Determination of the relative value of HealthSelect coverage and the coverage provided by the various HMO's. The management of the UGIP is a dynamic process that is always under consideration, reevaluation and revision. Informed decisions and modifications can be made only with the benefit of valid, meaningful data. Although admissions are preferred since they provide data on an incurred basis, discharges are also acceptable. Admissions refers to the number of general hospital, acute care or specialty facility admissions during the fiscal year.
Age is to be calculated as of the last birth date.
COB represents the coordination of benefits savings resulting from coverage of the participant by another insurance plan, including Medicare. Savings recorded under COB should include those accruing as a result of a participant's qualification for Medicare primary payment for end stage renal disease. Discounts refer to the HMO's discounts with providers. These are discounts from billed charges. For certain HMO's, discounts may also include provider withholds.