Stop Loss Insurance RenewalTHE CITY OF
DUB E
~-~-~
MEMORANDUM
June 12, 2007
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Specific and Aggregate Stop Loss Insurance Renewal -Health and
Prescription Drug Plans
Personnel Manager Randy Peck recommends that we continue with HCC Life
Insurance Company (formerly known as Allianz) as the stop-loss carrier for the City's
health plans for individual and aggregate stop-loss insurance, with a premium in the
amount of $463,484.92 effective July 1, 2007. This is a 9.5% increase in premium from
the previous year.
One of our plan members may have to undergo a bone marrow transplant. As a
contingency of the renewal, if the transplant is necessary, it must be performed at a
facility that participates in the transplant network. The contracted facilities or centers of
Excellence in the Midwest area are the University of Minnesota, Mayo Clinic, University
of Wisconsin-Madison, Froedert Hospital-Milwaukee and Nebraska Medical Center. If
the City did not agree to this contingency, the premium would increase by an additional
$200,000.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
''l
~~ ~ ~~~
Michael C. Van Milligen
MCVM/jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Randy Peck, Personnel Manager
THE CITY OF
DUB E
~~
Memorandum
June 8, 2007
TO: Michael C. Van Milligen
City Manager
FROM: Randy Peck
Personnel Manager
SUBJECT: Specific and Aggregate Stop Loss Insurance Renewal -Health and
Prescription Drug Plans
Health Choices, our health plan administrator, obtained specific and aggregate stop loss
quotes from Allianz, which is now HCC Life Insurance Company, our current stop loss
carrier, and from two other insurance companies.
The following is a summary of the quotes.
• HCC Life Insurance Company - $463,484.92
• American National Insurance Company - $640,200.00
• HM Insurance Group - $589,622.00
Sun Life was asked to provide a quote, but declined. HCC Life Insurance Company
presented the most competitive quote. Their quote $463,484.52. All of the quotes were
based on a specific stop loss of $85,000, which is our current specific stop loss amount.
The quote submitted by HCC Life Insurance Company represents an increase in the
premium of $40,352.16 or a 9.5% increase.
The quote from HCC Life Insurance Company has a contingency. One of our plan
members may have to undergo a bone marrow transplant. If the transplant is
necessary, it must be performed at a facility that participates in the transplant network.
The contracted facilities or Centers of Excellence in the Midwest area are the University
of Minnesota, Mayo Clinic, University of Wisconsin-Madison, Froedert Hospital-
Milwaukee and Nebraska Medical Center. The transplant network is a national network.
If we do not agree to the contingency, the premium would increase by an additional
$200,000. If we were to approve this option, our plan administrator would be able to
refer the plan member who may need the bone marrow transplant to a facility such as
the University of Iowa and the cost, which is estimated at $300,000, would be covered
by the stop loss policy.
The Health Care Committee recommends that we continue with HCC Life Insurance
Company as our stop loss carrier. They also recommend that we maintain the specific
stop loss amount at $85,000, and agree to the contingency proposed by HCC Life
Insurance Company, which would mean that if the bone marrow transplant is needed, it
would have to be performed at a facility that participates in the transplant network. Bill
Robinson of Gallagher Benefit Services, our actuarial and benefit consultant, has
reviewed the quotes and concurs with the recommendation. Sufficient funds are
available in the health insurance reserve to finance this recommendation. Coverage
would go into effect on July 1, 2007.
The requested action is for the City Council to pass a motion approving the renewal
rates submitted by HCC Life Insurance Company effective July 1, 2007 for specific and
aggregate stop loss insurance for the City's health and prescription drug plan, as
recommended by the Health Care Committee.
If you have any questions, please feel free to call.
RP:tlb
cc: Health Care Committee
City of Dubuque
Cost Analysis
Reinsurance Renewal
2007
Prepared by:
(HEALTH CHOICES
C~iy of i?utni:~iae
larke€ Search S~tlnrvtarY
Sinpb F1tsollmeM 121
t?aml EnroNmsnt 387 165,0110
Deduetlhla 5110.000
Dedueflble i~,~
- Dedtrctlble ~•~
Wtth 585 000 Deducllbb
Carder Contract rLlatdmum Amwl Flied Costs AtUchmerrt Po1M A+tnual Flxad Goets AttaciNrrenl Pohrt Annwl Flied Costs Attachment PoHrt Arrnusl Pbted Costs Attachment Point'
HCC LMe Cum9M PaW 11 000 000 23132 391 569
HCC Llfs Ineunnce
Com Renewal
Paid
11,000,000
5463,485
56,177,049
5449,279
56,219,246
5428,249
16,260,382
5340,504
56,177,049
Amsrir:an Natbnal
MsunnuCom
24112
11,000,000
1640,200
16,204,537
5606,709
16,223,279
1576149
16.241,929
WA
WA
HM Inwrarres Grou 24/12 11 000,000 9 622 17 15 499 1559,742 57,247,669 5532 288 57 277 227 f0 50
gun Life Declined -Rates are rwt OtNe
AI t7rras an ub/ecf fo Mal undevwridnp
A,Yrumum AdarJrmem Point k d. ps4etsrminsd oval a aop~loss carrier •el provitls segregate coveryp for poop U~M have a rsductlon in srcdlmeM. TM peeler d the Minimum Aeprepate Attarlxnem Point or da ecwal amud appepate
(based on sciud montldy counts muhiPliad by the epgroeats laga) must be mN belors meakd claims becans payabb under die apgreeata covarpe.
I:unlayi~
~.allnrgb
City of Dubuque.
HCC Life Annual Cost Illustration
July 7, 2007
Current Renewal Renewal Renewal
}'r. .~ ` °_`I HCC Life
Sin le Enrollment 1 1' $85,000 $85;000 $9D,000 - $95;000
Famil Enrollment .387 S ....CiflC Deductible S ciflc Deductible $ eafic Deductible ~ cifie Deductible
F,Ixe #~(3.0 . _ f,
Specific Coverage
(Paid Contract Inc/udaa MadkaL S1 MI°kn LTMJ Pald
Sin le Premium 528.13 $40;845 $33.77 $49;034 $32.58. $47,306 $30:.87 $44,823
Famif Premium $78.42 $364;1•$7 $84.86' $394,090 $82.16 $381,551 $78.14`: $362 882.
Aggregate Coverage
(1Gf 2 conbct Incfudas MedkaL Rx Otvp Card, fi M°Ibn LTMJ
Com osite Premium $2.97 $18,105 $3.34 $20,361 $3.35 $20;422 $3.37 $20,544
A re ate Accommodation $0.00 $0 $0.00 $0 $0.00 $0 $0.00 $0
Terminal Liabilit $0.00 $0 $0.00 $0 $0.00 $0 $0.00 $0
Subtotal Sto Loss Premium $423,132.36 $463, 484.52 $449,278.80 $428 248.92
Administration Fees
TPA Fee .$17.59 . $107,229 $17.59 $107,229- $17.59' $1U7,229 . ' $4:7:59: $107,229
Utilization Review Fee $0.00 $0 $O.OU' $0 $0:00 $~' $0.00 ' $0'
PPO Access Fee $0.00 $0 $0.00- $0 $O.OU $f3 . 50.00: $0
A ent Fee $0.00 $0 $0,00 $.0 $0:00 $0 $0:00' $0
Total Sin le Fixed Cost $48 .69 $,54 .70 $53 .52 $51 .83
Total Famil Fixed Cost $98:98 $1;0 5.79- $1.03.:10 $99 .10
Total Annual Fixed Costs $530,361 $570 ,713 $556,507 $535,478
Chan a Over Prior Year 8% 5°k 1°k
A">.'..
Sin le Factor
$464.55 $674,527
$488.04 5710,086
$492.4$ $71'5 037
95,77 ' $718 858
Famil Month! Factor $1,231.06 $5 717,043 $1,177.21 $5,466,963 $1 185.23 $5 504 208. 493.U5 $5,540 524
Aggregate Attachment Point $6,391,569 $6,177,049 $6,219,246 $6,260,382
Chan a Over Prior Year -3% -3% -2%
Ex ected Attachment Point less 25% corridor $5,113 255 $4,941 639 $4,975 396 $5,008,306
Maximum Liabilit $6,921,930 $6,747,762 $6,775,753 $6,795,860
Ex ected Liabilit $5,643,616 $5,512,353 $5,531,904 $5,543,783
Contingencies: If member has a bone marrow transplant, City must agree to have the transplant done at a facility that is contracted through the transplant network.
contracted: Universit of Minnesota, Ma o Clinic, Universi of Wisconsin Madison, Froedert Hos ital-Milwaukee, Nebraska.Medical Center
If Cit does not a ree to contin enc listed above the remium will increase b $200,000
$85,000 Aggregating Specific-
splitfunding
Renewal
Deductible
$348,504.12
$17.59 $107,229
$0.00 $0
$0.00 $0
$0.00 $0
$45.94
$83.77
$455,733
-14%
An,
$489:04 $710,086
$1,177.21 $5,466,963
$6,177,049
-3%
$4,941,639
.fi ~ ,': t~
~. $6,632,782
$5,397,372
Following facilities are
5!29!07
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City of Dubuque
July- June 200012001 2001/2002 2002!2003 2003/2004 2004/2005 2006/2006 2006/2007
April
Total Medical Claims $ 2,568,296.83 $ 2,823,760.38 $ 3,370,239.13 $ 3,564,430.72 $ 4,203,764.19 $ 3,503,538.40 $ 3,062,233.09
Total Rx Claims $ 533,452.74 $ 650,830.70 $ 693,010.04 $ 868,650.04 $ 888,027.28 $ 919,600.31 $ 833,064.09
Total Dental Claims $ 149,493.27 $ 172,217.08 $ 177,929.72 $ 68,007.78 $ 25 066.50 $ 2,997.60 $ -
TotalClaimsCost $ 3,251,242.84 $ 3,646,808.16 $ 4,241,178.89 $ 4,501,088.54 $ 5,116,857.97 $ 4,426,136.31 $ 3,895,297.18
Reinsurance $ 170,354.64 $ 198,397.08 $ 240,374.37 $ 289,913.75 $ 332,780.59 $ 376,176.05 $ 355,087.81
Heatlh Choices Admin $ 93,130.05 $ 95,241.44 $ 103,614.05 $ 102,211.32 $ 104,676.00 $ 101,409.00 $ 92,209.90
Less Reinsurance Reimbursement $ 55,133.41 $ 3,155.38 $ 121,441.60 $ 246,759.98 $ 164,270.03 $ 86,179.92 $ 218,989.22
Total Cost $ 3,459,594.12 $ 3,937,291.30 $ 4,463,725.71 $ 4,646,453.63.. $ 5,390,044.53 $ 4,817,541.44 $ 4,123,605.67
%Change 13.81% 13.37% 4.09% 16.00% -10.62% -14.40%
City of Dubuque
July- June 2000/2001 2001/2002 2002/Z003 2003/2004 2004/2005 2005/2006 2006/2007
April.
Employees 529 541 535 533 528 519 508
Total Medical Claims $ 4,855.77 $ 5,221.93 $ 6,300.49 $ 6,687.49 $ 7,962.93 $ 6,747.31 $ 6,025.65
Total RxClaims $ 1,008.58 $ 1,203.57 $ 1,295.55 $ 1,629.74 $ 1,682.14 $ .1,771.02 $ 1,639.24
Total Dental Claims $ 282.64 $ 318.48 $ 332.63 $ 127.59 $ 47.48 $ 5.77 $ -
Total Claims Cost $ 6,146.99 $ 6,743.98 $ 7,928.67 $ 8,444.82 $ 9,692.55 $ 8,524.09 $ 7,664.89
Reinsurance $ 322.08 $ 366.89 $ 449.37 $ 543.93 $ 630.37 $ 724.46 $ 698.72
Heatlh Choices Admin $ 176.08 $ 176.13 $ 193.70 $ 191.77 $ 198.28 $ 195.30 $ 181.44
Less Reinsurance Reimbursement $ 104.24 $ 5.84 $ 227.03 $ 462.96 $ 311.17 $ 165.97 $ 430.91
Total Cost $ 6,540.91 $ 7,281.17 $ 8,344.71 $ 8,717.55 $ 10,210.03 $ 9,277 88 $ 8,114 14
%Change 11.32% 14.61% 4.47% 17.12% -9.13% -12.54%
Loss Ratio (Stop-Loss) 32.36% 1.59% 50.52% 85.11% 49.36% 22.91% 61.67%
Grand Total Loss Ratio (Stop-Loss} 45.64%
.. .
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''~~ ~ City of Dubuque Claims Paid ~~' ~ ~ ,' City of Dubuque Claims Paid
~~tiw~.. r ~ ~' a, ~~
~',b July 2006-Apri12007 ,, July 2005-June 2006
~~ ~ ?~ ,~:;,; r r'° Dental $2,998 ~'"A M
~. ~ A~
t ,'~~ ~.
r '„ Poc $833,064 AN, ~ ~~
~ ~~'~~" 21.4% "~'~~ ~{'?~, ^ Dental ~~~' ~.~'~,
hr~ ~~ ^Medical ~~,~~~~~~~ ~~-~:~ ~ '~ ~ ~
nt~.. ~'.'~ Poc $919 600 "
,~,~~ ~' 'r~~ ®Medical /,
20.8% ^
~ Medical ^ RX ~ ~,, ,A'~"~~`r Medical ^ ~ _~'~4:
~;~ , .", $3,062,233 ,~"~` ;, $3,503,538 ~~ "~~'
~,"~''~ ~ 78.6% ~,~ ~>~~ 79.2% t''~±~"'A
i K, ^~..t I ~,+ ~r.~y~r
,Y 7F e.. ~` t,t.. ~,~.~'1i .'3'w
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~r, ~..,~~ t: ;.;'f ,~ ~„~ ~~,~~;,;~~•.7R *. ~# Cityof Dubuque Claims Paid ~~, , f-, q`~ :~Y~r;~~,,, ~°,
~~ .~•~ ~~~~~',~~~. ;.~'s~'~f Ju1y2004)une 2005 :~•'.t'~ ~~~ '~t~.~ w ~~ ',;
',r~ ~"{"e7~,`~ ~r, ~; ..afi~ ~~ '.~. ~~ -,s y~. is ' ,~ ~ ~i ''
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~* '~~'- ~p "y ' ~,x_ n. '^ 25,067 0.5% ~~ ~ ~r~,f ~ ~`'~~ i
'~'~^b .CAA bI~ 'f .~,1/~,F 1~'~C $ ~ ~!e!. {. ~.y 'd' F. 4. ,~y~,., Y/#y
' ~1^ a+~1'~ 4ry4.~t'~ ~ ,y~~, _..~:~f,, + ~'0~~ ,,~ - ,.q~~,.~ll r -P!•ti'~ ~'~!'~
~~1 ,~~,y, ~ ~' ^ Dental ~:., ~ `~~ ~' ~~
. ~~~ ' of A 1
i'~p'~ ~,d~A.,.M ' .~ ~,~~ ~C $888,027 •:r ~' .r~ ~ °~, `F '.r ''~a
.. ~ '~ A ~ 17.4 /° k ~• ,w~"i~ 4d` ,
~~;~~~~,, ,+,.~i, _~~r~, ~.,,~~ b_ ^Medical ~T .~ - ~,y ~ ~ - ~~~
~ ,- , ?~ +~c`'^Y,i~ ~i#i' 3'',+1r~~r~Al{r~'~~"«,~4?~'' J~~,~~,+,i,a- +r~rr'E
/~" `I...r ,~C,}~Y. ~"~?.~~ "~ ~ 4.'F.x,[~"~F+,b'~r"A '~ r'rr;~' ,>*~!,,6„ My `I"l~aR~ ~-, S#`^~-~ ~i,
'~+'''`~{4~~~~S~F .~~,~~~~:tt'1~ ' ~ ,~~~~~~ `*i~~lR'~, ' Medical ^ ~ ~ ~ y x , -~E.~Rt13+~t~r b«;'~~~"k +~y >~~
,~iy ~~,~,~s."`~ ', `~" ~ . , a,- $4,203,764 ~' * ~ I _ t'". 'T`
~ ~ ~ ' r 82.2 /° ,~ 4 ~ ~, -'
• ~N~ ,~ `a ` o 1..
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p_ ~ ~:
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~~:-, ~ `~~~` 1$".~-:~'M" ,'`.,~,~~.~~~~ _ .i~~~'.'IC..,{"`y.=f.-r ;%.el- _-~ 5'~NM .~j"•.`.' .+.'M''',...M_~~~+.~~i Ft`~ir'~I'.~~"';~,Ic+i~4 ,.'S,~7. w!1"_~. 3Y~A''.~-,4'1:~ ~ ~y' ~t;~ r"w'!:...:?~
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~~ ~~ ~ [
~, ~ City of Dubuque Total Plan Savings
r ~ •~;
r July 2006-April 2007
~'~,~} ~~" Plan Design Total Charges $6,212,120
$'^,«"? . Reductions
.,.:~ ...
.~.~. $1,010,559
~+ ~ ,~ 16.3%
~'~ ~~;
~ '~!'
~°~~'~ HC Contract
~": ; Reductions Total Paid
~~ .~ $1,306,264 Claims
~'~~'~ ."
,
~ 21.0% $3,895,297
_~'A~~~
t
,,
62.7%
~°
'
~°
.*
;.a
r
Total Paid
Claims
^ HC Contract
Reductions
^ Plan Design
Reductions
9 t `E. "~. I.~. 'K' ~. f.
..~~'Tom?.+,~.,~s~`~-..~~'~::~~~',;
~ ; if~ .~. ~, ~ ,. ,. ~r~,.~~ "~ ~ r ~~ ..~,;JS-~?~'.,.S.~Cf'Y;'k~a ~S.4.f,~`7 ,.7.~y~,R-,
' ~~`'~ k Cityof Dubuque Total Plan Savings
~j ~ -~-
~,~ ~ July 2005-June 2006
~~~ ~}~,.~,~i Plan Design Total Charges $6,617,516
~'~'~~ ''~~~'~ ~' Reductions
`~'~~ $938,600
~~~
,~~'^.n 14.2%
°~ • l
~~ HC Contract
~\ ~"~ Reductions Total Paid
$1,252,780 Claims
18.9% $4,426,136
+~+" 66.9%
~~ r~w'+}~} 4 ~} ~1' r ~ ro fir. , y~''~ L1 "~ ' ~ ;~R , '~+,`r'' `"~ .,y. 4:".~`ri~'~" ~~;`~ ~ ',~ {~,.~ •-°~w
~ '-t~`;.e~ ' f`:~ "y ~,"± s,,. ~'~t°~°~'+ 4~~{~~J~t '~ ~ ~}~ City of Dubuque Total Plan Savings
~gg' •~:~~`~•<y ~~~~ ~~~~ ~r'x~ 7*°':~ ~ ~ Jul 2004-June 2005
~ry~~ ~~W~ ~~~ 4•
~~ • - .,,; ~~ ~,~, ~,~ ~ ~;~ ~ ~y"~~ ~ Plan Design Tota Charges $7,017,596
~''~-~ : ~~ •~ ., Reductions
~~,,~„~ ~' $789 143
'' ~ ^
~*.~~~~~~'.+.`~:'.~ C.."~~~~' r ~~~~ _`.! .""k •y,`w, 11.2%
~^j r~
,yy~.
~y M
~_ ll~,
~~
;~~~
,1,, ,~,.~- ~.
~~ , .~~t'~i~
~,,, ~.
` HC Contract
Reductions
~: $1,111,596 Total P
id
15.8% a
Claims
$5,116, 858
~`,' 72.9%
°;~ t,,
,,,,~..
~.~, j~'+i~'~~,F
^ Total Paid
Claims
^ HC Contract
Reductions
^ Plan Design
Reductions
k
^ Total Paid
Claims
^ HC Contract
Reductions
^ Plan Design
Reductions
'~~'~
~BYc~ ay~S~I~fF
~;~~"'~.
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/" ~ . .
' *`,~~,,-~ City of Dubuque Total Cost
~.~~+~~.''~ July 2006-April 2007
}r
y~C91 M '
"'" ' ~' FiC Admin
~* 1,'' Reinsurance
'~ Fee $355,088 $92,210 2.1%
r
r.~°.
~',~;~~1~,.+'•,?' L ~' -
1 '~''M~a J4 ~,-.~" ~
~ F 'M yt! NI...M.~•j. ~~Ir`rl ~. ~ ~~: •~/, } }~'~F'+l ~'a7~ 1,',~ N tT
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,1st" } y:. ~ Jn. ~.. ,{~2' t~fe~.~v ~ ~t 4 `~"tYJF ~i
~
I
r ;'"~~r~
Dubugue Total Cost
City of
r~•~~~~ July 2005~June 2006
~, .,tom ,
~~?~'~ ;~`
HC Admin
' ~ %4:~,~
C~,;'' $101,409
~~` ` ~'"^" Reinsurance 2.1%
.~
r " `,~;,/ ' Rx $833,064 ^ Medical a~ ~.~
r)
~.. ? #"`~ 19.2% ^ Rx ~ ~'~,'''.
~ ~' ,~ r ,1.~ ~_i9
~~, T~, :: ^ Reinsurance Fee r ~. ~ ~
..:~ '''~ ^ HC Admin. ~' Pf~.,;~;
~~~~
,~ r , ~ c; .:~i
,~`A`'~5 Medical
~. , ~.. q,
R* ~~ °~ $3,062,233
r ` R" 70.5%
•„
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r ~ y
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Fee $376,176 Dental $2,998
7.7% 0.1
Rx $919,600
18.8%
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City of Dubuque Total Cost
July 2004-June 2005
~.D ~ i+.. Xb ~ ,,a~ ± a'~~R . T~-~r,~.~ r~~ ti ~*1 ,,,., HC Admin
~,~~r~r~` ' ~~ ~ ~" i ~` ~` ~ ~..*~" ~~'~ ~ ~ 6, ~~~`~ 104 676 2°/
b ~ 4 , ~~ ,~ ~~ ~r5~ •~ ;~~ ~-~,,~ . ~~_~ Reinsurance$ ~ °
~* ~~ . ~ ~~~ ~^ ~~ *~,`~~`^~' ~.,~ ~~,+~~ "r,. ~ . ' Fee $332,781-. Dental $25,067
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~~ ~, .~' ~. '~,~ ~ ~ ~?'`~,~ ti'~',>~~. ~r~,,. `~ 4~~-." Rx $888
~" ~ ' ~ -~ ~k ''1 p~4,'' kd~'1 ~~-,, ,• ~..~ ~4.. .~ r~^ ,027
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Medical
$4,203,764
76%
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^ Rx
^ Reinsurance Fee
^ HC Admin i
Medical
$3,503,538
71.4% g '
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^ Rx
^ Reinsurance Fee
^ HC Admin
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