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
OAl 111 ltQgt 22 1S t S)ZS() deglS736 2011Ql 19 122431 14US4 9506 1Slc22
I 1441n 21oc U71SS 431112111 71441
112 $201()
2309 17276amp 1amp4 US JS2 1no19 t64 SS9 264142
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
1163 deg 201c)2 30 109114 18sss 201(J 27 939lt 2nsz1 90300deg201401 19 OlJl 2012 201lt3 0 130117 l 110SS
19 1789 JSt712deglOlS(U 27 121amp2 2S910 2012 UOd t 31995 13 tllampn 212)()0 10591amp J69 117 deg 194 20m deg JS 10141 2011Q) 22 deg )9029
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
284 456
211213 1045 294
1708 21776 401 St 1S2 406
2amp2 S92 350374 296N3 193 955 288099
91 llll 433 287128
1
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372 bullu 2496 25ltU
212 728
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bull13929 1 165671
1l2023 116 207 361 amp86
41 285
127482 272 353 177 991
~ 29173 65 141
l 18800 136890 115 157 966bull26
68386
404028 317022
ll ll ll 91 2827 S4SU 47626 21564
33607 38S7 227Ul 17639 gt10S77 2S4C97 28190 369 7J8 3494S8 26762S
1218933 97820 927 SJ 119313 117497 114918 197 202 2S6 410 16702l 273 7bull3 JU 761 270692 303320 120 264 10S891 31801 25466S
1219804 2573M
SU396 462 2SO 462 250 4S07Jt 4S0738 6834
9 190CM
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1 35451t
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31812 9
321808 301643 90654
8119S1 782 976
91219 91219 61amp758 618758
1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
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618158 1171 631
10620 12856 111 l7l
919 S0087
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Ill ssm
6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
SI
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9 9
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2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
496bull56 S9002S 72 993
066sooa 53914 673 S94
674 066 S39U 673 59-C
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10amp SS4 131660
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
m~ tim
traderu
m~ m~ wm ~mumtrade
tradern mm~~
mm mm ~ m ~trade mootrade~
mm Mm m~
mm s~=~
l 9 ll2 25 350
210266
39312 2S 350
2102
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110266
40418 26064
21618
40418
2606 216183
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bull~ trade~ -trade trade~ nw wm ~m ww wm m-
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166 796 6171S9 69513
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165 796 6171S9 69SU
114 531
170-461 63-02
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17046gt 634 526 71469
117 760
170462 634S26
71469 111160
170462 6WS26
71 469 117 NO
11680 6576n
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17668() 657 672 7076
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12a301
185 721 691 326
11861 128101
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uuo
194 936 72S626 81730 134~
19036 72S 626 81 uo
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mlli laquo ~
mm laquo rn
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mm bullm
m ~ ~m
187 OU 431316
111 OU 43136
1870W bulll 736
192 307 44 967
192 )07
44967 192307 44967
192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
237049 15J22S
2881ll 160821
248 810~ 2015Ql 20150
27
~~
~~
~~
~~
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wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
nm mtrade ~w mm
u= mm~trade rn~
~rn ~m v~ m~
sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
s11u 102 6l4 9010amp
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t34 7Sl
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134 753
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59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New Yorilt Department of Financial Services poundxhibit4
Quarterty AnaiSls of New Yortc Medical Indemnity Fund Page 2
cumulative Average Payments per Partldpant by Admittance Quarter AsofSeptember 30 2017
_- - OIMulatM 5oeyenttlly by FundhrticlpatlolI Quatter
JU ~ 111 Qi Qi lll llZ lll Ill ~ iw Wl lW llli IIIi Qli Q1Z WI lUl ~ QA Im w lllS
2011Q4 2012Ql
2012Q2
11
11
16 4S
286 1083
13416
8855
3648
27333
21962
5052
40837
2soo 5397
54635
28334
6240
68347
30399 8508
86126
39625
111n 104071
15273
126623
8628
21195
147720
5 1248
242Sl
167131
56231
27783 184912
60561 205461
63067
31Sl
228S70
67SOl
33179
ZS0783
n3so 37502
81060
38234
295227
-38987
317058
89190 40293
338117
93743
4398s
361616
98814
49917
389135
104246
59470
laquogt9870
110595
nltgt90
115352
2012Ql 2012Q4
2013Ql
2013Q2
2S
bullbull s 30
689 3045
1899
lS6
1380
7823 5557 2327
3637
U S34 16353 9670
6252
18964 31951
17088
9897
24884 44973
3436S
15265
33333 71106
69907
22523
45351 100618
102417
28579
62708 129760
128822
32452
74188
158480 156200
36957
SS166 1SB953 4lS31
98871 lll316
203563
52078
110970
235nz 221092
5764S
U0150 258969
246076
66no
129218 292)131
275891
73957
ll9M6 322 187
298-075
80334
152339 344850 324486
89851
164644 70800
lSo319 174180 41S284
385819
186754
448ln
200()39
201JQJ
201JQA
2014Ql
201402 201Q3
27
bull 19
2S 20
32
1238 1223
348
1981
2112 _ 6S06
3669 4786
7389 14764 38728
degmiddotdeg 11287
16178 23975
SBill
23107 18173
2ln9
37407 72496
36673
22917
37922 46303
87758
Sl760
41967 S279S
60317 102596
67 733
47 246 72397
71531 U S080
81136
S2A06
84370 82425
133980
94708
609SS
105634
95506
147207
10625-4
75983
123097
10S693 164791
116280
89224
1A2279
116307 186149
128891
94958 161434
134940 200BSB
140 125 104 169
190383
142782
lS0554 116624
207451
162620
US121
167283
201AQ4 19 BS 9418 18SU 28965 37 47552 60958 74861 92560 111281 U700S
2015Ql 27 14S 45Sl 9627 16446 23682 32226 42896 S077S 6391 76470 amp3493 2015Q2 31 4421 17412 31452 42839 56073 72953 15272 106623 126SM 140196
2015Ql 16 1-5 8354 133S9 17751 23486 27785 41724 Sl727
2015QA 20 191 S296 9855 lll4S6 34523 45078 57695 66045
2016Ql 18 12 942 11240 203S2 30198 42SlS SS80lt 2016Q2 3S 290 2329 6928 144n 20249 30835 2016Ql 22 4303 13624 21n4 26769
2016Q4 15 10micro3 20974 36130
2017Q1 19 6- 14278 2017Q2 29 328 S618
2017Cl3 17
Totgt sos
Note ltd ctv 2017 diagonal data only indudes thtolcenth83117
New York Medical Indemnity Fund as of9-3~17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
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New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
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9ll 49618
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so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
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219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
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2U617 1367
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2015Q1 2015(14 2015Ql 20160
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2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
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10t0Cl9 130974
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191810
110836 139571
198808
110amp16 139 571
198808
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116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New Yorilt Department of FIMnelal SMllces amptlibit 4
Quarterty Analysis of New York Medical Indemnity Fund Incremental 8eneftts Payments by Admittance Quarter AsofSe~30 2017 _- _ 9l 9l 91IQlt
2012Q1 11 u gtQl 111 20939 ms 2012Q3 U9
2012Qlt n t46Ul 20UQl 108$7 20UQJ 27 deg 201lQ( lS7a7 22 442 bull2014 19 deg 1002sa 2014 2S 1n10 205442 2014()3 20 2460 10565) 2014Qt 19 19 nJs1 201SQl 3902 111911 13108 U 1049 40272 435224 20 9 1 lll201lt()gt 1amp 210 167$4 t8S361
OAl 111 ltQgt 22 1S t S)ZS() deglS736 2011Ql 19 122431 14US4 9506 1Slc22
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2162018~ Pinnacle Actuarial Resources Inc
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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9001J 1017115 110$460 1 23011 13194$3 10SttJ 15amp113 tntJ5 201)110() 2118124 2amp880 J l 39S2 )480047 3 78l31 406491()
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
284 456
211213 1045 294
1708 21776 401 St 1S2 406
2amp2 S92 350374 296N3 193 955 288099
91 llll 433 287128
1
162 ss 18167S 431269 bull2 227
372 bullu 2496 25ltU
212 728
91 6
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bull13929 1 165671
1l2023 116 207 361 amp86
41 285
127482 272 353 177 991
~ 29173 65 141
l 18800 136890 115 157 966bull26
68386
404028 317022
ll ll ll 91 2827 S4SU 47626 21564
33607 38S7 227Ul 17639 gt10S77 2S4C97 28190 369 7J8 3494S8 26762S
1218933 97820 927 SJ 119313 117497 114918 197 202 2S6 410 16702l 273 7bull3 JU 761 270692 303320 120 264 10S891 31801 25466S
1219804 2573M
SU396 462 2SO 462 250 4S07Jt 4S0738 6834
9 190CM
3S5bull1c 226106
1 35451t
1907S 21S624
644 200 121980C
2s1n
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9 108661 47SS5
322 911 256 2oa
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110923
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1219804 2SHl4 622SO
9 9 S148l 800
31812 9
321808 301643 90654
8119S1 782 976
91219 91219 61amp758 618758
1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
811951 7amp2 976 941 219 608390
618158 1171 631
10620 12856 111 l7l
919 S0087
8119S1 712 976 941219 60890 6187i8 ll4 7S2
70620 126856 111 tl
Ill ssm
6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
SI
24A S11 402980 6-S8086 642289 619368 137 S04 139847 2pound4803 S864
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9 9
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2laquoS71 244S71 402980 402980 153880 1S3 880 642289 619 168 176961 212727 2U717 1375deg 137 S04 09847 ll9S47 264803 1008 88101 88 101
2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
496bull56 S9002S 72 993
066sooa 53914 673 S94
674 066 S39U 673 59-C
674066 67C 066 6069U 606 913 bullS0084 4S0084 406246 534914 48162C 131607 6n 594 673 S94 1732amp2 171282
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166 SS6 166 SS6 Ut212 1112U 132173 U217 166439 16609
166 556 111 212 12113 166 439
166S56 111212 112 171 166439
U17S3 81973
1045S4 131 660
131 7S3 87973
10amp SS4 131660
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131660 131660 2017Ql 1~330 1 058 330 1osa130 1 0S8330 959 477 9S9bulln 9S9477 274 136 24682fi 246126 26826 246126 237071 237078 137 078 23707t 1815~ 17S39 187 S39 lt7S39 17Ql 17 578133 607807 607 807 607907 f1)1801 SSl 015 ss1 oas 157 4l8 1S7 431 11s 141 7S4 14115 14175-4 1316156 136 1S6 1316156 U6 1S6 10770S 1077()6 107705 107 70S
so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
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tradern mm~~
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l 9 ll2 25 350
210266
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110266
40418 26064
21618
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166 796 6171S9 69513
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11680 6576n
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m ~ ~m
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192 307 44 967
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192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
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mm mm
2U617 1367
211617 13678
t u 11 11678
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217 S72 140 S5
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22S S09 14$ 766
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225S09 145 766
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27
~~
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wm mw
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mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
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182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
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16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
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sssn 998lS 87641
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146816
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146 816
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2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
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~m m~ mm
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m~ m-mm
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10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New Yorilt Department of FIMnelal SMllces Quarterly Analysis of New York Medical Indemnity Fund Cumulative Benefits Payments by Admittance Quarte r AsofSeptenINr 30 2017 _
I 9 9 l 20UQlt 11 241S9 - -2012Q1 11 11909 ltOUbull 2012Q2 16 216S6 43331 2012Ql 25 11222 1111 313341 20UQlt 1S958 nm
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19 1789 JSt712deglOlS(U 27 121amp2 2S910 2012 UOd t 31995 13 tllampn 212)()0 10591amp J69 117 deg 194 20m deg JS 10141 2011Q) 22 deg )9029
15 t512SO 11416 519$2deg2017Ql Ul4ll 171214 101Q2 29 9soc 162928 101Q)
91 degt141S1
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11JS2S2 1071 S81911
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mm
Stl6 990171
720511 1isso
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109229
JI 33l91
1mo11 133319
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ll97S2t J3SJ9
1 001 109 l S079J7 20$192amp l tSt l9S 243417 lll908 l 0040
9 -0S81S 1l2952
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851)$1 112819
177
t11SS41 1mm 210160S 1 isa201 13703 lXIS 109 6Hn
91 OltSll 16amp002
202914 t S67693
64110 91lS6S
21908J 419~1
l GOlOJ 2060flti
2619596 14223amp l 2S6G 3921472 tl7alS
9a 3149
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2k41SO l 151 43 J4C011
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9 9 9l JI 9ll S3Tll 6LIS4l u SJln3 71SlS 305611
2614 090 2 9SI S87 llUU-8 HS) U S -4012529
2~148 2471711 2114240 3003745 3ll04Sl ssa lll 8$2623 930 103Samp1d ll)U2St
9001J 1017115 110$460 1 23011 13194$3 10SttJ 15amp113 tntJ5 201)110() 2118124 2amp880 J l 39S2 )480047 3 78l31 406491()
lt07900 1U791 7S92 8lUS6 912996 UUampSl 2 703299 l0fi12Sl 117211 J941569 242W 29079 ll7J 93 l S69SSS
l19SS1amp J1197 0111$4
2ll4ll9 2413104
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4 11S50l uaa 481
H90l6 2410008
4 l907ll 100098
I 420S11-n2
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I 91 410
SGn9lA 411Gt0S
1tl20ll 111St7 2908261
I 98108amp laquoms
540981 4 3S4 sos
16UJampamp 19290k
ll lOllltS S7tS9tit 488$2
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49084 6226162 S000911
IY 114711
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91
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111870 792988
6SS7919 5000901
J792()9IJ 19094 4S1G44
10009ltamp J941S9 1S8SSS 4011 lSamp 2 13 104
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so 6a141899
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2162018 ~ Pinnacle Actuarial Resources Inc
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
284 456
211213 1045 294
1708 21776 401 St 1S2 406
2amp2 S92 350374 296N3 193 955 288099
91 llll 433 287128
1
162 ss 18167S 431269 bull2 227
372 bullu 2496 25ltU
212 728
91 6
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bull13929 1 165671
1l2023 116 207 361 amp86
41 285
127482 272 353 177 991
~ 29173 65 141
l 18800 136890 115 157 966bull26
68386
404028 317022
ll ll ll 91 2827 S4SU 47626 21564
33607 38S7 227Ul 17639 gt10S77 2S4C97 28190 369 7J8 3494S8 26762S
1218933 97820 927 SJ 119313 117497 114918 197 202 2S6 410 16702l 273 7bull3 JU 761 270692 303320 120 264 10S891 31801 25466S
1219804 2573M
SU396 462 2SO 462 250 4S07Jt 4S0738 6834
9 190CM
3S5bull1c 226106
1 35451t
1907S 21S624
644 200 121980C
2s1n
462 2SO 40583lt
9 108661 47SS5
322 911 256 2oa
1174 22)
110923
979919 633404 644 200
1219804 2SHl4 622SO
9 9 S148l 800
31812 9
321808 301643 90654
8119S1 782 976
91219 91219 61amp758 618758
1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
811951 7amp2 976 941 219 608390
618158 1171 631
10620 12856 111 l7l
919 S0087
8119S1 712 976 941219 60890 6187i8 ll4 7S2
70620 126856 111 tl
Ill ssm
6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
SI
24A S11 402980 6-S8086 642289 619368 137 S04 139847 2pound4803 S864
Ul0343 88101
9 9
531311 2 171 l8S
2laquoS71 244S71 402980 402980 153880 1S3 880 642289 619 168 176961 212727 2U717 1375deg 137 S04 09847 ll9S47 264803 1008 88101 88 101
2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
496bull56 S9002S 72 993
066sooa 53914 673 S94
674 066 S39U 673 59-C
674066 67C 066 6069U 606 913 bullS0084 4S0084 406246 534914 48162C 131607 6n 594 673 S94 1732amp2 171282
606913 11578lt U7607 171282
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137607 173282
166 SS6 166 SS6 Ut212 1112U 132173 U217 166439 16609
166 556 111 212 12113 166 439
166S56 111212 112 171 166439
U17S3 81973
1045S4 131 660
131 7S3 87973
10amp SS4 131660
Ul7U 1l1 75l 87971 amp79tl U)4 SS4
131660 131660 2017Ql 1~330 1 058 330 1osa130 1 0S8330 959 477 9S9bulln 9S9477 274 136 24682fi 246126 26826 246126 237071 237078 137 078 23707t 1815~ 17S39 187 S39 lt7S39 17Ql 17 578133 607807 607 807 607907 f1)1801 SSl 015 ss1 oas 157 4l8 1S7 431 11s 141 7S4 14115 14175-4 1316156 136 1S6 1316156 U6 1S6 10770S 1077()6 107705 107 70S
so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
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New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
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tradern mm~~
mm mm ~ m ~trade mootrade~
mm Mm m~
mm s~=~
l 9 ll2 25 350
210266
39312 2S 350
2102
l9JU 25 350
110266
40418 26064
21618
40418
2606 216183
40418
2606 216 183
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2064 216183
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27015 224069
41 393
27015 224 069
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27015 224 069
44037
28197 lliS35
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166 796 6171S9 69513
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170-461 63-02
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17046gt 634 526 71469
117 760
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71 469 117 NO
11680 6576n
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11861 128101
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192 307 44 967
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192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
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mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
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22S S09 14$ 766
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225S09 145 766
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237 049 1S 2lS
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248 810~ 2015Ql 20150
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mw mw
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U9U7 263 4ll
139117 263 422
09117 263422
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27004 143032 270amp3A
141032 270834
1432SO 280711
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182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
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frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
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~rn ~m v~ m~
sssn 998lS 87641
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sssn 9982S 87641 lll 065
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139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department ofFinancial Services Exhibits
QuanOly Analygtis of NewYork Medlcal Indemnity fund 1
Projlaquoted lncremental Nominal Paymtnts per Participant by Admittanot Quarter As Of ~embef 30 2017 -- - ~ al lifflefitshldly-FundPatldpatlonOwarte
91 9l 91 9 9 9 11Q4 11 l 146 94260 14173 27926 42167 2012Ql 11 11909 2a-21s 1S444 92S 2012Ql m 213 939 222 67S 216063 221gt760 219402 2012Ql 2S 17222 S889S 119-68 117 7S5 160748 lASOU OUQ4 40 l7l JAampUl C31312 6l3934 208amp9 lOUQl 780 10851 361U 7090 86 20UQl 41 406 678 784Al 1)9369 161013 OUQl 27 9394 176462 366 278 20UQ4 60 l787 2242 52010 S080 201Ql lJ 602 1-00258 166996 10474 296S9 2010 2S l094S l ll 707 20S42 230289 lJS796 2223amp3 tOlAQl 20 105657 9 392438 232 863 30$247 201Q4 1609 73351 103 1n1u 198 623 1S9203 2015Ql 27 118 971 -137043 18lt125 19S 370 2015Ql 0709 -02 726 43522C 3S2 996 4102S7 SU4S1 2015Ql 16 30164 so 69794 91758 2015Q4 20 3829 102 081 91131 112019 321337 16Ql 18 210 16154 UISl61 164 559
gz 22720 2C92
284 456
211213 1045 294
1708 21776 401 St 1S2 406
2amp2 S92 350374 296N3 193 955 288099
91 llll 433 287128
1
162 ss 18167S 431269 bull2 227
372 bullu 2496 25ltU
212 728
91 6
4SOSO )60amp35
bull13929 1 165671
1l2023 116 207 361 amp86
41 285
127482 272 353 177 991
~ 29173 65 141
l 18800 136890 115 157 966bull26
68386
404028 317022
ll ll ll 91 2827 S4SU 47626 21564
33607 38S7 227Ul 17639 gt10S77 2S4C97 28190 369 7J8 3494S8 26762S
1218933 97820 927 SJ 119313 117497 114918 197 202 2S6 410 16702l 273 7bull3 JU 761 270692 303320 120 264 10S891 31801 25466S
1219804 2573M
SU396 462 2SO 462 250 4S07Jt 4S0738 6834
9 190CM
3S5bull1c 226106
1 35451t
1907S 21S624
644 200 121980C
2s1n
462 2SO 40583lt
9 108661 47SS5
322 911 256 2oa
1174 22)
110923
979919 633404 644 200
1219804 2SHl4 622SO
9 9 S148l 800
31812 9
321808 301643 90654
8119S1 782 976
91219 91219 61amp758 618758
1171631 1 171631 241171 27171 1268S6 111373 111973
9ll 49618
811951 7amp2 976 941 219 608390
618158 1171 631
10620 12856 111 l7l
919 S0087
8119S1 712 976 941219 60890 6187i8 ll4 7S2
70620 126856 111 tl
Ill ssm
6S8086 1S3880 62289 619368 744 S4S 31 263 13987 264803 100343 83101
SI
24A S11 402980 6-S8086 642289 619368 137 S04 139847 2pound4803 S864
Ul0343 88101
9 9
531311 2 171 l8S
2laquoS71 244S71 402980 402980 153880 1S3 880 642289 619 168 176961 212727 2U717 1375deg 137 S04 09847 ll9S47 264803 1008 88101 88 101
2lt16Ql s 10 141 71 367 2016Ql 22 16Q4 1S 11Ql 7C2993 742 993
496bull56 S9002S 72 993
066sooa 53914 673 S94
674 066 S39U 673 59-C
674066 67C 066 6069U 606 913 bullS0084 4S0084 406246 534914 48162C 131607 6n 594 673 S94 1732amp2 171282
606913 11578lt U7607 171282
tn404 11S7amp4
137607 173282
166 SS6 166 SS6 Ut212 1112U 132173 U217 166439 16609
166 556 111 212 12113 166 439
166S56 111212 112 171 166439
U17S3 81973
1045S4 131 660
131 7S3 87973
10amp SS4 131660
Ul7U 1l1 75l 87971 amp79tl U)4 SS4
131660 131660 2017Ql 1~330 1 058 330 1osa130 1 0S8330 959 477 9S9bulln 9S9477 274 136 24682fi 246126 26826 246126 237071 237078 137 078 23707t 1815~ 17S39 187 S39 lt7S39 17Ql 17 578133 607807 607 807 607907 f1)1801 SSl 015 ss1 oas 157 4l8 1S7 431 11s 141 7S4 14115 14175-4 1316156 136 1S6 1316156 U6 1S6 10770S 1077()6 107705 107 70S
so
Sources Nt MIF forJunddbullaakulatrd ciagonabbased on btibit6 Selected UltimateScYerity
flaquoJte31-d Qu 2017 diapal data only IIKiuda lttougfl 83117
New Yort Mtdieal lfldetMityfilndti of9--3~172 216201B ~ Pinnacle Actuarial Resources Inc
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
m~ tim
traderu
m~ m~ wm ~mumtrade
tradern mm~~
mm mm ~ m ~trade mootrade~
mm Mm m~
mm s~=~
l 9 ll2 25 350
210266
39312 2S 350
2102
l9JU 25 350
110266
40418 26064
21618
40418
2606 216183
40418
2606 216 183
40418
2064 216183
1893
27015 224069
41 393
27015 224 069
4 1893 2701S
22bull 069
41893
27015 224 069
44037
28197 lliS35
44037
2897 215 S35
44011
28397 235535
laquo on 28397
23SS3S
46221 29806
27221
46221 2bull 7121
20UQ1 2012(14 201lQl 201l(U
2S lO
ru~ ru~ m~ m~ ~~ 2mm2mm2mm2rnm2mffl
bull~ trade~ -trade trade~ nw wm ~m ww wm m-
~~
~lli
n w m-
m~~trade nw m~
m = illtrade nm m-
~~
m~
~m ~m
166 796 6171S9 69513
114 S37
16S 196 617 1S9 69SU
UA Sl7
165 796 6171S9 69SU
114 531
170-461 63-02
11469 117760
17046gt 634 526 71469
117 760
170462 634S26
71469 111160
170462 6WS26
71 469 117 NO
11680 6576n
74076 lll OSS
116680 657671
74076 1210SS
176680 6S76n
74016 1220SS
17668() 657 672 7076
122oss
1SS721 691 326 n861
12a301
185 721 691 326
11861 128101
1asn1 91326
121301
18S 721 691326 77867
uuo
194 936 72S626 81730 134~
19036 72S 626 81 uo
13667 201CU 2lt)1)(14
27 ~m trade~
~m laquo~
mlli laquo ~
mm laquo rn
mm ~-
mm bullm
mm am
mm bullm
m ~ ~m
187 OU 431316
111 OU 43136
1870W bulll 736
192 307 44 967
192 )07
44967 192307 44967
192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
237049 15J22S
2881ll 160821
248 810~ 2015Ql 20150
27
~~
~~
~~
~~
~~~= ~~ ~~
wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
nm mtrade ~w mm
u= mm~trade rn~
~rn ~m v~ m~
sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
s11u 102 6l4 9010amp
134 7Sl
57136 102634 ~10S
t34 7Sl
57 U6 10263 90 108
U 4 7Sl
57 ll6 102amp14 90 108
134 753
S9 220 1deg)78 93ffl
U9669
S9 220 106311 93 39S
139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Departmentof Financial Services QuanbullrfyAnalysis of New York Medical Indemnity F1md Projected lnaemental Nominal Payments per Participant by Admittance Quarter As ofSeptembet 30 2017
Exhibits
Page 2
llllClelMIUI lendltshid byieud ~ QIMlrter
91 9ll ll ll1 ll 911 9 9 91 9 91 112 1011(14 lOUQl 10120
11 11 16
m~ ~m
tradem
m~ tim
traderu
m~ m~ wm ~mumtrade
tradern mm~~
mm mm ~ m ~trade mootrade~
mm Mm m~
mm s~=~
l 9 ll2 25 350
210266
39312 2S 350
2102
l9JU 25 350
110266
40418 26064
21618
40418
2606 216183
40418
2606 216 183
40418
2064 216183
1893
27015 224069
41 393
27015 224 069
4 1893 2701S
22bull 069
41893
27015 224 069
44037
28197 lliS35
44037
2897 215 S35
44011
28397 235535
laquo on 28397
23SS3S
46221 29806
27221
46221 2bull 7121
20UQ1 2012(14 201lQl 201l(U
2S lO
ru~ ru~ m~ m~ ~~ 2mm2mm2mm2rnm2mffl
bull~ trade~ -trade trade~ nw wm ~m ww wm m-
~~
~lli
n w m-
m~~trade nw m~
m = illtrade nm m-
~~
m~
~m ~m
166 796 6171S9 69513
114 S37
16S 196 617 1S9 69SU
UA Sl7
165 796 6171S9 69SU
114 531
170-461 63-02
11469 117760
17046gt 634 526 71469
117 760
170462 634S26
71469 111160
170462 6WS26
71 469 117 NO
11680 6576n
74076 lll OSS
116680 657671
74076 1210SS
176680 6S76n
74016 1220SS
17668() 657 672 7076
122oss
1SS721 691 326 n861
12a301
185 721 691 326
11861 128101
1asn1 91326
121301
18S 721 691326 77867
uuo
194 936 72S626 81730 134~
19036 72S 626 81 uo
13667 201CU 2lt)1)(14
27 ~m trade~
~m laquo~
mlli laquo ~
mm laquo rn
mm ~-
mm bullm
mm am
mm bullm
m ~ ~m
187 OU 431316
111 OU 43136
1870W bulll 736
192 307 44 967
192 )07
44967 192307 44967
192 307 44967
199 321 6fi01
199 322 46601
199322 46607
199 321 bull6 607
209 S22 48 992
1522 209 522 209S22 219917 51423
219 917 S14middotU
201AQ1 19 mm mm mm wm mm mm mm mm wtrade 181 ss 1amp2 SS4 182 S5 181691 181691 l87691 181691 194 537 194 537 1ssn 19bull S37 20 492 2042 204492 20U91 214 638 2U6l 2014Ql 2S m~ m~ m~ m~ m~ w~ w= m= o~~ 1760l9 l76Q39 17609 180 993 180993 180 991 180993 Ul7 595 187 S9S Uffl 181 S95 197195 197 1~ 19719S 197 19 2ltl6978 206 978 101cu 2014(l4
20 19
ru~ mm
m~ mm
m~ mm
m~ mm
m~ mm
m~ m m
m~ mm
mw mm
mm mm
2U617 1367
211617 13678
t u 11 11678
211 s12 140 63S
117Sn 140635
217 S72 140 S5
217572 140635
22S S09 14$ 766
22S S09 14S 766
225S09 145 766
us S09 lAS 766
237 049 1S 2lS
17049 153225
270t 153225
237049 15J22S
2881ll 160821
248 810~ 2015Ql 20150
27
~~
~~
~~
~~
~~~= ~~ ~~
wm mw
mm m w
mm mw
mw mw
mm ~m
U9U7 263 4ll
139117 263 422
09117 263422
tO0)2 270834
143032
27004 143032 270amp3A
141032 270834
1432SO 280711
14amp2SO 280714
182SO 28071bull
18 2SO 280 11bull
l SS 836 295 078
155836 29S07t
15S 836 29S078
155836 295071
16568 16l 568 309119
2015Q1 2015(14 2015Ql 20160
16
20 18 lS
~m ~~
u~ m ~
~= ~~
u~ rn~
frac12=~mum ~~ ~ffl tradetrade bull~ u~ ~~
m= w ~ m~
um wrn ~~
rn~
nm mtrade ~w mm
u= mm~trade rn~
~rn ~m v~ m~
sssn 998lS 87641
13106S
sss12 99 amp2S 176tl
131 065
sssn 9982S 87641 lll 065
s11u 102 6l4 9010amp
134 7Sl
57136 102634 ~10S
t34 7Sl
57 U6 10263 90 108
U 4 7Sl
57 ll6 102amp14 90 108
134 753
S9 220 1deg)78 93ffl
U9669
S9 220 106311 93 39S
139 669
59220 106178 93S
139669
59120 106 378 93395
139 669
62 2Sl 111 amp21 9811bull
146 816
62 251
111821 9817bull
146816
6l2St 111821 9817bull
16816
622Si l U821 98nbull
146 816
6339 111369
154 100 6Sl39
111369 103045 1 lOO
2016Q1 22 um um um um~~~~ ~m ~~ vm 87S1A 11S14- 875 14 89971 899 89 m 89 917 93 259 93 259 93259 93259 98031 98031 98031 9801 102 895 102 89 1016(14 2017Ql 20170
1S 19 29
tradem w~ wm
trademlli mm
~m m~ mm
~mm~ w~ rn~ mm mm
m~ m-mm
bull~ m~ mm
bull~ ~~ rn- ~m mm~trade
10t0Cl9 130974
186561
10 009 130974
186 561
104009 ll097bull 186 S61
106935 134 659 191 810
106935 134659 191810
10693S U4659
191810
106935 1W6S9
191810
110836 139571
198808
110amp16 139 571
198808
U0836 l39S71 198808
110836 ll9 571 198808
116508 146 713 208981
116508 146713 208981
116 S08 IA6n9 208981
116508 14713 122288
153992
219 349
122 288 1S3992 219349
2017Q1 107126 107826 107826 107826 110802 110802 110802 110802 107 143 107143 101143 107 143 1101S8 110 158 110 158 110 158 114 1n 114 177 nun 1u 1n 120019 20019 120019 120019 12597bull 125974
Sourus rft MIF fOIfund du~diqoalsbtsed onbhibit6 Select~ UltimateSeverity
Note3rd0v2017diagonaldta entv irctudes thro1gh 3)117
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial ServicH Ellthibit S
Qvarter1y Analysis of New Yorilt Medical Indemnity Fund Cel ProjKted~mental Nominal Payments per Participant by Admittance Quarter As of 5-tembet30 1017
IMftfflul lenefits PHIbyFund h rtkiP11doft~ - 9 ga 9a I 9ll I 9 9H 9 91 9 98 9Q 9 AfterQampl 2011Q4 11 4221 6221 49923 49928 49928 49918 3581 4aS81 1S9S1125 198788Jl 11 -- 2012Ql 11 291J06 l2196 22 196 32196 32196 31327 91127 l1U7 91 327 l1S90 31S90 )1590 l l 590 10286037 12an1M 2012()2 16 247121 147 221 267deg8 167048 7048 2S9841 2S98A1 259841 1S9841 262 017 262017 261017 262 017 ampSl1US7 106SOS7n 2012Ql 1~936 194936 110569 210S69 210 569 210S69 204SS1 104ampamp1 206 602 6602 gt06601 1062 1112136 83965184 l012Q4 72S 626 725626 183821 713121 783 821 71lamp21 M267 762 67 762667 1 70S4 769054 25041S248 3124390n 013Ql 11 7l0 81130 81285 SSlSS SS902 SS902 85902 amp6621 86621 86621 28 20S 159 3S2l082 2013-Ql lO 13 667 4661 145 47 145467 145467 145 467 lAl 541 141 541 141 S41 141 S41 142 726 142 726 142 726 141726 46 4131(1 saooo1n 20UQl 219 917 119917 ll7 SS4 237 SS4 237 SS4 231 SS4 231 143 231 143 231 143 2l114J 23J 079 2U079 233019 233079 15893856 ~845996 20134 51 423 51421 55541 S5S47 55 S47 5SSO 54048 54501 S4501 54501 1174 182 212010n 2014Ql 19 Ubullamp38 114638 23U52 231852 231U2 231 SS2 22SS9a 225594 225S94 12S~ 227484 121484 2274114 74072001 9-2 841143 1014Ql 206 978 6911 22351amp 213S71 123 S78 123 sa 21754t 217 544 217 S44 2175-U 219366 219 366 219366 119 366 71418689 89669S44
2014Q3 10 148 810 248810 268 764 268 764 163164 2631lt4 MtSlt 261S11 261511 261511 2lt)100 23700 26) 700 263100 IS 164 762 107966457 1014Q4 19 160127 160817 111725 173 72S mns 11372S 1f80316 169016 169036 1 170452 170S2 170452 1104S1 SS SOl 661 69893980 201SQ1 21 lampl S68 l63S61 176 686 116686 1166S6 17 686 171917 171 917 171 917 171917 17) 157 17357 173 3S7 1733S7 56 447 S85 112Sl 124 2015lt12 309 719 l09119 33458 3l4 SS8 1MSS8 lWSS8 32S 529 l2S S29 31SS29 32SS19 3282SS 3282SS 282SS 3281SS 1deg884S99 13SS10N3 101SQl 16 65139 6Sl9 10519 6t67S 6867 61675 69SO 69250 69250 692SO 21S48720 28607822 101SQ4 20 117 )69 117 369 126712 116711 1261amp2 126182 123361 123361 113361 121361 124 394 124 394 124394 114 394 40504 371 51418831 2016Ql 1S tOJ 045 111 309 U19 111309 111309 10UOS 108tOS ous 10SOS 109 211 109U 109212 109 212 3SSfi09S3 45206872 2016Q2 100 154 100 166459 1664S9 166459 16 4S9 161967 161 967 161967 161967 163lU 163 32l 16332) 163)23 Sl 180U9 67492649 l016Ql 102 89S 1l29lt 111 147 111 147 111147 111147 108iA8 108148 108148 109 053 w 10905) 109053 JS S09 l90 451412ltraquo
201604 1S 1222-H U2188 U1096 132096 131096 l ll 096 128531 128531 ll8SU U8U1 119 607 129601 129 607 119607 42 202 0a9 SJ737113 011Ql 19 l SJ 991 151992 166343 166343 166 34J 166 343 1618Sl 161853 161SS3 1611S) 163 209 163 209 163209 1632()9 SJ 143 161 67S3131l 2017Ql 119 149 2369-tl 236941 236941 2lOS46 1 2l05 1305 232 477 n2n 132 477 2324n 75697911 96 2904lS 2011Ql 11 12S974 12S97t U6077 u6on u6on 1)6017 132404 112 604 U2404 lllSU 1USU U3S13 133513 43 411863 S5 391266deg Toal Total t lwu 1017Q3 1823 841196
deg HY MIF fot fund amplrta alouteddi~onals based on amphlbit6 Sellaquotcd Ultimate Sewr~ ~ 3rd(ttr 1017dlJonaldataonlyindudu~hlll17
New Yort Mtdieal lfldetMityfilndti of9--3~ 172 216201B ~ Pinnacle Act uarial Resources Inc
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Finandal Services pounddllbltS
Quarmly Analysls of New Y0lt1lt Medical Indemnity Fund Page4
Projected lncnmental Discounted Payments plaquo Partldpant by Admittance Quarter As ofSeptember 30 2017 -- - Incremental 8eneflts aid by fund Patti~Quarter
Jl1 lU Ill lit ~ gj l2Z ga Q2 lllll 1W lllZ lUl llli 1W Jl1i lllZ lUl Im ~ Jw lllZ Im 1W 20UQ4 11 3146 94260 144173 27926 2167 2V20 10181 69656 29373 28827 54812 bull7626 27564 482 1-1 51481 28752 C9678 50()67 SS77S 59762
2012Ql 11 11909 2-821S 15444 3802 9275 24942 29365 45050 6S147 33607 38857 22710 17639 1900l 47SSS 8QSO 82-87 40610 2012Ql 16 m 213939 222675 216()153 220760 219402 284456 287128 36083S 337540 310Sn 284497 318790 369738 35541 322971 388125 349296 2012Q3 2012Q4
2S 17222
371 5889lt 75588
119468
146331
117755 431812
1607-48 623934
18012
520889
211218 1045294
300micro5 1180508
433929 1165671
286997 1148800
349458 1218931
267625 894490
302 978263
229506 9278S7
226706
135451 256203
1174221 311JI08 906524
307643 1038009
572628 2118425
2013Q1 780 10857 36713 37090 86384 1n1oa 162554 132023 136890 119318 117497 87645 121918 19075 110923 240083 237137 2013Q2 30 41406 67708 78micro1 109369 161013 217746 181675 116207 135157 197202 256410 167023 273743 393151 388328 2013Q3 201JQlt
27 60
9394 15787
89664 22micro2
176462
52010
348379 SS080
366278
37953 407151 152406
431269 42227
361886
bull t285
366426 311761 120264
270692 105891
340 303320
73694
816657 -us783
642035 149203
638084 148284
634157 147372
630254 146465
201AQ1 19 602 39529 100258 166996 143474- 269659 282S92 372432 227482 404028 331801 36447 797053 792147 787272 618934 61S12S 611339 61)1577 2014Q2 2S 30945 132707 205442 230289 335796 222383 350374 280346 272lSJ 327022 25466S 768609 763879 759178 754506 593174 589523 585895 166368
2014Q3 20 24460 10S657 9 392A88 282863 305247 296763 249677 1n991 MASS4 918263 912611 906995 901413 708-669 704308 199992 198762 2014(14 19 1609 73351 10398 172768 198623 159203 19395S 25-4713 264161 336275 617955 589898 586268 582660 579074 455254 129272 128476 127686
201SQ1 27 3902 118971 137048 184125 195370 230680 288099 212na 632379 628437 624620 S96260 592590 588943 585319 -1314s 130666 129862 129063 201SQ2 31 137049 401726 435224 3S2996 410257 S2l4S1 38171 1197422 1190053 1182729 117SA51 1122081 1115175 1108312 314712 247419 245896 244383 242879
201SQ3 16 30164 103507 80558 91758 280563 251057 2(9~512 247977 246ASl lli261 233813 66393 6Sl84 51875 51556 51239 50923 201SQ_4 20 3829 102088 9 11amp1 172019 211Ugt6 500874 448200 445442 U2701 439976 420000 119261 118527 117798 92610 92040 9147 90911
2016Ql 18 210 1675 164559 U2467 439744 437038 mon 388671 386279 383901 104706 104062 103421 102785 80807 80310 7981S 79324 2016Ql 2016Q)
3S 22
10141 71367 661697
439107 65762S_ 653578
433719 649556
431050
581246 385719
S77Ei69 383345
57411 108853
163023 108-183
155621
103271
154663 102636
153712 102004
152766 101376
120101 79700
119361 79209
118627 78722
117897
78237 2016Q4 1S 579199 575635 518656 515464 512292 509139 45SS96 129369 128573 127782 121980 121229 120483 119742 94138 93559 92983 92AU 2017Ql 19 729360 124871 720410 649101 645106 641136 637191 162909 161906 160910 159920 152659 151719 150786 J49858 J17SLt 117089 116369 115653 2017Q2 29 1032517 1026163 1019848 918899 913244 907624 257725 230622 229202 227792 226390 216111 214181 211459 212146 166784 165757 164737 161723 2017Q3 17 567525 589333 585706 582102 524W 5212SS 148013 147103 131633 130823 130017 129217 123~50 122591 121837 121087 95196 94610 94028 93449
Total sos
Sou NYMlF fOf Fund daucalculated diagonals ba$NI on Exhibit6 lldcet~ Uftimat~ Stverity andbull diSCIOutll factor of25
Note ltdQ_tr2017 diagonal data o~ includes lhrough 83117
New York Medkal Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New Yorilt DepartmentofFinancial Services EllthibttS
Quarterly Analyls of New York Medical Indemnity Fund Pa_geS Projected Incremental Discounted Paymtftts per Partldpant by Admittance Quart1t Asof September 30 1017
-- ~al8enefltshid byFund hrtkfpadotlltblarter-Im llli Im lUI ~ lllll lll1 llD 1111 llit lU1 IU2 QM SID ~ 1W Qi1 Q1 lHi llS1 Jljj w a ~ ~ 2011Q4 11 137617 136770 13S928 135092 137967 137117 13627bull 135435 130157 36959 36731 36505 37302 37072 3684- 36617 37719 3787 37256 37027 38682 38201 37973 39611 39368
2012Q2 2012Q2
2012Ql
11 16
2S
88196
727029
5697-40
8 7653
722SSS
566234
8 711 718108
562749
86577
713689
559286
88420
728-875 571187
87876 87335 724~390 719932
567672 16119A
86797
204429
160202
23llll
196462
153959
23686
19S2Sl
1S3D11
23540
194051
15~069
23395 191857
151134
U906 197o64
154430
23759
195851
1SlA80
23612 152515
23467
193448
151596
24174
199271
156160
2A02S 19Slt)44
155199
2lsn 196826
St243
23730 19561
153294
24791
204359
160147
U638 203101
159161
middot201851
158182
2A3l6
2009
157208
25386 2092fi6
163993
25230 207978
162983-2012Q4 40 210770 209t772 2Dampl880 2069068 21U096 600026 596334 592664 S69566 566lt)61 562578 559115 57U11 S67795 564301 560amp28 577709 S7C154 S70621 567109 S92micro0 588814 585190 581589 606687
201IQI 215942 23A-90 233046 231612 67SH 67167 6675 663A3 63757 63365 62975 62588 63953 63559 63 168 ~719 64669 64271 63875 6l482 66120 65912 66506 65103 67913 67495 2013Ql
2013Ql 201lQ4
lO
27
386370
627077 145726
lampl992
623218 uo
381629
176966 1us
10866
175877
40872
110672
179620 417tl
109991
178-514 41lt85
109314
177416 41230
108641
176324 40976
104407
169452
l939
103764
168A09 39137
103126
167373
33896
102-491
1663
38656
104721
169971
39500
1deg082
168925
39257
103442
167886 39015
1028()5
166852 38775
lOS900
171875
39942
105248_170817
104600
169766
39s2
103956
168721
39209
108604
176263
40962
107935
175179
40710
107271
11100 40459
106611
173029 40210
111212
180496
4 1MS
110527
179385
41687
2014Ql 19 172718 1716SS 170599 169549 173157 172091 171032 169980 1633SS 162350 161351 1603S8 163856 162847 161845 160849 16S691 164671 163658 162650 169921 16887S 167836 166803 174002 172931
2014Q2
2014QJ
25 165530
197759
161511
196s42
163499
195333
162-492
194131
165950
19S262
161929
1970U
163914
195829
162905
194624
156556
187039
155593
185888
15635
lM744
15368t
183607
157036
187612 156069 186457
155109
185310
154154
184169
158795
189713
157817
18854S
156846
187lampS
155881
186232
162849 194557
161M7
193359
160851
192170
159861
190987
166760
199229
16S733
198003 2014Q4 19 127042 126260 12SW 124711 12736S Ult581 125802 12S02B 12015S 119416 118681 117950 120523 119781 119044 118312 121873 121123 1203n 119637 12498S 12421S 1234S1 122691 127986 127198
201SQ1 27 128412 127622 126836 126056 128738 127946 U71S8 126376 121451 120703 119961 119222 121823 121073 120328 119587 123187 122429 121676 120927 126332 1BSSS 124782 124014 129366 128570 201SQ2 l1 241654 240167 238689 237220 242268 240777 239295 237amp23 228SM 227148 225750 224360 229254 227MJ 226441 225048 231822 23039S 228-977 227S68 2377U 236278 23A824 23337amp 2434SO 241952
201SQ)
2015QltI
2016Ql
16
20
18
50666
904S2 _ S03SS 89896 78amp38
S004S 89342
n956
49737
889l
77476
5079S 90682
79125
50482
90124
78638
50111 89560
781Samp
49863
89018
77673
47920 74646
47625 85022
7186
47332
84499
73730
47041
83979
73276
48lt)67 85811
74874
47771 85283
7441bull
1n 84758
73956
47 185
84236
73500
48605 86772
75713
48306 75247
8008 85707
74784
47713
8S180
74324
49M6
88987
77646
49539
88440 n168
49234
87895
76693
48931 87lSS
76221
Sl041 9 1124
79511
50729
90564 79021
2016Q2 lS 117302 116580 11S863 11S150 117600 116sn 1161S7 115442 110943 110261 109582 108908 111283 110598 109918 109241 112530 111837 111149 11046S 11S403 114693 11397 113285 118174 1174-t7
2016Q)
2016Q4
22
15
n so 9194S
n364
91379
76887
90817
76414
90258
78040
92178
nsGO 91611
n08l 91047
76606
90487
73623 73170
86lt25
72719
8S89l
72272
8S36S
7l88
81221
73394
86690
72942
86156
72493
8S626
74675
88204
74216
87661
73759
87121
7l305
66585
76582
90456
76111 7S642
89346
7S177
88796
78421
92628
n9a 92058
2017QI
2017U 19 115(169
162898
114361
16189S
113657
160899
112958
159909
115362
163312
114652
162307
113946
161308
113AS
16031S
108831
154067
106162
1S3119
107496
is21n
106slS
151240
10916S
154539
10849
1S3588
107825
152643
107162
151703
110387
156270
109708
lSS308 109033
1543S2
108362
lSl402
113206
16021i0
112509
1S9274
111817
158293
111129
157319
11S924
164106
11S211
16098 2017Ql 17 92978 92405 91837 91272 93214 9U40 92070 9 1503 87937 87396 86858 86324 88207 87664 87124 86588 8919S 88646 88100 87558 91472 90909 90350 8979lt 93669 93002
Total sos
SOutlte NYMlf tot Fund data telcw~ dlaeonillS based on Egttitiit 6 lndkated lHtlmate severity end a d~unt factorof2S
Not~ 3tdQtt 2017 diagonal dbta only indudes thrOICh 8ll17
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
-- -New Yorilt Department of Financial Services Exhibits
Quarterly Analysis of New Yorlc Medical Indemnity Fund Page6
Projecffll lncmental Discounted PavMnts per Participant by Admittance Quarter Asof~r30r 2017
lnctementtl Bendu aidby fund hrtldpfflon Qulrtel
w JIIZ JIU Ila w ~ JIil ga 1W lllill 1111 ~ w Slit lalal 2011Q4
2011Q1 12Q2
11
11 3912S
25075
206698
24_920
205426
41745
26 753 220536
41488
26589 219179
41232
26425 217830
40979
26-262 216489
39627
25396 209350
39383
25240- 39141
25085 2067amp1
3amp900
24930
205509
24984
20595-
387(5
24amp31
204687
3amp5(]6
24678
203427
38269
2s26 202175
5303607
3398968 28018886
8989649
snou1 781016
12Q) 25 161980 160983 172824 171760 170703 169651 161058- 163049 162045 161()48 161397 160404 159417 158-06 2 1957161 37505493
2012Q4
2013Q1
40 599243
67)79
595SSS 639359
71S70
635425
71130
63151(
70692
627628
70257
606931
67940
603196
67522
59948
67106
595794 S97086
66838
593412
66427
589760
66018
586130
65612
81230084 9()92927
138834856
15601870
20130Z JO 109347 109-171 U7201 116479 115761 115050 111256 110S72 109891 109llS 109ampS2 11l6m 108 109 107laquol 14890253 25533692
2013Ql 2013Q4
14Qt
27 178281
41431
171867
1n184 41176
170809
190216
204
183372
189046 43932
182244
187882
43662
181122
186726 43391
180007
180569 41962
174072
179457
4 1704
173microl(l
178353 171936
1n2ss
41192
170877
177640
middot ~282 171248
176546
1028
17019
175460
40ns 169147
174380
40524
168-106
24166839
5616130
23297288
41622038
9713769
40493056 2014Q2 25 164713 163700 175740 176S9 173SM J72516 166827 165800 164780 163766 164121 163111 162107 161109 223l76SO 38993992
2014Ql
2014Q4 20 19678amp
126416
195573
125638
209958
13l87amp
206666
134048
207382
133223
206105
32A04 199309 128037
198082 127249
196863
126466
195652
125688
196076
125961
125185
193670
124415
192478
123649
26674994
17136195
amp6SU878
30211689
2015QI 27 127719 126992 136333 13Sffl 134660 133831 129418 128622 127830 12703 127ll9 126535 125757 124983 17320993 l0735056 201SQgt
2015Q3 201SQ4
2016Q1
l1
240463
S0417 78535
233983
S0106
amp9452
780S2
256560
53792 96032
13792
254982
Sl461 83277
153412
53132
94853
82764
251853
S2BOS 94270
8225S
243S-48
S1063 91161
79543
242049
5079
90600
79053
240559
50437 90042
78567
239079
50126
89488
239597
so235
89682
782S2
238123
49926 89130
77771
236657
49619
88582
77292
235201
49313
88017
76816
32595196
613-4195
12200747
10645767
58502708
12300447
220H819
19293312
16Q2
2016Q3
2016Q4
17Ql
2017Q2
22
15
116724
nAS9 91491
114502
162095
116006 90928
113797
161097
124538
82644
97616
122167
172946
121n-2
82136
97016
121416
171882
121()10
81630
96A18
120668
170824
122253
81121
9S82S J19926
169771
118221 78amp53
92665 115971
16174
117494 77970
92095
115257
163164
116nt
77490
9 2S28 114548
162160
116052
nou 9096S
113843
161162
116304
n 1ao
91 162
11090 161511
115588
76705
90601
113388
160517
114877
76233 112690
1S9S29
114170
JS764
89489 111996
15822461
10A99892
12402068
15521264
21972660
2859272S
19068322
22632090
28212326
40073784 2017Q) 17 92519 91950 98713 98105 97502 96902 93706 middot~130 92SS6 91987 92186 91619 9 105S 9049S 12S4400 22984578
Total sos Totalthru 20170l 792303696
Sou NYM lf fo Fund data alcutattd dlagonals based on Exhibit 6 Indicated UCtimat~Soewirky~nd a diSltOIHltfacto of 2S
Note 3tdQtr2017 diagonal data orly includes thro~ 83117
New York Medk al Indemnity Fund as of 9middot30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Expected Fund Payments by Admittance Year
Exhibit 6
Cumulative Expected Expected Development B-F Indicated Selected Indicated Fiscal Admitted Benefit Benefit of Benefits of Current Benefit Ultimate Ultimate Year Live Births Participants Payments Payments Paid Payments Payments Payments Severity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
2011 239608 22 2275964 30959025 716 31797104 31019013 31258380 1420835 2012 238237 86 31711496 520547963 633 501321266 519331763 513733664 5973647 2013 235956 84 12345530 256598845 537 230086088 255176273 255176273 3037813 2014 237491 91 12199946 322397099 429 284455841 320769848 320769848 3524943
2015 236335 85 7437433 245042955 312 238115493 244826579 244826579 2880313 2016 235084 91 2432448 220057476 183 132594952 218452980 219255228 2409398 2017 233832 46 159384 142277072 053 29985699 141680207 141978639 3086492
Total 1656542 sos 68562200 1737880436 1448356442 1731256661 1726998611 3419799
Sources (2) Vital Statistics of New York State adjusted to MIF fiscal year (3) Provided by MIF includes participants admitted through 093017 (4) Provided by MIF includes 79 load for prescription drugs
(5) (6) Pinnacle estimate of expected payments and payment distributions based on admittance year (7) Col (4) Col (6) (8) Col (4) + Col (5) x [lbullCol (6)1 (9) Judgmentally selected from (5) (7) and (8) - these selections do not reflect the impact of recent legislation see Exhibit 5 page 3 (10) Col (9) Col (3)
New York Medical Indemnity Fund as of 9-30-17 v2 2162018~ Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 1
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
2523 119772 119772 1662 57197 35221 92418
13828 302916 302916 276786 1631 278416
102634 316517 316517 15056 133083 133083
280 280 85916 2275921 2275921
1S0 2091 8946 11038 326 14194 14194
4437 76014 7885 83899 1417 1417 8557 11723 20280
219S 133929 133929 50 13237 1853 15090
4811 72845 10875 83719 8036 85843 85843 6171 59722 59722
3S910 1426397 1426397 20670 268793 268793
221780 25289 247068 719 8025 8744
1553 19333 10565 29898 3888 103804 103804
6530 6530 60011 132901 132901
9660 9660 88799 1710384 3057 1713441
49609 49609 11 174 11174
814 22290 22290 147 147
503 53611 9231 62842 4773 319672 319672 1692 37614 37614 1322 7418 7418
14806 487365 65793 553158 18723 78293 78293 8430 98318 98318
38904 38904 1559 13250 13250 1754 32064 32064
113154 113154 582 582
2158 63444 4130 67574 61 5650 5650
12598 156133 156 133 310 76807 76807
165902 165902 14097 287143 287143 15639 323906 50146 374052
594 7631 7631 3203 62624 62624
11007 432159 22702 454861
827 26304 26304 77829 552292 38552 590844
309 309 291 291
88296 1117737 1117737
47300 1260165 1260165 44253 623022 623022
218 5299 5299 7065 99889 99889
23317 53368 53368 2240 18165 18165
322022 322022 63866 399658 399658 58227 978827 978827
46545 775017 775017 41681 1139951 1139951 1242 21591 21591
32904 242180 242180 42 325 993016 993016
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 2
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in MLF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
15543 15543 8415 135327 135327
2623 2623 613 28399 28399
80189 998391 998391 7095 168232 168232
59078 590672 590672 25140 243674 243674 27755 271617 271617
201277 3351366 3351 366 184283 371450 371450 84927 1673356 1673356
186 4845 4845 483 23520 23520 897 10041 10041 739 150459 150459
5235 5235 3782 3782
1812 77382 77382 87598 1202844 1202844
193 40791 40791 1014 35005 35005 1014 34776 34776 2243 148535 148535
9497 9497 88 4148 4148
38683 344764 344764 469 20553 20553
57751 802244 802244 1835 1835
31788 640324 640324 29445 280380 280380 14531 59643 59643
37475 37475 1620 15807 15807
44915 525247 525247 1276 8460 8460
40 2074 2074 5732 50340 50340 7290 23227 23227
3098 3098 336 996 996
19189 310505 310505
6736 6736 2633 2633
388 388
636 8691 8691 18410 98075 98075 1047 181540 181540
52252 710625 710625
7135 7135 376 1504 1504
2852 7522 7522 1201 12690 12690
1435 1435 31925 472141 472141
3484 203901 203901
640 92121 92121 6551 150083 150083
971 3356 3356 6005 79543 79543
384 6584 6584 82 82
47786 47786 7836 51037 51037 2375 26178 26178
37 37 40 15980 15980
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 3
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
10822 176032 176032
488 6502 6502 1510 1510
12972 478360 478360 1629 16147 16147
1636 17584 17584 23622 255471 255471 3842 71453 71453 5447 2127253 2127253
26714 512735 512735 474 474
7S9 19472 19472 244 9499 9499
1003 17574 17574 162 162
29348 366576 366576 125 12154 12154
4161 4161 766 17199 17199
306S7 482290 482290 7854 7854 1104 1104
633 34033 34033 3S790 746612 746612
54735 54735 38190 634588 634588
4154 41S4 307 1580 1580
28641 352090 352090
22667 119611 119611 10719 10719
1485 24478 24478
132804 1152132 1152132 5833 23632 23632 1499 54437 54437 8201 145414 145414 5180 33076 33076
12474 27740S 277405 48S 3597 3597
20029 134 176 134176
1875 12253 12253 39409 861316 861316
105 105
4230 4230
836 3349 3349 8292 92759 92759 6763 20375 20375 6562 207769 207769
8193 B193 185036 185036
2292 31604 31604 3233 82000 82000
20211 48963S 489635 8141 155527 155527
2111S 148901 148901 387 102615 102615
1663 1663 29575 394634 394634 8759 364380 364380
8088 B088 37544 255392 255392
232 13793 13793 BS809 846036 846036 5020 34776 34776
9942 9942 1040 1040 631S 631S
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page4
State Paid Benefits
I Affiliate Number
Current Age Gender
Effective Date Primary Diagnosis Injury
Years in M IF
Date of Death (if applicable)
Current Quarter
Cumulative To Date Medicaid
Incurred to Date
768 36513 36513 35 554S 5545
567 23774 23774 2216 62652 62652
S0S3 S053 6748 6748
14863 14863
1762 40904 40904 3117 113360 113360
129228 2225651 2225651
7308 7308
38S8 59371 59371 105016 516S05 516505
6740 199377 199377 14829 298407 298407 24794 38676 38676
1748 1748 82188 82188
295 295 477 S204 5204
69487 497547 497547 14878 141975 141975 16474 224867 224867
6410 6410 1670 4300 4300
12220 135236 135236
1146S 14841S 148415 7S0 27713 27713
16012 273256 273256
16396 93592 93S92 6000 6000
297 15306 15306 2018 2018
1111 1111 1350 2914 2914 S7S5 66937 66937
788 4830 4830 895 10104 10104
33287 363836 363836 15661 276895 276895 10354 78174 78174 8896 82839 82839 5888 109783 109783
10862 237706 237706 13665 147573 147573
525 2282 2282 9607 60566 60566 9173 61486 61486
283 283 45084 382025 382025
17413 17413
1259 1259 7846 7846
1881 19251 19251 934 1440 1440
105093 807831 807831 225 2500 2500
10094 84924 84924 2433 2433
128S09 1649866 1649866 11205 326394 326394
394 12610 12610 1120 29272 29272 2297 166658 166658
New York Medical Indemnity Fund as of930-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 5
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
24737
Cumulative To Date
165719 204
Medicaid Incurred to Date
165719 204
122 122
150 3532 3532
1502 567
757 21335 6960 1231
757 21335
6960 1231
48753
710 860
1312
274581 11365 13424
57798 53344
3167
274581 11365 13424 57798 53344
3167
6855 78446 2361 1029
5939
44683
88144 194712
69579 2134 1923
13502
49579 178
196065
88144 194712 69579
2134 1923
13502 49579
178 196065
2689 2145
400 2844
14432 368
2455 14812
207
17999
32027 1104
68101 96939 11093
20536 55358
562 2105
181 30
17999
32027 1104
68101 96939 11093 20536 55358
562 2105
181
30
16670 265
1081 37019 1510 1301
55650
25650 815
187752 776
2176 230789 12446 41635
449635
82239 3498
187752 776
2176 230789 12446 41635
449635
82239 3498
271 12593
25420 26726
300 13048 46893 1065
77769 255194
300 13048
46893 1065
77769 255194
10968 12739 10958 3500
78948 3770 3784
77248 67163 54468 18120
3190 147374
58090 13256
77248 67163 54468 18120
3190 147374
58090 13256
9291 96
11017 614
11017 614
527 2195
1523 7941
147
1523 7941
147
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 6
I Affiliate Number
Current Age Gender
State Effective
Date Primary Oiaenosis Injury Years in
M IF Date of Death (if applicable)
Paid Benefits Current Quarter
18S3 325 528
4 2810
Cumulative To Date
4436 5193 1665
4 9565
Medicaid Incurred to Date
4436 5193 1665
4 9565
252 65 174 1067
15177 53516
14444 315
1532 89426 31446 19487
101238 35724 2855
89464 315
1532 89426 31446 19487
101238 35724
2855 89464
315
26641 11242 45510 12730 2008
8497
54766 78873
176127 16686
4795 2125
25011
54766 78873
176127
16686 4795 2125
25011
55052
6138
198532 3007 7562
198532 3007 7562
1758 2082
20
3723 16500
20
3723 16500
601 4398
3825 34659
3825 34659
298 572 30 68
84475
1333 275
1036 593
89 118
445395
1333 275
1036 593 89
118 445395
332 4550
301
332 26241
301
332 26241
301
77451 1242
30041 23258 1002
38783
217581 3284
106840 65169 1002
39189
217581 3284
106840 65169
1002 39189
169 1860
17462 5581
1669 1860
18420 20481
1669 1860
18420 20481
4868 4068
11071 23123 3460
636 6123 3884
7817 6904
13928 79693
3460 636
8211 3942
7817 6904
13928 79693
3460 636
8211 3942
1401 42416
1401 56572
1401 56572
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-
New York Department of Financial Services Quarterly Analysis of New York Medical Indemnity Fund As of September 30 2017 Participant Profile
Exhibit 7
Page 7
State Paid Benefits Affiliate Current Effective Years in Date of Death Current Cumulative Incurred
I Number Age Gender Date Primary Diagnosis Injury M IF (if applicable) Quarter To Date Medicaid to Date
1080 1080 1080 8658 11642 11642 1550 2824 2824
190 190 23426 56589 56589 2348 2348 2348
5567 5567 5567
138 152 152
57548 57548 57548
2375 2375 2375
17369 17369 17369
54603 63390 63390
2163 2163 2163
4079 4079 4079
453 453 453
1S0 150 150
571246 5037116 5037116
25232 25232
Total 6026240 68267130 322301 68589431
New York Medical Indemnity Fund as of9-30-17 v2 2162018-- Pinnacle Actuarial Resources Inc
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- Appendix A MIF Claims Requirements for 1500 Professional Form claims received with missing required elements will be rejected
- 10 01 19 MIF Privacy Notice pdf
-
- New York State Medical Indemnity Fund (MIF)
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
- NEW YORK STATE MEDICAL INDEMNITY FUND (MIF) NOTICE OF PRIVACY PRACTICES
-