PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: Commercial Age of Enrollees Members at End of Period Male Female Member Months Total Male Female Total <1 86 81 167 1,153 1,104 2,257 1-4 363 395 758 5,051 5,279 10,330 5-9 562 522 1,084 7,299 7,117 14,416 10-14 576 542 1,118 7,658 7,196 14,854 15-17 393 307 700 4,985 4,323 9,308 18-19 226 248 474 3,174 3,159 6,333 20-24 676 549 1,225 9,080 7,124 16,204 25-29 680 560 1,240 9,165 7,411 16,576 30-34 705 655 1,360 9,778 8,372 18,150 35-39 658 558 1,216 8,612 7,374 15,986 40-44 717 616 1,333 9,747 8,256 18,003 45-49 739 703 1,442 9,973 9,349 19,322 50-54 838 734 1,572 11,211 9,492 20,703 55-59 702 563 1,265 9,309 7,398 16,707 60-64 438 391 829 5,676 5,116 10,792 65-69 76 63 139 1,025 772 1,797 70-74 17 10 27 169 97 266 75-79 7 - 7 85 22 107 80-84 3 1 4 34 9 43 85-89 1 - 1 8 4 12 90+ NR NR Unknown NR NR Total 8,463 7,498 15,961 113,192 98,974 212,166 PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: Medicare + Choice Age of Enrollees Members at End of Period Male Female Total Member Months Male Female Total <1 NR NR 1-4 NR NR 5-9 NR NR 10-14 NR NR 15-17 NR NR 18-19 NR NR 20-24 NR NR 25-29 NR NR 30-34 NR NR 35-39 NR NR 40-44 NR NR 45-49 NR NR 50-54 NR NR 55-59 NR NR 60-64 NR NR 65-69 NR NR 70-74 NR NR 75-79 NR NR 80-84 NR NR 85-89 NR NR 90+ NR NR Unknown NR NR Total NR NR NR NR NR NR PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: Medicare Cost Age of Enrollees Members at End of Period Male Female Total Member Months Male Female Total <1 NR NR 1-4 NR NR 5-9 NR NR 10-14 NR NR 15-17 NR NR 18-19 NR NR 20-24 NR NR 25-29 NR NR 30-34 NR NR 35-39 NR NR 40-44 NR NR 45-49 NR NR 50-54 NR NR 55-59 NR NR 60-64 NR NR 65-69 NR NR 70-74 NR NR 75-79 NR NR 80-84 NR NR 85-89 NR NR 90+ NR NR Unknown NR NR Total NR NR NR NR NR NR PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: Minnesota Senior Health Options (MSHO) Age of Enrollees Members at End of Period Male Female Total Member Months Male Female Total <1 NR NR 1-4 NR NR 5-9 NR NR 10-14 NR NR 15-17 NR NR 18-19 NR NR 20-24 NR NR 25-29 NR NR 30-34 NR NR 35-39 NR NR 40-44 NR NR 45-49 NR NR 50-54 NR NR 55-59 NR NR 60-64 NR NR 65-69 NR NR 70-74 NR NR 75-79 NR NR 80-84 NR NR 85-89 NR NR 90+ NR NR Unknown NR NR Total NR NR NR NR NR NR PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: Special Needs Basic Care (MA only) Age of Enrollees Members at End of Period Male Female Total Member Months Male Female Total <1 NR NR 1-4 NR NR 5-9 NR NR 10-14 NR NR 15-17 NR NR 18-19 NR NR 20-24 NR NR 25-29 NR NR 30-34 NR NR 35-39 NR NR 40-44 NR NR 45-49 NR NR 50-54 NR NR 55-59 NR NR 60-64 NR NR 65-69 NR NR 70-74 NR NR 75-79 NR NR 80-84 NR NR 85-89 NR NR 90+ NR NR Unknown NR NR Total NR NR NR NR NR NR PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: Special Needs Basic Care Integrated Age of Enrollees Members at End of Period Male Female Total Member Months Male Female Total <1 NR NR 1-4 NR NR 5-9 NR NR 10-14 NR NR 15-17 NR NR 18-19 NR NR 20-24 NR NR 25-29 NR NR 30-34 NR NR 35-39 NR NR 40-44 NR NR 45-49 NR NR 50-54 NR NR 55-59 NR NR 60-64 NR NR 65-69 NR NR 70-74 NR NR 75-79 NR NR 80-84 NR NR 85-89 NR NR 90+ NR NR Unknown NR NR Total NR NR NR NR NR NR PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: Prepaid Medical Assistance Program (PMAP) Age of Enrollees Members at End of Period Male Female Total Member Months Male Female Total <1 NR NR 1-4 NR NR 5-9 NR NR 10-14 NR NR 15-17 NR NR 18-19 NR NR 20-24 NR NR 25-29 NR NR 30-34 NR NR 35-39 NR NR 40-44 NR NR 45-49 NR NR 50-54 NR NR 55-59 NR NR 60-64 NR NR 65-69 NR NR 70-74 NR NR 75-79 NR NR 80-84 NR NR 85-89 NR NR 90+ NR NR Unknown NR NR Total NR NR NR NR NR NR PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: MNCare Age of Enrollees Members at End of Period Male Female Total Member Months Male Female Total <1 NR NR 1-4 NR NR 5-9 NR NR 10-14 NR NR 15-17 NR NR 18-19 NR NR 20-24 NR NR 25-29 NR NR 30-34 NR NR 35-39 NR NR 40-44 NR NR 45-49 NR NR 50-54 NR NR 55-59 NR NR 60-64 NR NR 65-69 NR NR 70-74 NR NR 75-79 NR NR 80-84 NR NR 85-89 NR NR 90+ NR NR Unknown NR NR Total NR NR NR NR NR NR PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: Other: Age of Enrollees Members at End of Period Male Female Total Member Months Male Female Total <1 NR NR 1-4 NR NR 5-9 NR NR 10-14 NR NR 15-17 NR NR 18-19 NR NR 20-24 NR NR 25-29 NR NR 30-34 NR NR 35-39 NR NR 40-44 NR NR 45-49 NR NR 50-54 NR NR 55-59 NR NR 60-64 NR NR 65-69 NR NR 70-74 NR NR 75-79 NR NR 80-84 NR NR 85-89 NR NR 90+ NR NR Unknown NR NR Total NR NR NR NR NR NR PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY DEMOGRAPHIC GROUPS, AGE, GENDER AND ENROLLEE MONTHS OF PARTICIPATION As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Type of Product: Administrative Services Only Age of Enrollees Members at End of Period Male Female Total Member Months Male Female Total <1 NR NR 1-4 NR NR 5-9 NR NR 10-14 NR NR 15-17 NR NR 18-19 NR NR 20-24 NR NR 25-29 NR NR 30-34 NR NR 35-39 NR NR 40-44 NR NR 45-49 NR NR 50-54 NR NR 55-59 NR NR 60-64 NR NR 65-69 NR NR 70-74 NR NR 75-79 NR NR 80-84 NR NR 85-89 NR NR 90+ NR NR Unknown NR NR Total NR NR NR NR NR NR PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY COUNTY AND PRODUCT TYPE As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Other: County (code) Medicare + Choice Commercial Medicare Cost MN Senior Health Options (MSHO) Special Needs Basic Care (MA Only) Special Needs Basic Care Integrated Prepaid Medical Assistance Program (PMAP) MNCare Please Specify on Demog Page Administrative Services Only Total Enrollees Aitkin 1 1 1 Anoka 2 906 906 Becker 3 42 42 Beltrami 4 20 20 Benton 5 189 189 Big Stone 6 9 9 Blue Earth 7 51 51 Brown 8 353 353 Carlton 9 75 75 Carver 10 565 565 Cass 11 51 51 Chippewa 12 15 15 Chisago 13 130 130 Clay 14 1 1 Clearwater 15 11 11 Cook 16 22 22 Cottonwood 17 3 3 Crow Wing 18 201 201 Dakota 19 1,371 1,371 Dodge 20 14 14 Douglas 21 388 388 Faribault 22 44 44 Fillmore 23 7 7 Freeborn 24 92 92 Goodhue 25 136 136 Grant 26 36 36 Hennepin 27 3,707 3,707 Houston 28 1 1 Hubbard 29 5 5 Isanti 30 70 70 Itasca 31 62 62 Jackson 32 - - Kanabec 33 21 21 Kandiyohi 34 113 113 Kittson 35 - - P1 2012 Page 11 of 13 PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY COUNTY AND PRODUCT TYPE As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Other: County (code) Medicare + Choice Commercial Medicare Cost MN Senior Health Options (MSHO) Special Needs Basic Care (MA Only) Special Needs Basic Care Integrated Prepaid Medical Assistance Program (PMAP) MNCare Please Specify on Demog Page Administrative Services Only Total Enrollees Koochiching 36 3 3 Lac Qui Parle 37 31 31 8 Lake 38 8 Lake of the Woods 39 - - Le Sueur 40 82 82 Lincoln 41 4 4 Lyon 42 109 109 McLeod 43 429 429 Mahnomen 44 2 2 Marshall 45 - - Martin 46 2 2 Meeker 47 105 105 Mille Lacs 48 82 82 Morrison 49 106 106 Mower 50 33 33 Murray 51 6 6 Nicollett 52 59 59 Nobles 53 - - Norman 54 - - Olmsted 55 142 142 Otter Tail 56 73 73 Pennington 57 - - Pine 58 9 9 Pipestone 59 20 20 Polk 60 47 47 Pope 61 33 33 Ramsey 62 1,188 1,188 Red Lake 63 13 13 Redwood 64 5 5 Renville 65 57 57 Rice 66 296 296 Rock 67 - - Roseau 68 1 1 Saint Louis 69 191 191 Scott 70 562 562 P1 2012 Page 12 of 13 PreferredOne Community Health Plan Minnesota Supplement Report #3 ENROLLMENT BY COUNTY AND PRODUCT TYPE As of December 31, 2012 Public Information, Minnesota Statutes § 62D.08 Other: County (code) Medicare + Choice Commercial Medicare Cost MN Senior Health Options (MSHO) Special Needs Basic Care (MA Only) Special Needs Basic Care Integrated Prepaid Medical Assistance Program (PMAP) MNCare Please Specify on Demog Page Administrative Services Only Total Enrollees Sherburne 71 380 Sibley 72 63 63 Stearns 73 719 719 Steele 74 85 85 Stevens 75 51 51 Swift 76 14 14 Todd 77 98 98 Traverse 78 6 6 Wabasha 79 19 19 Wadena 80 84 84 Waseca 81 18 18 Washington 82 656 656 Watonwan 83 30 30 Wilkin 84 - - Winona 85 8 8 Wright 86 723 723 Yellow Medicine 87 65 65 State Total 88 15,429 Outside State 89 483 Unknown 90 49 SUBTOTAL 91 15,961 P1 2012 380 NR NR NR NR NR NR NR NR NR 15,429 483 49 NR NR NR NR Page 13 of 13 NR NR NR NR NR 15,961
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