Subject:
Title
Agreement with United Healthcare Insurance Company for Excess Loss Insurance Coverage.
label
Recommended Action:
Recommended Action
Approval of the agreement with United Healthcare Insurance Company for stop-loss insurance coverage to protect the self-funded health plan from catastrophic losses.
• This insurance coverage is engaged in the event an individual has over $650,000.00 in health care expenses in a year. This new policy will replace the current policy, which was previously terminated for convenience by Cigna Health and Life Insurance and Evernorth Behavioral Health, Inc. (Cigna), expiring December 31, 2024.
• The agreement provides stop-loss insurance coverage to protect the self-funded health plan from catastrophic losses.
• The agreement has a term of twelve months, with a service start date of January 1, 2025, and an estimated total expenditure of $1,750,000.00.
• The Cigna Health and Life Insurance Contract was previously terminated for convenience, effective December 31, 2024.
• Funds for this contract are included in the Fiscal Year 2025 Adopted Budget in the Health Benefits Fund. The contract has a fiscal non-funding clause if this portion of the budget is not adopted.
Contract No. 25-0153-P for a twelve-month contract value of $1,750,000.00; Authorize the Chairman to sign and the Clerk of the Circuit Court to attest.
Body
Strategic Plan:
Create a Quality Workforce in a Positive, Supportive Organization
1.1 Recruit, select, and retain the most diverse and talented workforce
1.3 Make workforce safety and wellness a priority
1.4 Maintain a fair and competitive compensation package
Summary:
Summary
This contract provides third-party administration services for stop-loss insurance coverage to protect the self-funded health plan from catastrophic losses. The insurance coverage is engaged in the event the individual has over $650,000 in health care expenses in a year.
Body
Background Information:
Gallagher Benefit Services conducted a solicitation on August 21, 2024, for alternate carrier coverage, which required carriers to be agreeable to conditions such as no new lasers at renewal, waive any active at-work provision, agree to the County’s plan document and the Summary Plan Description (SPD) that are the guiding documents for claims approval, no additional exclusions or limitations, and other additional underwriting considerations. On September 23, 2024, Gallagher received five responses.
The contract award to United Healthcare is based on price, contractual conditions, and administrative ease of having the health Third Party Administrator (TPA) and the stop-loss carrier integrated.
Fiscal Impact:
Twelve-month fees not to exceed $1,750,000.00
Funding for the Agreement is included in the FY25 Adopted Budget for the Employee Health Benefits Fund and is consistent with the current level of spending.
Staff Member Responsible:
Wade Childress, Director, Human Resources Department
Merry Celeste, Purchasing Director, Administrative Services
Joe Lauro, Director, Administrative Services
Partners:
N/A
Attachments:
Agreement