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Commission hears plan financials showing roughly $12M year‑to‑date surplus
Summary
Lockton told the commission that administrative payments totaled $11,554,480 and that self‑funded medical claims through April 2026 were 95.3% of budget, producing an approximate $12 million surplus year‑to‑date; SunLife reimbursements of $3.3M were reported for very high‑cost claimants.
Lockton presented the State of Maine’s July 1, 2025–April 30, 2026 monthly cost reporting package and said administrative payments for plan administration and fees totaled $11,554,480 for the plan year to date. Lockton reported that self‑funded medical claims were 95.3% of the budget through April 2026, down from a 108.2% loss ratio in the prior plan year, and that the plan was running slightly under budget with an approximate year‑to‑date surplus of $12 million.
The presenter gave plan‑level details: 133,960 active employee claims totaled $209,805,156 (about $1,566 per employee per month) and 14,217 retiree claims through December 2025 totaled $26,770,257 (about $1,883 per member per month). The Dental plan recorded 140,125 claims at a total cost of approximately $7.4 million and was at about 94.7% of budget with a roughly $393,000 surplus. Lockton also reported $3.3 million received from SunLife to cover high‑cost claimants who exceeded the $750,000 individual stop‑loss threshold; staff said two months remain in the plan year.
