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<br />City of Lake Elmo <br />September 26, 2025 <br />Page 4 <br /> <br /> <br /> <br />2026 Actuarial Value3 <br />Plan % of Total Allowed Costs <br />2026 Cost Sharing Projection4 <br />Plan % of Total Allowed Costs <br />High HSA HIGH HSA <br />89.8% 74.0% 93.6% 85.9% <br /> <br />3This minimum value calculator was released by the Department of Health and Human Services in conjunction with the final rule <br />for determining minimum value, finalized as 45 CFR 156.145. This tool is being used to calculate actuarial value as required by <br />Minnesota Statute 2023, section 471.6161, subdivision 8 as amended by Chapter 114, Article 1, Section 15. <br /> <br />The HHS minimum value calculator utilizes 2009 data trended to 2014 to determine each plan’s actuarial value <br />and relies solely on the Single coverage plan design. No employer premium or HRA/HSA contributions are <br />included in these actuarial value calculations <br /> <br />4Using recent, actual claims data, as well as projected benefit changes, this represents PEIP’s estimated member cost sharing <br />associated with the HIGH and HSA plans. This estimate is calculated using actual PEIP membership and claim experience for both <br />Single and Family coverages, trended forward to 2026 and using 2026 plan designs. No employer premium or HRA/HSA <br />contributions are included in these actuarial value calculations. <br />