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Over the course of 2017 we experienced an unusual number of high dollar medical claims as compared to our historical averages and actuarial expectations. As such we do not expect to experience a similar level of year over year increases in this area in 2018.As Dave noted the vast majority of our merger integration activities are now in the rearview mirror. Our 2017 results reflected $11 million of cost savings from synergies and we wrapped up with cumulative savings from synergies at $48 million annual run rate at the end of 2017, well above our initial projection when we completed the merger.

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