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Does anyone know where the following 2 formulas were outlined in the study material? I’ve looked all over the module slides and recommended textbooks and had no luck.
Cost Sharing = [(Base Year PMPM Claim * Trend) – Deductible and Limit Costs] * Coinsurance Percentage + Deductible and Limit Costs
Profit = (1 – Variable Expenses %) * Base Premium – Fixed Expenses –[(Base Year PMPM Claim * Trend) – Cost Sharing]
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