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Medical Plan Administrative Services Fee and Stop Loss Insurance Coverage Renewal 6 17 19 Copyrighted June 17, 2019 City of Dubuque Consent Items # 9. ITEM TITLE: Medical PlanAdministrative Services Fee and Stop Loss Insurance Coverage Renewal SUMMARY: City Manager recommending approval of the Medical Plan Administrative Services Fee and Stop Loss I nsurance Coverage Renewal for the City's health and prescription drug plans with Wellmark effective July 1 , 2019 through June 30, 2020. SUGGESTED DISPOSITION: Suggested Disposition: Receiveand File;Approve ATTACHMENTS: Description Type Medical Plan Administrati� Services Fee Renewal- City Manager Memo MVM Memo Staff Memo Staff Memo Self Funded Final Renewal 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 10, 2019 Human Resources Director Randy Peck recommends City Council approval of the Medical Plan Administrative Services Fee and Stop Loss Insurance Coverage Renewal for the City's health and prescription drug plans with Wellmark effective July 1 , 2019 through June 30, 2020. Based on 550 contracts, the Fiscal Year 2020 Administrative Services Fee will be $309,804. The Fiscal Year 2019 Administrative Services Fee, based on 563 contracts, is $304,628. The annual increase in the administrative services fee for Fiscal Year 2020 is $5,176. I concur with the recommendation and respectfully request Mayor and City Council approval. �� . 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, Human Resources Director �'I�3� �1 T"��' �� , _ _ _._ _ i��m��►qi �� - . . . . �UX:tk1�.(,3.x:� .. �- � .� � - � �# a x � � a ��`��.��. ,.��"d��`� �� 7 TO: Michael C. Van Milligen, City Manager FROM: Randy Peck, Human Resources Director SUBJECT: Medical Plan Administrative Services Fee and Stop Loss Insurance Coverage Renewal DATE: June 5, 2019 Administrative Services Fee Wellmark has presented their Administrative Services Fee renewal that will go into effect on July 1, 2019 through June 30, 2020. The following is a comparison between the Fiscal Year 2019 Administrafiive Services Fee and the proposed Administrative Services Fee for Fiscal Year 2020: Cost Per Month Per Contract ', 7/1/2018 to 6/30/2019 7/1/2019 to 6/30/2020 ' Administrative Fee-Health $35.06 $36.78 ' � Pharmacy Vendor Coordination Fee $2:D0 � $1.75 I Network Access Fee $8.03 $8.41 i Based on 550 contracts, fihe Fiscal Year 2020 Administrative Services Fee will be $309,804. The Fiscal Year 2019 Administrative Services Fee, based on 563 contracts, i is $304,628. The annual increase in the administrative services fee for Fiscal Year 2020 is $5,176. Stop-Loss Insurance Requests for proposals were sent to eight other stop-loss providers. Seven of the eight providers declined to quote stating their rates were not competitive. The only provider to respond was Tokio Marine. Their proposed estimated annual premium is $671,729. Their proposal also included specific annual deductibles over $120,000 for six existing claims. 1 The following is a summary of the current stop-loss rates and the new stop-loss rafies proposed by Wellmark: Cost Per Month Per Contract 7/1/2018 to 6/30/2019 7/1/2019 to 6/30/2020 Individual Stop Loss $82,63 $gg.2� Aggregates Sfiop Loss $2,3g $2,3g Based on 550 contracts, the Fiscal Year 2020 stop-loss insurance cost will be $597,894. The Fiscal Year 2019 stop-loss insurance cost, based on 563 contracts, is $574,328. The annual increase in the stop-loss insurance for Fiscal Year 2020 is $23,566. The specific annual stop-loss amount will remain at $120,000. I recommend thafi Wellmark be selected as the specific and aggregate stop-loss carrier effective July 1, 2019, through June 3, 2020. The requested action is for the City Council to pass a motion approving the proposal submitted by Wellmark effective July 1, 2019 through June 30, 2020 for administrative services fees and specific and aggregate stop-loss insurance for the City's health and prescription drug plans. RP:alk �I i i � I 2 � � _.�'�"� '' � � +�a¢Ilret�r&��ek��r��#srx��r�rr�Jg t Lk�r�a4f l�Clu��rc��sn��,"ahte!#�:(�ebn. O 0 � Group Name: City of Dubuque Account Key: 00005303 Renewal Period: 07/01/2019 to 06/30/2020 � . s .� . OBS#241874-25 /Drugs Excluded 96 Single 24/12 Contract Alliance Select 286 Family Deductible: $0/$0;$250/$750 87 2-Person Coinsurance: 0%/30% Actual Weekly Claims OPM: $800/$2,400;$1,500/$4,500 469 Total Office Visit Copay: $25 Drugs Excluded Estimated Annual Premium Level Fee/Contract Based on Current Enrollment Individua) Stop Loss $120,000 $88.21 $496,446 Aggregate Stop Loss 125% $2.38 $13,395 Administrative Fees-Health w/weekly settlement $36.78 $206,998 Administrative Fees-Pharmacy Vendor Coordination Fee $1.75 $9,849 Consultant Fee $0.00 $0 Total Administrative Fees $129.12 $726,687 Network Access Fee $8.41 $47,331 Sinale Familv 2-Person Annual Projection Expected Claims $639.35 $1,943.62 $1,219.25 $8,679,932 Admin, NAF&Stop Loss Fees 57.00 173.28 108.69 773 833 Estimated $uggested Rates* $696.35 $2,116.90 $1,327.94 $9,453,765 Attachment Points $799.19 $2,429.54 $1,524.06 $10,849,967 Admin, NAF&Stop Loss Fees 57.00 173.28 108.69 773 833 Estimated Max Liability to Fund* $856.19 $2,602.82 $1,632,75 $11,623,800 *Actual results may vary. Also,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 maximum of unlimited. Aggregate Stop Loss includes coverage for Health and Drug.The maximum Aggregate reimbursement is unlimited. Employer Signature: Date: Comments: v41655 Independent Licensee of the Blue Cross and Blue Shield Association Proposal Date:4/5/2019 �� _ � �� •; ' � � �i�r�:�r�c�a��,a��.��ro��t : Lbr�r�nf It��4u��ez��ic��h;ak!�:[ak�n, • • ' Group Name:. City of Dubuque AccountKey: 00005303 Renewal Period: 07/01/2019 fo 06/30/2020 Consultant fee,if applicable,is an amount determined by the consultant and employer,and included here for the convenlence of the employer to understand the total cost of services from Wellmark and the consultant. The consultant fee will be involced by Wellmark pursuant to agreement between Wellmark,Employer and Consultant ' Wellmark is not providing any lega/orprofessional advice with regard to comp/iance of any federal or state law,regulations,or guidance.Law, regulations and guidance on specific provisions has been and will continue to be provided by the appropriate federal and sEate agencies and regulators. The information provided reflects Wellmark's understanding of the most current information and is subject to change without further notice. Please note that plan benefits,rates,renewal rate adjustments,and rating impact calculations are subject to change and may be revised during a plan's rating period based on guidance and regulations issued by the appropriate federal and state agencies and regulators. Wellmark makes no representation as to the impact of plan changes on a plan's grandfathered status or interpretation or implementatlon of any other provisions of law or regulation. Wellmark will not determine whether coverage is discriminatory or otherwise in violation of Internal Revenue Code Section 105(h). Wellmark a/so will not provide any testing for compliance with Internal Revenue Code Section 105(h). Wellmark wi/l not be he/d liable for any penalties or other losses resulting from any employer offering coverage in violation of section 105(h). Wellmark will not determine whether any change In an Employer Administered Funding Arrangement affects a health plan's grandfathered health plan status under ACA or otherwise complies with ACA. Wellmark will not be held liable for any penalties or other losses resulting from any EmployerAdministered Funding Arrangement.For purposes of this paragraph,an"Employer Administered Funding Arrangement"is an arrangement administered by an employer in which the employer contributes toward the member's share of benefit costs(such as the member's deductible, coinsurance,or copayments)in the absence of whlch the member would be financially responsible.An EmployerAdministrative Funding Arrangement does not include the employer's contribution to health insurance premiums or rates. The subrogation recovery vendor(s)retain a service fee calculated as a percentage of the recovered amount after deductions for attorneys' fees and costs.For subrogation cases initiated prior to July 1,2016,the subrogation recovery vendor's service fee is 12%%of the recovered amount.For subrogation cases initiated on or after July 1,2016,the subrogation recovery vendor's service fee Is 19.5%of the recovered amount. This fee is subject to change. The final recovered amount received from the vendor is credited to Account. Wellmark's agreement with the subrogation recovery vendor may from time to time allow for the application of no vendor service fees to amounts recovered during that period of time.Any subrogation recovery amount obtained by the vendor on behalf of the Account during that time period will be provided fo Account without application of the vendor servlce fee. v41655 Independent Licensee of the Blue Cross and Blue Shield Association Proposal Date:4/5/2019 � �� .�� , , � � 1�l1R�YsrS��t��.'hrkJ S�J��t'��rb IYi�q '-k I:l�t�i�#ft lh9'�IU��.'P��ii�I(�9�hE94il 4�.t�tBC�ti. • • A Group Name: City of Dubuque Account Key: 00005303 Renewal Period: 07/01/2019 to 06/30/2020 - 0 e . oo . OBS#241874-26 /Drugs Excluded 17 Single 24/12 Contract Alliance Select 50 Family Deductible: $0/$0;$250/$750 14 2-Person Coinsurance: 0%/30% . Actual Weekly Claims OPM: $400/$1,200;$750/$2,250 81 Total Office Visit Copay: $15 Drugs Excluded I I � I Estimated Annual Premium Level Fee/Confract Based on Current Enrollment Individual Stop Loss $120,000 $88,21 $85,740 Aggregate Stop Loss 125% $2,38 $2,313 I Administrative Fees-Health w/weekly settlement $36,78 $35,750 Administrative Fees-Pharmacy Vendor Coordination �'ee $1,75 $1,701 Consultant Fee $Q.00 $0 Total Administrative Fees $129.12 $125,505 NetworkAccess Fee $8,41 $8,175 Sin le Familv 2-Person Annual Projection Expected Claims $649.86 $1,975.57 $1,239.28 $1,526,113 Admin, NAF&Stop Loss Fees 57.00 173.28 108.70 133 857 Estimated Suggested Rates* $706.86 $2,148.85 $1,347.98 $1,659,970 Attachment Points $812.33 $2,469.48 $1,549.11 $1,907,654 Admin, NAF&Stop Loss Fees 57.00 173.28 108.70 133 857 Estimated Max Liability to Fund* $869,33 $2,642.76 $1,657.81 $2,041,511 "Actual results may vary. Also,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 maximum of unlimited. Aggregate Stop Loss includes coverage for Health and Drug.The maximum Aggregate reimbursement is unlimited. Employer Signature: Date: Comments: v41655 Independent Licensee of the Blue Cross and Blue Shield Association Proposal Date:4/5/2019 �� i � �"�� [ � � , . �Ihr��r°��lt��t�.��i�#3�+�at`�'��r�Ir�;l��+�k Li�r�zt�i I�i�ku��r�sa��{�Sh!'eH��s�taC�n. , � � A Group Name: City of Dubuque ' Account Key: 00005303 ' Renewa!Period: 07/01/2019 to 06/30/2020 Consultant fee,if applicable,is an amount determined by the consultant and employer,and included here for the convenience of the employer ', to understand the total cost of services from Wellmark and the consultant. The consultant fee will be invoiced by Wellmark pursuant to , agreement between Wellmark,Employer and Consultant. ' Wellrnark is not providing any legal or professional advice with regard to compliance of any federal or state law, regulations,or guidance. Law, regulations and guidance on specific provisions has been and wlll continue to be provided by the appropriate federal and state agencies and , regulators. The information provided reflects Wellmark's understanding of the most current information and!s subject to change without further notice. P/ease note that plan benefits,rates,renewal rate adjustments, and rating impact calculations are subject to change and may be revised during a plan's rating period based on guidance and regulations issued by fhe appropriate federal and state agencies and regulators. Wellmark makes no representation as to the impact of plan changes on a plan's grandfathered status or interpretat(on or implementafion of any other provisions of law or regulation. Wellmark will not determine whether coverage is discriminatory or otherwise in violation of lnternal Revenue Code Section 105(h). Wellmark also will not provide any testing for compliance with lnternal Revenue Code Section 105(h). Wellmark will not be held liable for any penalties or other losses resulting from any employer offering coverage in violation of section 105(h). Wellmark will not determine whether any change in an • Employer Administered Funding Arrangement affects a health plan's grandfathered health plan status underACA or otherwise complies wifh ACA. Wellmark will not be held liable for any penalties or other losses resulting from any EmployerAdministered Funding Arrangement.For purposes of this paragraph,an"Employer Administered Funding ArrangemenY'is an arrangement adminlstered by an employer in which the employer contributes toward the member's share of benefit costs(such as the member's deductible,coinsurance,or copayments)in the absence of which the member would be financially responsible.An Employer Adminisfrafive Funding Arrangement does not Include the employer's contribution to health insurance premiums or rates. The subrogation recovery vendor(s)retain a service fee calculated as a percentage of the recovered amount after deductions for attorneys' 1 fees and costs.For subrogation cases initiated prior to July 1,2016,the subrogation recovery vendor's service fee is 12%%of fhe recovered amount.For subrogation cases initiated on or aiter July 1, 2016,the subrogation recovery vendor's service fee is 19.5%of the recovered amount. This fee is subject to change. The final recovered amount received from the vendor is credited to Account. Wellmark's agreement with the subrogation recovery vendor may from time to time allow for the application of no vendor service fees to amounts recovered during that period of time.Any subrogation recovery amount obtained by the vendor on behalf of the Account during that time period will be provided to Account without application of the vendor service fee. v41655 Independent Licensee of the Blue Cross and Blue Shield Association Proposal Date:4/5/2019 � .� � � M,�,� . � � We11m&rk�fue Crbss�nd 131u�S}ileid is an ind�pand�nt L(cens�e at tha 8tup GPoss�nti @tue Shteicl As�nci�tinn. i o o " e � o ', Wellmark Blue Cross and Blue Shield receives rebate payments from its pharmacy benefits manager for certain prescription drug � claims of your plan members. The entire rebate amount received by Wellmark that is attributable to your health or prescription drug I benefit plan will be paid to your group. Payments of drug rebates will be set forth in more detail in your administrative services agreement. + a s e r o :• Welimark Blue Cross and Blue Shield requires each employer to contribute 100%of the single rate or 50%of the total premium toward their employees'health care costs, � . 4 . . � � : Wellmark Blue Cross and Biue Shieid reserves the right to re-evaluate rates if enrollment fluctuates more than 10%from the enrollment assumptions. For information on change of monthly administrative fees or other fees and stop loss premiums notification, please see your administrative services agreement or stop loss policy. e . . . +e . -o o e an All quotations are subject to change based on updated claims experience, health conditions,or rate information received prior to the effective date. � a � A A ^i 0 " p Wellmark Blue Cross and Blue Shield uses an experience rated methodology in determining the rates for your group. The rates are based primarily on prlor claims experience of your group,or, if your group's relevant experience is not available, prior experience of groups of similar demographics. This experience will assist in indicating the providers your group's covered members are likely to use and the amount of claims expected to be incurred. This information is adjusted to reflect changes expected to occur for your group's contract period. The rates for your group reflect the provider contracts in place or anticipated to be in place for the new contract period. Your group's finanical agreement allows for payment of your group's claims on a monthly basis up to maximums set forth in your financial agreement. The actual amount your group will be charged for claims and the amount of savings your group will receive will be � calculated on a claim-by-claim basis during the contract period. Your charges and savings will be based on the payment arrangements i Wellmark has in effect with the provider at the time a covered member receives services. Payment arrangements may change, therefore,claims payment and savings amount are subject to change during the contract period. For further information on how provider savings are calculated, please see your administrative services agreement or stop loss policy. « . . . d p • . Wellmark Blue Cross and Blue Shield recommends at least 75% participation of the eligible employees without other creditable coverage enroll in a Wellmark Blue Cross and Blue Shield health and/or dental plan. Upon renewal,Wellmark Blue Cross and Blue Shield will require at least 75% participation of the eligible employees without other creditable coverage to be enrolled in a Wellmark Blue Cross and Blue Shield health and/or dental plan. .� � � � , , � Wellmark is not providing any legal or professional advice with regard to compliance of any federal or state law,regulations, or guidance. Law, regulations and guidance on specific provisions has been and will continue to be provided by the appropriate federal and state agencies and regulators. The information provided reflects Wellmark's understanding of the most current information and is subject to change without further notice. Please note that plan benefits,rates,renewal rate adjustments, and rating impact calculations are subject to change and may be revised during a plan's rating period based on guidance and regulations Issued by the appropriate federal and state agencies and regulators. Wellmark makes no representation as to the impact of plan changes on a plan's grandfathered status or interpretafion or implementation of any other provisions of law or regulation. �� .� �. � , � �� W�allrnprk E31u�Crass and Rlue Shleid Is an Ine3epenctant Lic�ns��of tl��Blu�Cross and qlu�5hiei�t fissnc]�tir�ri. . o a a " � � Wellmark will not determine whether coverage is discriminatory or otherwise in violation of Internal Revenue Code Section 105(h). ' Wellmark a/so will not provide any testing for comp/iance wifh Internal Revenue Code Section 105(h). We//mark will not be held liable ', for any penalties or other/osses resulting from any employer offering coverage in violation of section 105(h). Wellmark will not determine whether any change in an Employer Administered Funding Arrangement affects a health plan's grandfathered health plan ; status under ACA or otherwise complies with ACA. Wellmark will not be held liable for any pen�lties or other/osses resulting from any Employer Administered Funding Arrangement. For purposes of this paragraph,an "Employer Administered Funding ArrangemenP'is an arrangement adminisfered by an employer in which the employer contributes toward the member's share of beneflf costs(such as fhe member's deductible, coinsurance, or copayments)in the absence of which the member would be financially responsible.An Employer � Administrative Funding Arrangement does not include the employer's contribution to health insurance premiums or rates. Required Federal Accessibility and We"marko �.� � Nondiscriminafiion Notice � � � . � � Discrimination is against the law Wellmark complies with applicable federal civil rights laws and if you believe that Wellmark has failed to provide these services or does not discriminate on the basis of race, color, national origin, discriminated in another way on the basis of race,color, national age, disability or sex, Wellmark does not exclude people or treat origin,age,disability or sex,you can file a grievance with:Wellmark them differently because of their race, color, national origin, age, Civil Rights Coordinator, 1331 Grand Avenue, Station 5W189, disability or sex. Des Moines, IA 50309-2901,515-376-4500,TTY 888-781-4262, Fax 515-376-9073, Email CRCCcr�Wellmark.com.You can file a Wellmark provides: grievance in person, by mail, fax or email. If you need help filing • Free aids and services to people with disabilities so they may a grievance, the Wellmark Civil Rights Coordinator is available to communicate effectively with us, such as: help you.You can also file a civil rights complaint with the U.S. Department of Health and Human Services Office for Civil Rights • Qualified sign language interpreters electronically through the Office for Civil Rights Complaint Portal • Written information in other formats(large print, audio, available at https://ocrportal.hhs.aov/ocr/portal/lobb,xjsf, or by mail, accessible electronic formats, other formats) phone or fax at: U.S. Department of Health and Human Services, • Free language services to people whose primary language is 200 Independence Avenue S.W., Room 509F, HHH Building, not English, such as: Washington DC 20201,800-368-1019, 800-537-7697(TDD). • Qualified interpreters Complaint forms are available at http://www.hhs.gov/ocr/office/file/ • Information written in other languages index.html. If you need these services, call 800-524-9242. ATENC16N:Si habla espar�ol,los servicios de asistencia de idiomas Geb Acht:Wann du Deitsch schwetze duscht,kannscht du Hilf in del se encuentran disponlbles gratuitamente para usted.Comun(quese eegnl Schprooch koschdefrei griege.Ruf 800-524-9242 odder(TTY: al 800-524-9242 o al(TTY:888-781-4262). 888-781-4262)uff. i��: �n�1�i3��i�i�'� 7�'v'll�'"JT'+�/Y/'�1,;TlEIi}LRRt��0 1��Y'L�J T1)541V15�1J:L9'1f1N�flbl^,{Gl'�VIfJ l5'l�llifl'15'If�UlN�a41'1L6f1'll�'1c�1LP5LN�fliTG1£J�IBJ 800-524-9242�'c (pfr��'�'��: 888-781-4262), ��`l�io�u�i�ma 800-524-9242 Nsa(TTY;888-781-4262) CHU f:N�u quy vj nbi ti�ng Vigt,c�c d�ch vu h6 trp ngon ngCv mi�n phf cb PAG-UKULAN NG PANSIN:Kung Tagalog ang wikang ginagamit mo, s�n cho quy vj.Xin h�y li@n h�800-524-9242 hoac(TTY:888-781-4262). may makukuha kang mga serbisyong tulong sa wika na walang bayad. Makipag-ugnayan sa 800-524-9242 0(TTY:888-781-4262). 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T�!�I4. FUULEFFANNAA:Yo Isln Oromiffaa,kan dubbattan taatan,tajaajiloonni �'�'�:ar+rc aTr�'�rar�'�',��r��'`�rr t�7�'�r�',f�:�� gargaarsa afaanii,kaffaltii malee,isiniif ni jiru.800-524-9242 yookin(TTY: �€r�I 800-524-9242 Tr��rr(TTY:888-781-4262)I 888-781-4262)quunnamaa. ATTENTION:si vous parlez fran�als,des services d'assistance YBA�AI SII(LI�O BVI p03MOB11S1ET0 yKp81HCbK010 MOBOtO,,qnA eac AocrynHi dans votre langue sont�votre disposition gratuitement.Appelez le 6eai<owrosHi nocnyrv�MosHoY niqTp�MK�n.3arenec�oHy�nre aa HOMeponn 800 524 9242(ou la IfgneATS au 888 781 4262). 800-524-9242 a6o(TeneraNn:888-781-4262). Ge': Dine k'ehji yanifti'go nika bizaad bee aka'adoowo�,t'aa jiik'e, naholQ, Koj�'holne'800-524-9242 doodaii'(TTY:888-781-4262) Wellmark Blue Cross and Blue Shield of lowa,Wellmark Health Plan of lowa,Inc„Wellmark Synergy Health,Inc.,Wellmark Value Health Plan,Inc. and Wellmark Blue Cross and Blue Shleld of South Dakota are Independent Ilcensees of the Blue Cross and Blue Shleld Association. M-2318376 08/16 A