Filetype Excel XLSX | Posted on 15 Aug 2022 | 3 years ago
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227x Filetype XLSX File size 0.21 MB Source: www.dhs.wisconsin.gov
Sheet 1: Instructions
| IRIS | |||||||||||
| Three Year Financial Projection Submission | |||||||||||
| Required worksheet Instructions | |||||||||||
| 1 | This financial projections template workbook should be completed and submitted as an excel workbook and include all formulas and worksheet links. | ||||||||||
| 2 | Instructions and clarification are included at the top of each worksheet. The F/EA Acronym refers to the IRIS Fiscal/Employer Agency. The ICA Acronym refers to the IRIS Consultant Agency. | ||||||||||
| 3 | Additional required worksheets are provided for entities with other operations (green tab) and/ or have multiple corporations under a parent company adding the requirement of the consolidated worksheets (purple tabs). | ||||||||||
| 4 | All submissions must include completed worksheets identified with the orange tabs. Critical inputs must be completed in the assumptions worksheet prior to completing other worksheets. | ||||||||||
| 5 | The preparer should complete the worksheets at the far right of the workbook prior to entry in the revenue/expense, balance sheet and cash flow worksheets. The recommended order for entry in the worksheets with orange tabs is: Assumptions & Notes (see #4 above), Occupancy, Personnel, Admin Detail, Prog Staff Exp, Enrollment, Rev/ Exp by Month, Rev Exp Mult Yr Summ Total Co., Balance Sheet, and Cash Flows. | ||||||||||
| 6 | Additional supporting documents/ worksheets may be inserted at the end of the workbook to support calculations and modeling and should be described in the assumptions and budget narrative. | ||||||||||
| 7 | Many links have been formatted in the workbook and many cells have been locked. Additional links between the worksheets may be added to support calculations in unlocked cells as desired. | ||||||||||
| 8 | Cross checks have been included in some worksheets to ensure consistency of results. Error messages will appear and provide direction to identify the specific inconsistencies. All Errors must be cleared prior to submission. | ||||||||||
| 9 | The submission requires narrative description in the Assumptions & Notes worksheet to support the financial projections and resulting revenues and expenses. The submission should also describe subcontracted functions necessary to operate as an ICA/FEA and describe the nature of the agreement(s) to include but not limited to related parties &/or risk sharing agreements. | ||||||||||
| This is a required document. The Assumptions and Notes section should provide sufficient detail for the reviewer to gain a complete understanding of the financial projections proposed for the IRIS program and the entity as a whole. Categories and related descriptions have been provided but the preparer should include any relevant assumptions necessary to communicate the plans and program direction underpinning the financial projections. Identification of the year specific assumptions relate to should be included. | |||||||||||||||||||||||||||||||||
| REQUIRED INPUTS IN THIS WORKSHEET: | |||||||||||||||||||||||||||||||||
| The Entity name, starting year and contracted service should be entered in this document. The entries will be carried through to all other worksheets. | |||||||||||||||||||||||||||||||||
| Click Cell to Select Service | |||||||||||||||||||||||||||||||||
| Entity: | Service: | Click Cell to Select Service | ICA | ||||||||||||||||||||||||||||||
| 3 Year Business Plan | F/EA | ||||||||||||||||||||||||||||||||
| Starting Year: | ERROR: Enter Entity Name, Starting Year, and Select contracted Service prior to moving forward | ||||||||||||||||||||||||||||||||
| Financial Projection Assumptions and Notes: | |||||||||||||||||||||||||||||||||
| Participant Enrollment: Describe specific enrollment assumptions and reasoning for enrollment plan in each region included in the financial projections. | |||||||||||||||||||||||||||||||||
| Monthly IRIS Contract Revenues: Describe additional information regarding the IRIS contracted revenues that support the reviewers understanding of the ability to support IRIS operations. | |||||||||||||||||||||||||||||||||
| Other Revenue: Describe assumptions on investments earnings, interest and "other" revenue included in the projections | |||||||||||||||||||||||||||||||||
| Personnel: Describe assumptions for wages and benefits, cost of living, staffing ramp up for new regions and any other assumption that supports the reviewers understanding of the projected personnel expenses. | |||||||||||||||||||||||||||||||||
| IRIS Care Consultants-ICA: Describe the anticipated ratio of Care Consultants to Participants and any other relevant assumptions such as staffing ramp up for new regions included in the financial projections. | |||||||||||||||||||||||||||||||||
| Administrative & General: Describe the cost allocation method for shared expenses across other operations or inter-company charges from related entities. Describe assumptions for the addition of expenses specific to the IRIS program. | |||||||||||||||||||||||||||||||||
| Fiscal Management: Describe assumptions and requirements to enhance fiscal operations to conduct projected IRIS operations such as dedicated fiscal staffing or enhancements to the financial accounting system. Describe the planned accounting structure to ensure separation of IRIS operations from other entity operations. | |||||||||||||||||||||||||||||||||
| Information Management: Describe assumptions used to project system leases, purchases, maintenance, support and consultation costs to conduct the projected IRIS operations or other general operations. Describe whether systems are developed and supported internally or contracted. | |||||||||||||||||||||||||||||||||
| Facilities: Describe whether facilities are leased or owned, shared with other operations unrelated to the IRIS program, and space specific to the IRIS program. Describe the staging of additional facilities/space to support IRIS expansion included in the projections. | |||||||||||||||||||||||||||||||||
| Other: Describe additional categories to support the reviewer's complete understanding of the proposed IRIS program projections, the strategic plans included in the financial projections, and the fiscal health of the entity as a whole. Describe start up costs, and other planned one time or ongoing infrastructure investments not described above. | |||||||||||||||||||||||||||||||||
| Direct Expenses, Other Contracted Ops: Describe other operations and significant expense categories to support the reviewer's understanding of assumptions, projections and the financial position from other operations. | |||||||||||||||||||||||||||||||||
| IRIS | ||||||
| Three Year Financial Projection Submission | ||||||
| ERROR VALIDATION | ||||||
| Please ensure all errors are cleared prior to submission | ||||||
| Embedded Error Location | -1 | 0 | 1 | 2 | Description of Cross Check | Description of reason for Errors included in final submission |
| Assumpt & Notes | ERROR: Enter Entity Name, Starting Year, and Select contracted Service prior to moving forward | Entity Name, Start Year and Program Type | ||||
| Balance Sheet Mult Yr Summ | Assets = Liabilities + Equity | |||||
| Balance Sheet Mult Yr Summ | ERROR, WORKING CAPITAL REQUIREMENT MUST BE SATISFIED | Satisfaction of Working Capital Requirement | ||||
| Balance Sheet Mult Yr Summ | Satisfaction of Reserve Requirement | |||||
| Balance Sheet Mult Yr Consol | Assets = Liabilities + Equity | |||||
| Cash Flows Row 49 | Cash: Bal Sheet | |||||
| Cash Flows Row 51 | Reserve: Bal Sheet | |||||
| Cash Flows Row 65 | Cash: Bal Sheet | |||||
| Enrollment Row 37 | SDPC Enrollment > Total Enrollment | |||||
| Admin Detail Row 9 | Total Salaries Agree with Personnel Schedule | |||||
| Admin Detail Row 39 | IRIS Admin OH Totals Must Agree | |||||
| Admin Detail Row 41 | Allocation to Other Lines of Bus. Must Agree | |||||
| Program Staff Exp Row 8 | Total Salaries Agree with Personnel Schedule- Direct Program Staff | |||||
| Personnel Schedule Row 43 | Input of F/EA Positions in Designated Section | |||||
| Personnel Schedule Row 77 | Input of ICA Positions in Designated Section | |||||
| Personnel Schedule Row 122 | ERROR, INPUT OF ADMIN POSITIONS IS REQUIRED | ERROR, INPUT OF ADMIN POSITIONS IS REQUIRED | ERROR, INPUT OF ADMIN POSITIONS IS REQUIRED | Input of Admin Positions | ||
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