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CABARRUS COUNTY
<br />SELF INSURANCE
<br />FUND610
<br />As of May 24, 2016
<br />FY 2016
<br />ORG OBJ
<br />ACCOUNT DESCRIPTION
<br />61061917 6606
<br />MP
<br />61061917 6606
<br />WSACC
<br />61061917 6661
<br />Insurance Premiums
<br />61061917 6701
<br />Interest on Investments
<br />61061917 6804
<br />Insurance Refunds
<br />61061917 6902
<br />Contribution From GF
<br />61061917 6901
<br />Fund Balance Appropriated
<br />61061918 6661
<br />Insurance Premiums - Dental
<br />BUDGET
<br />Total Revenues
<br />61091917 9331 Minor Office Equipment
<br />61091917 9360 Medical Supplies
<br />61091917 9401 B &E Rental
<br />61091917 9412 Power
<br />61091917 9445 Purchased Services
<br />61091917 9485 Administration Fees
<br />61091917 948501 Admin - HSA Origination Fee
<br />61091917 948502 HRAAccount - Gilsbar
<br />61091917 948503 Federal PPACA Fees
<br />61091917 9570 Service Contracts
<br />61091917 9605 Consultants
<br />61091917 9645 Self - Insured Hospital Claims
<br />61091918 9485 Admin Fees - Dental
<br />61091918 9645 Self - Insured Dental Claims
<br />Total
<br />9,632,793.00 41,104.00 9,673,897.00 8,406,205.89 299,378.38 - - - - 1,706,626.00 350,000.00 10,762,210.27 (1,088,313.27) 1,159,500.00
<br />- - - (727,097.00) (299,378.38) 6,250.00 1,366,400.00 119,900.00 700,000.00 (1,702,419.66) (350,000.00) (886,345.04) (845,241.04) -
<br />Attachment number 1 \n
<br />F -7
<br />Page 176
<br />ESTIMATED
<br />ORIGINAL
<br />TRANFRS
<br />REVISED
<br />YTD
<br />RETIREE UNUSED CLAIMS/
<br />(OVER) / UNDER
<br />BUDGET
<br />ADJUST
<br />BUDGET
<br />ACTUAL
<br />ENCUMBRANCE
<br />COBRA PREMIUMS PREMIUMS PREMIUMS OTHER IBNR
<br />TOTAL
<br />BUDGET
<br />BA
<br />-
<br />-
<br />-
<br />(1,353.24)
<br />-
<br />- - - - (225.54) -
<br />(1,578.78)
<br />(1,578.78)
<br />1,350.00
<br />-
<br />-
<br />-
<br />(12,404.00)
<br />-
<br />- - - - (2,480.80) -
<br />(14,884.80)
<br />(14,884.80)
<br />12,400.00
<br />(9,127,237.00)
<br />-
<br />(9,127,237.00)
<br />(7,115,032.26)
<br />-
<br />(6,135.00) (1,297,800.00) (119,900.00) (700,000.00) - -
<br />(9,238,867.26)
<br />(111,630.26)
<br />-
<br />(4,000.00)
<br />-
<br />(4,000.00)
<br />(3,858.10)
<br />-
<br />- - - - (1,500.00) -
<br />(5,358.10)
<br />(1,358.10)
<br />-
<br />(100,000.00)
<br />-
<br />(100,000.00)
<br />(202,850.35)
<br />-
<br />- - - - - -
<br />(202,850.35)
<br />(102,850.35)
<br />102,000.00
<br />-
<br />(41,104.00)
<br />(41,104.00)
<br />-
<br />-
<br />- - - - - -
<br />-
<br />-
<br />1,043,750.00
<br />(401,556.00)
<br />-
<br />(401,556.00)
<br />(343,610.94)
<br />-
<br />(115.00) (68,600.00) - - - -
<br />(412,325.94)
<br />(10,769.94)
<br />-
<br />(9,632,793.00)
<br />(41,104.00)
<br />(9,673,897.00)
<br />(7,679,108.89)
<br />-
<br />(6,250.00) (1,366,400.00) (119,900.00) (700,000.00) (4,206.34) -
<br />(9,875,865.23)
<br />(243,072.23)
<br />1,159,500.00
<br />-
<br />13,010.00
<br />13,010.00
<br />18,567.14
<br />-
<br />- - - - 800.00 -
<br />19,367.14
<br />(6,357.14)
<br />6,500.00
<br />90,000.00
<br />(23,000.00)
<br />67,000.00
<br />64,798.21
<br />-
<br />- - - - 4,950.00 -
<br />69,748.21
<br />(2,748.21)
<br />3,000.00
<br />-
<br />26,000.00
<br />26,000.00
<br />23,083.38
<br />2,558.96
<br />- - - - - -
<br />25,642.34
<br />357.66
<br />-
<br />-
<br />3,000.00
<br />3,000.00
<br />839.16
<br />-
<br />- - - - 1,250.00 -
<br />2,089.16
<br />910.84
<br />-
<br />-
<br />7,500.00
<br />7,500.00
<br />-
<br />7,500.00
<br />- - - - - -
<br />7,500.00
<br />-
<br />-
<br />1,789,475.00
<br />-
<br />1,789,475.00
<br />1,566,241.59
<br />223,233.41
<br />- - - - - -
<br />1,789,475.00
<br />-
<br />-
<br />320,000.00
<br />10,500.00
<br />330,500.00
<br />327,000.00
<br />-
<br />- - - - 1,200.00 -
<br />328,200.00
<br />2,300.00
<br />-
<br />80,000.00
<br />(3,500.00)
<br />76,500.00
<br />53,905.02
<br />-
<br />- - - - 18,000.00 -
<br />71,905.02
<br />4,594.98
<br />-
<br />59,300.00
<br />(843.00)
<br />58,457.00
<br />58,456.64
<br />-
<br />- - - - - -
<br />58,456.64
<br />0.36
<br />-
<br />450,000.00
<br />(2,496.00)
<br />447,504.00
<br />197,563.90
<br />66,086.01
<br />- - - - 15,226.00 -
<br />278,875.91
<br />168,628.09
<br />(150,000.00)
<br />-
<br />6,442,462.00
<br />-
<br />(5,067.00)
<br />-
<br />6,437,395.00
<br />-
<br />5,775,741.39
<br />-
<br />-
<br />- - - - - -
<br />- - - - 1,600,000.00 350,000.00
<br />-
<br />7,725,741.39
<br />-
<br />(1,288,346.39)
<br />-
<br />1,300,000.00
<br />40,009.00
<br />16,000.00
<br />56,009.00
<br />45,721.97
<br />-
<br />- - - - 9,200.00 -
<br />54,921.97
<br />1,087.03
<br />-
<br />361,547.00
<br />-
<br />361,547.00
<br />274,287.49
<br />-
<br />- - - - 56,000.00 -
<br />330,287.49
<br />31,259.51
<br />-
<br />9,632,793.00 41,104.00 9,673,897.00 8,406,205.89 299,378.38 - - - - 1,706,626.00 350,000.00 10,762,210.27 (1,088,313.27) 1,159,500.00
<br />- - - (727,097.00) (299,378.38) 6,250.00 1,366,400.00 119,900.00 700,000.00 (1,702,419.66) (350,000.00) (886,345.04) (845,241.04) -
<br />Attachment number 1 \n
<br />F -7
<br />Page 176
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