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Medical Plan Administrative Services Fee and Stop Loss Insurance Coverage Renewal Copyrighted July 2, 2018 City of Dubuque Consent Items # 11. ITEM TITLE: Medical Plan Administrative Services Fee and Stop Loss Insurance Coverage Renewal SUMMARY: City Manager recommending renewal of the Medical Plan Administrative Services Fee and Stop Loss Insurance Coverage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve ATTACHMENTS: Description Type Medical Plan Administrative Services Fee and Stop City Manager Memo Loss Insurance Renewal-NNM Memo Staff Memo Staff Memo Self Funded Final Alternate Rates Supporting Documentation Self Funded Final Alternate Rates Supporting Documentation THE CITY OF Dubuque � AIFA�erlwGh UB E '�� III► Masterpiece on the Mississippi Z°°'�w'2 7A13 2017 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Medical Plan Administrative Services Fee and Stop Loss Insurance Coverage Renewal DATE: June 26, 2018 Personnel Manager Randy Peck recommends approval of the Medical Plan Administrative Services Fee and Stop Loss Insurance Coverage renewal. I concur with the recommendation and respectfully request Mayor and City Council approval. �L;� 1��, ��.� Mic ael C. Van Milligen �� MCVM:jh Attachment cc: Crenna Brumwell, City Attorney Teri Goodmann, Assistant City Manager Cori Burbach, Assistant City Manager Randy Peck, Personnel Manager _ . �� '�� _ _... �.��.. � l�F° ��l�i� __ _ _._.. �;is�:�,w.�,�,�� 7� � ��V2� ��s��` �� [Y1�� b1��9�7 TO: Michael C. Van Milligen, City Manag �I'�� ) �i FROM: Randy Peck, Rersonnel Manager � �� SUBJECT: Medical Plan Administrative Services Fee and Stop Loss Insurance Coverage Renewal DATE: June 19, 2018 Administrative Services Fee Wellmark has presented their Administrative Services Fee renewal that will go into effect on July 1, 2018 through June 30, 2019. The following is a comparison between the Fiscal Year 2018 Administrative Services Fee and the proposed Administrative ' Services Fee for Fiscal Year 2019: Cost Per Month Per Contract 7/1/2017 to 6/30/2018 7/1/2018 to 6/30/2019 Administrative Ex ense $34.99 $35.06 PBM Administrative Fee $0.00 $2.00 Network Access Fee $6.95 $8.03 Based on the 563 contacts, the Fiscal Year 2019 Administrative Services Fee is $304,628. The Fiscal Year 2018 Administrative Services Fee, based on 576 contracts, is $289,889. The annual increase in the administrative services fee for Fiscal Year 2019 is $14,73�. Stop Loss Insurance � Wellmark, our current stop loss carrier, and Optum, Symetra, HM Insurance Group, Sunlife and Voya were asked to provide quotes for specific and aggregate stop loss insurance. Only Wellmark provided a quote. Optum and Symetra declined to quofie. HM Insurance Group and Sunlife did not submit a quote. Voya stated they could not provide a completive bid. I recommend that Wellmark be selected as the specific and aggregate stop loss carrier for the health and prescription drug plans effective July 1, 2018 through June 30, 2019. The specific stop loss amount of $120,000 will remain the same. The following is a summary of the new rates and current rates: 1 Cost Per Month Per Contract 7/1/2017 to 6/30/2018 7/1/2018 to 6/30/2019 Individual Sto Loss $79.89 $82.63 A re ates Sto Loss $2.38 $2.38 Based on 563 contracts, the Fiscal Year 2019 stop loss insurance cost will be $574,328. The Fiscal Year 2018 stop loss insurance cost, based on 576 confiracts, is $568,650. The annual increase in the stop loss insurance for Fiscal Year 2019 is $5,678. The requested action is for the City Council to pass a motion approving the proposal submitted by Wellmark effective July 1, 2018 through June 30, 2019 for administrative services fees and specific and aggregate stop loss insurance for the City's health and prescription drug plan. � Wellmark has issued a binder to make sure there is no lapse in coverage on July 1, 2018 RP:alk 2 _�� ',� � . � � V+�itmarxE4�vtCress��sa(3��rShetl as�relrrJuCrn��nl Litaan,e4 oP Ih�1 Btue Crass tf1eF BIu'?S�iuf�$ns+�+:+'.iati�n. a a. , � Group Name: City of Dubuque AccountKey: 00005303 Rating Period; 07/01/2098 to 06/30/201A � i a aa e - QBS#241874-15 /#Drugs Exciuded 123 Single 24/12 Contract Aliiance Select 321 Family peductible:$Q/$0;$250/$750 119 2-Person Na Manthly Aggregate Coinsurance:0%/30% Actual Weekly Claims OPM:$800/$2,400;$1,500/$4,500 663 7otal O�ce Visit Copay: $25 Drugs Excluded Estimated Annual Premium Lev�l Fee/Contract Based on Current�nrollment Individual Stop Loss $120,Q00 $82.63 $558,248 Aggregate Stop Loss 125% $2.38 $16,079 Administrative�ees-Mealth w/weekly settlement $35.06 $236,$65 Administrative Fees-PBM Carveout $2.Q0 $13,512 Consultant Fee $0.00 $0 Total Administrative Fees $122.07 $824,705 N�twork�ccess Fee $8.03 $54,251 in I Fam� 2�Person Annual,�rojection Expected Claims $642.69 $1,953.78 $1,225.61 $1Q,224,742 Administrative, NAF&Stop Loss Fees $�.�24 16 . 3 5 4 �7 ,,$26 EstimatPd Suc�gested Rates* $697.93 $2,121,71 $1,330.95 $11,103,568 Attachment Points $803.35 $2,442.18 $1,531.99 $12,78b,7p4 Administrativ�,NAF&Stop Loss Fees 55 24 167. 3 105:34 8 8 82 Estimated Maximum Liability to Fund"' $858.59 $2,510.11 $1,637.33 $13,659,530 `Actual results rnay vary. Aiso,rates provided include administrative costs based on the entire group population. Individual Stop Loss includes coverage for Health and Drug and is based on a lifetime maxlmum of unlimited. Aggregatc Stop Loss i cl des covorag4 for Heaith and Drug.The maximum Aggregate reimbursement is uniimited. Employer Signat re: Date: �� Comments: I� ��J426 Independent Licensee of the Blue Cross and Blue Shield Associatian I�roposal Date:5/29/2�18 �� n �`„� •` m $ 1'rktiir,ur:R Gt�CYnsr.aixl�hu�.",•}x�vJ�:r at:Iru'it�nu'�t L'X:&�a9�Of IJ'u.t pluaCr✓!as:3+tG 0l�ak 3hiedu�fi5scela€'r�n. 9 4 � ! Group Name: City of Dubuque AccountKey.' OODQ5303 Rating Period: 07/01/2p18 to 06l30/2019 ____.._ �`� 4� 0� ! I� � Q 0 i:" OBS#241874-16 /#Orugs Expluded 123 Single 24/12 Confract Allience Select. 321 Family Deducfible:$0/$0;$250/$750 119 2-Person Na Monthly Aggregat� Coinsurance:0%/30% Acfual Weekly Claims OPM:$400/$1,200;$750/$2,250 �G3 Total Office Visit Copay: $15 Drugs Excluded �stimated Annual Premium Level Fee/Contract Based on Current�nraliment ' Individual Stop Loss $120,n00 $82.63 $558,248 ' Aggregate Stop Loss • 125% $2.38 $16,079 Administrative Fees-Health w/weekly settlement $35.06 $236,865 ''� Administrative�ees-PBM Carveout $2.00 $13,512 ! Consultant Fee $Q,00 $p �I Tot�l Administrative Fees $122,07 $g24,7p� Nefwork Access Fee $8.03 $54,251 �,j�g)„� Familv 2-Person Annual ro ctian Expected Claims $657:9g $2,000.26 $1,254.7% $10,�167,992 Administrativ�, NAF&Stop Loss�'ees 5$,5.25 96 105.36 g7 gg5 Estimated Suggested Rates` $713.23 $2,168.22 $1,360.13 $11,346,977 Attachment Points $$22.47 $2,50Q.31 $1,568.45 $13,084,906 Administrative, NAF&Stop Loss Fees 5 .25 167.96 5 6 g ggg Estimat�d Maximum Liability to Fund* $8�7.72 $2,668.27 $1,673.81 $13,963,891 'Actual results may vary. Also,rates provided include administrat(ve costs based on the entire group population. Individual Stop�oss includes covorac�e for Health end Drug and is based on a IifetimQ maximum of unlimited. Aggrogate Stop Loss includes coverage for Health and Drug.The max(mum Agc�regate reimbursdment is unlimited, Employer S(gnature: �'i�- �„__w______ Date: Comments: v3�J426 Independent Licensee of the Blue Cross and Blue Shield Assor,iation Proposai Date:5/29/2018