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Specific and Aggregate Stop-Loss Renewal_Health and Prescription DrugMasterpiece on the Mississippi TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Specific and Aggregate Stop -Loss Renewal - Health and Prescription Drug Insurance Plans DATE: June 14, 2011 The Health Care Committee recommends City Council approval of the renewal rate of $583,147 submitted by HM Life for Specific and Aggregate Stop -Loss Renewal for the City's Health and Prescription Drug Insurance Plans. The cost of this policy is $76,490 higher than the current stop loss premium of $506,657. This policy provides a $5,000,000 annual limit and specific deductible of $100,000. The previous policy had a $2,000,000 annual limit and specific deductible of $90,000. These changes will protect the City in the event of a catastrophic claim. The policy would be effective July 1, 2011. I concur with the recommendation and respectfully request Mayor and City Council approval. MCVM:jh Attachment cc: Barry Lindahl, City Attorney Cindy Steinhauser, Assistant City Manager Randy Peck, Personnel Manager Michael C. Van Milligen Dubuque bitIA 111- Amedcacity III I, 2007 Masterpiece on the Mississippi DATE: June 8, 2011 Dubuque AO- America City 2007 TO: Michael C. Van Milligen, City Manager FROM: Randy Peck, Personnel Manager SUBJECT: Specific and Aggregate Stop -Loss Renewal - Health and Prescription Drug Insurance Plans On June 7, 2011, the Health Care committee met to discuss the specific and aggregate stop loss renewals proposals. The Health Care Committee recommends that we increase the annual limit from $2,000,000 to $5,000,000, in the event of a catastrophic claim. In addition, and in order to reduce the increase in cost, the Health Care Committee recommends that we increase the current specific stop loss amount from $90,000 to $100,000. This year we had seven claims that exceeded the specific stop - loss amount of $90,000. In Fiscal Year 2010, three claims exceeded the specific stop - loss amount and in Fiscal Year 2009, two claims exceeded the specific stop -loss amount. As of May 31, 2011, our stop -loss carrier has reimbursed the City $497,524. Our premium for Fiscal Year 2011 is $506,657. Health Choices, Inc, our health plan administrator, obtained specific and aggregate stop -loss quotes from American National Life of Texas, our current stop -loss carrier, and from six other stop -loss carriers. The other stop -loss carriers are Imperium Insurance Company, HM Life, QBE Insurance, Companion Life, Perico Life and Perico Life - Aggregating. Our current carrier would not provide a quote for a specific stop -loss amount of less than $115,000. In addition, they would require a specific stop -loss amount of between $225,000 to $350,000 for one of the existing large claims. HM Life is the only company that provided a quote for a $5,000,000 annual limit and a specific deductible of $100,000, without requiring a specific stop loss amount for any of the existing large claims. The quote is $583,147. The Health Care Committee recommends that we accept the proposal submitted by HM Life in the amount of $583,147 for a policy that provides a $5,000,000 annual limit and a specific deductible of $100,000. Their quote is $76,490 higher than the current stop loss premium of $506,657. Coverage would go into effect on July 1, 2011. The requested action is for the City Council to pass a motion approving the renewal rate submitted by HM Life effective July 1, 2011 for a policy that provides a $5,000,000 annual limit and specific stop -loss amount of $100,000 for the City's health and prescription drug plan. Health Choices, Inc has obtained a binder to make sure there would not be a lapse in coverage on July 1, 2011. RP:jmh Single Enrollment 117 Contract Maximum Specific $90,000 Deductible $95,000 S ific Deductible $100,000 S ific Deductible $115,000 Specific Deductible $125,000 S�ecific Deductible S P I 1 e �Annual $150,000 Mc Deductible $200,000 S Mc Deductible Family Enrollment 422 Total 539 Stoploss Premium Annual Fixed Costs Attachment Point Stoploss Premium IP Annual Fixed Costs Attachment Point Ip� Stoploss Annual Premium Fixed Costs Attachment Point Stoploss Premium Annual Fixed Costs Attachment Point Stoploss Premium I Annual Fixed Costs Attachment Point Stoploss Premium Fixed Costs Attachment Point Stoptoss Premium I 1 � c Annual Fixed Costs Attachment Point Carrier American National Life of To Incumbent 24/12 $2 Million Lifetime Max $506,657 5635,370 57985 American National Life of To Laser 1 $225k or $350k depending on tx. Renewal 24/12 $2 Million Die, Max $529,090 $657,803 $8,238,661 $500,045 $628,758 $8,054,916 $437,010 $566723 $8,456,291 $310,895 $439,608 $8,569,103 American National Life of Tx Laser. 1 $225k or 03506 depending on ❑. Renewal 24/12 55 Million Annual /Untimit, -.: Lifetime $513,878 $642,591 $8,363,410 $441,020 $569,733 $8,456,291 $314,905 $443,618 $8,569,103 American National Life of Tx Laser 1 E225k 015350k depending on tx. Renewal 24/12 $ 2 Million Annual /Unlirnlr, Lifetime 5517 371 $646,084 58,363,410 0444,513 $573.226 $8,456,291 $318.449 5447 162 $8.569 103 Mast Complet .s Proposal Imperium Insurance Company Laser 1 $250,000 2 $150,000 if chemo starts 3'$200,000 24/12 Unlimited Lifetime Max $621,181 $749,894 $8,875,962 $600,575 $729,288 $8,964,702 $575,685 $704,398 $9,054,358 $518,259 $646,972 $9,507,059 HM Life 24/12 $2 Million Annual /Unlimited Lifetime $635,637 $764,351 $8,370,974 $606,242 $734,955 $8,429,553 $575,398 $704,111 $8,488,183 $431.035 $599,748 $8,739,294 HM Life 24/12 $5 Million Annual /Unlimited Lifetime $643,452 $772,165 $8,370,974 $613,955 $742,668 $8,429,553 $583,147 $711,861 $8,488,183 $438,351 $567,064 $8,739,294 HM Life 24/12 Unlimited Lifetime Max $646,762 $775,476 $8,370,974 $617,367 $746,080 $8,429,553 $586,458 $715,171 $8,488,183 $441,381 $570,094 $8,739,294 OBE Insurance 24/12 $2 Million Annual /Unlimited Lifetime $657 $786,520 $8 $627 $756,010 58,658 $577,590 $706,304 $8,709,945 Non -Compe0tive or Preliminary Proposals 24/12 55 Million Lifetim $775,852 $904,565 $8,156,941 $740,513 $869,226 $8,182,967 $686,280 $814,993 $8,209,160 C2panion Life Penco Life 24/12 $2 Million Annual Max $1,270,660 $1,399,374 $8,266,837 $1,210,095 $1,338,808 $8,339,682 $1,097,637 $1,226,350 $8,415,380 Perico Life-Aggregating Spec 24/12 $2 Million Annual Max $450,000 Aggregate Spec $430,000 Aggregatf Spec $390,000 Aggregat ng Spec $730,080 $858,793 $6,266,837 $693,555 $822,268 $8,339,682 $692,157 $757,871 $8,415,380 PERU Declined to quote - uncompetitive Medical Excess Spectrum OptumHeaoh IISI City of Dubuque Market Search Summa Jhayes Preferred Health Choices, LLC 6/6/11