Self-Funded Health Plan 509A Certification Consultant Copyrighted
September 17, 2018
City of Dubuque Consent Items # 14.
ITEM TITLE: Self-Funded Health Plan 509A Certification Consultant
SUMMARY: City Manager recommending approval to continue using
Insurance Strategies Consulting to prepare the 509A
Certification for the City of Dubuque's Self-Funded Health
Plan and approve the Services Engagement Letter.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve
ATTACHMENTS:
Description Type
509A Certification for the Self-Funded Health Plan- City Manager Memo
NNM Memo
Staff Memo Staff Memo
Services Engagement Letter 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: Preparation of the 509A Certification for the Self-Funded Health Plan
DATE: September 10, 2018
Personnel Manager Randy Peck recommends City Council approval to continue using
Insurance Strategies Consulting to prepare the 509A Certification for the City of
Dubuque's Self-Funded Health Plan and approve the Services Engagement Letter.
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
�����r���
������
�___ �
,�� _ ,�� �
� _._ �:��.�:,��
� � : ��
* r a� e a ��i '�!��.�
�����'��`���� l�� ���`.����������� �1�����7
TO: Michael C. Van Milligen, City Manager
�R6nli: Randy Peck, i�ersonnel Manager ��
SUBJECT: Preparation of the 509A Certification for the Self-Funded Health Plan
DATE: September 10, 2018
Each year we have an actuarial firm prepare the 509A Certification for our health plan.
For many years we have used Insurance Strategies Consulting. I have obtained quotes
from Insurance Strategies Consulting and Gallagher Benefit Services. The quotes are
as follows:
Insurance Strategies Consulfiing - $975
Gallagher Benefit Services - $3,500
I recommend that we continue using Insurance Strategies Consulting to prepare the
509A Certification for our medical plan. I request that the City Council pass a motion
approving the attached Services Engagement letter.
RP/alk ,
,Ili
� �
� DES MOIi�IES,IA
��+, f��������` ' CHICAGO, IL
� � PORT JEFFERSOf�I,P•IY
'�t+ ST,PATEG(ES CQ,�lSULTI,VG,LLC AUSTII�I,TX
�„..„,,_,._„r� HARTFORD,CT
September 4, 2018
NIr. Randy Pecl< ,
City Nlanagers Office
City Hall
50 `Vest 13t�' Street
DUbllCllle � J2��1
It is time once 1g1in for Insurance Strltegies Consulting, L,L.C. ("ISC") to prepare the 509A
certific�ttion for the sel.f-fimded health plan City of Dubuque(Client"). In order to provide you
with the fin�ncill an�lysis,�ve�vill require some inform�tion from you,
The infonnation that�ve require to perform the above shidy is:
1. Copies of the monthly suinmaries of the costs incurred�nd the income deposited to the
fund, through the end of the plan year. If possible,please include a copy of the plan year-
to-date incolne stateinent.
2. A census of the participants as of the anniversary date, includin�se:c, either the date of
birth or tlle current attained age, anci type of coverlge(single or flmily).
3. A copy of the trial balance for the fiind 1s of the annivers�ry d�tte.
4, Information regarding ne�v contribution rates for the nest plan ye�r. These�re usu111y in
the form of Single,Family,M�le, �nd Female. Please include employer and employee,if
applicable.
5, Informltion reglyding ne�v reinsurance�nd ldministrative rates for the next plan ye�tr.
6. Infonn�tion as to�vho is the reinsurer foc the upcoming plan year. Also include the
infonnation reg�rding the specific and lgmea�te amottnts.
7, Any information regardin;l�rge claims invo(ving reinsurance during the p�st plan year,
8, Any infbrmltion regarding pl�n doctunent changes since the prior year.
�y;�� rei,ndu.,.aieini,rrcr P.O.B�xtioi�3':i �
�= ThIE.ICTU:1(iLSLALLI:ANCE �Ai�s�Des�,Ipinay,IA 502�5
OP�ica:i515�21�-!-1��41
F a;c. .�15,n'1-�-,30�
' sv����x.irsurance-sCrat.com ;
Page 2 of 2
Froin: Carl Harris
Date: September 4, 2018
We�vill obtain the specific claims infoi7nation from your Third Party Administrator in orcier to
calculate the Liability for Claims Incurred but not Reported,
This is a seivices engagement. ISC�vai7•ants that it shall perforin services hereunder in good
faith. ISC disclaims all other wat�lnties, either express or implieci, including, without limitation,
wlrrinties or merchantability and fitness for a particular purpose.
The fee for this seivice for this year will be$975.
It is understood and a�eed thlt ISC's services m1y include ldvice and recominendations,but all
decisions in connection�vith the implementation of such advice and recommendations shall be
the responsibility of, �ncl made by, the Client. In comiection tivith its services hereunder, ISC
shall be entitled to rely on 111 decisions and 1pprovals of the Client,
The Client shall be responsible for fhe performince of its personnel�nd�gents �nd for the
zccuracy and completeness of 111 data 1nd infonnition provided to ISC for purposes of the
performance by ISC of its services hereunder.
The Client agrees that all services hereunder and Deliverables shall be solely for the Client's
infonnition purposes and internal use, and are not intended to be and should not be used by any
person or entity other than the Client. The Client fiirther agrees that such services and
Deliverables shall not be circullted,quoteci,disclosed,or distributed to,nor shall reference to
such services or Deliver�bles be made to,lny person or entity other than the Client.
Not�vithstanding the Foregoing, the Client may make the statement of achtarial opinion and
related report issued by ISC hereunder avail�ble to applicable state authorities solely in
connection with the discharge of their reglil�tory oversight of the Client�nd for no other purpose.
The Client 1b ees thlt ISC and its personne!sh111 not be liable to the Client for any claims,
(ilbilities, oc expenses relating to this en�a�ement for�n lggregate amount in excess of the fees
paid by the Client to ISC pursuant to this engagement, except to the eYtent finally judici111y
determined to have resulted primarily froui the bad flith or intentional misconduct of ISC. In no
event shall ISC or its personnel be liable for consequenti�l, speci�l, indirect, incidental, punitive
or e:cemplary loss,damage or expense relating to this enga;ement.
IFyou have any nuestions regarding this, please call me at(51�) 214-154(. �Ve look Forward to
hearin�from you in the near fittuce.
Best cegards,
�
Carl NI. H�i7-is
CNIH!1s