Preparation of the 509A Certification for the Self-Funded Health Plan 2019 Copyrighted
August 5, 2019
City of Dubuque Consent Items # 25.
ITEM TITLE: Preparation of the 509A Certification for the Self-Funded
Health Plan
SUMMARY: City Manager recommending approval to continue using
Insurance Strategies Consulting to prepare the 509A
Certificationforthe Cityof Dubuque's Self-Funded Health
Plan and approval of the Services Engagement Letter.
SUGGESTED DISPOSITION: Suggested Disposition: Receiveand File;Approve
ATTACHMENTS:
Description Type
Preparation of 509A Certification for the Self-Funded City Manager Memo
Health Plan-MVM Memo
Staff Memo Staff Memo
Services Engagement Letter Supporting Documentation
Dubuque
THE CITY OF �
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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: July 24, 2019
Human Resources 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 for a cost of $975 and approve the Services
Engagement Letter
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
Dubuqu�
TI-�E CITY OF �,,,,,.
All•Aroepl�a City
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TO: Michael C. Van Milligen, City Manager
FROM: Randy Peck, Human Resources Director
SUBJECT: Preparation of the 509A Certification for the elf-Funded Health Plan
DATE: July 24, 2019
Each year we have an actuarial firm prepare the 509A Certification for our health plan.
For many years w� have used Insurance Strategies Consulting. I have obtained quotes
from Insurance Strategies Consulting and Gallagher Benefit Services. The quotes are
as follows:
Insurance Strategies Consulting - $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 atfiached Services Engagement letter.
RP/alk
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� DES MOINES, IA
J����� ��� CHICAGO, IL
r PORTJEFFERSON, NY
• STRATfGJES CONSULTING, LLC AUSTIN,TX
/ ' HARTFORD, CT
June 12, 2019
Mr. Randy Peck
City Mlnager's Office
City Hall
50 West 13��'Street
Dubuque, Io�v� 52001-4864
It is time once ag�in for Insurance Strategies Consulting, L.L,C. ("ISC") to prepare the 509A
certification for the self-fiinded health pl�n City of Duc�ue(Client"), In order to provide you tivith
the financi111nalysis, �ve�vill require some infoi�rnation from you.
The information th�tt�ve reqttire to perform the lbove study is; �
1, Copies of the monthly surrunaries of the costs incttrred and the income depositecl to the
fitnd, through the end of the pl�n year,� If possiUle,ple�se include�copy of the plan year-
to-date income stltement.
2. A census of the particip�nts�s of the annivers�ry date, including sex, either the date of
birth or tlle current�ttained�tge, and type of coverage (single or fainily),
3. A copy of the tri�l balance for the fiind as of the annivers�iy date,
4. Information reg�rding new contribution rates for the next pl�n year. These are usually in
the form of Single, F�nuly; Male, �nd Fem�Ie. I'lease include employer�tnd employee, if
�pplicable,
5. Information regarding ne�v reinsui•ance�nd aciministrltive rltes for the next plan year.
6. Infor�n�tion�s to who is the reinsurer for the upcoming plan year. Also include the .
inform�ition reglyding the specific and aggregate amounts.
7. Ariy information regarding l�rge cl�ims involving reinsurance during the past plan ye�r.
8. Any information c•eg�rding pl�n document ch�nges since the.prior year.
%�� FoundinK,Llemberuf P.O.Box 66039
��' THE ACTUARIAL ALLIANCE Wast Des Nloines,IA 50265
0(fiic2:(5'15)214-1541
- Fax:(515)414-7801 �
www.insurance-strat.com ',
P�ge 2 of 2
� Fro1n: Carl Harris
Date: June 12, 2019 '
We will obtlin the specific claims information from your Third P-arty Administrator in order to -
calculate the Liability for Claims Incurred but not Reported.
This is a seivices.englgement. ISC�varrants th�t it sh�ll perform services hereunder in good
f�ith. ISC discl�ims all other w�nanties, either express or implied,including, without liinitltion,
warranties or merchantability and�tness for a particul�tr puipose,
The fee for tlus service for this year�vill be$975.
It is understood and�greed that ISC's services may include advice and recommendations,but all
decisions in connection with the implementation of such�dvice and recomrnendations sh�ll be
the responsibility of, and mlde by, the Client. In connection with its services hereunder, ISC
sh�ll be entitled to rely on all decisions and approvals of the Client.
The Client shall be responsible for the performance of its personnel�nd agents and for the
accurlcy and completeness of all datl and information provided to ISC for purposes of the
performance by ISC of its services hereunder.
The Client lgrees that all services hereunder 1nd Deliverables sh111 be solely for the Client's
iriform�tion purposes�tnd internll use, and are not intended to be and should not be ttsed by any
person or entity other than the Client. The Client fiirther agrees th�tt such services and
Deliverables sh�ll not be circullted, quoted, disclosed, or distributed to;nor shall reference to
such services or DeliveraUles be made to, 1ny person or entity other than the Client.
Notwithstanding the foregoing, the Client may make the statement of actu�rill opinion�nd
related report issued by ISC hereunder�v�ilable to appliclble state authorities solely in ',
connection with the ciisch�rge of their regul�toiy oversight of the Client and for no other purpose. ,
The Client lgrees th�t ISC�nd its personnel shall not be liable to the Client for�ny claims, II
liabilities, or expenses rel�ting to this engagement for an aggreglte amount in excess of the fees
p�id by the Client to ISC pursuant to this engagement, except to the extent fin�lly judicially �
determined to hlve resulted prim�rily from the b�d flith or intention�l nusconduct of ISC. I�l no �
event sh111 ISC or its personnel be liable for consequentill, special, indirect, incident�l,punitive i
or exemplary loss, dam�ge or expense relating to this engagement. i
If you have�ny questions reg�rding this,please call me at(515) 214-1541. We look for�vard to
�
hearing from you in the near fiitiire. �
Best regards,
Carl M. II�rris
CMH/as