Subject:
Title
Calendar Year 2016 policy amendments with United Healthcare Services, Inc. for County employee medical benefits.
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Recommended Action:
Recommended Action
Approval and execution by the County Administrator of the 2016 Policy Rider No. 11 stop loss Medical Benefits with United Healthcare Services, Inc. (UHC) as administrator, and the Amendment to Medicare Advantage with Prescription Drug Benefit (MA-PD) Group Agreement with UHC.
Contract 101-0224-P(JA) Group Medical Benefits; funding for stop loss and administration of health programs in the amount of $2.5m; funding for Medicare with prescription drug program in the amount of $8.7m through December 31, 2016.
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Strategic Plan:
Create a Quality Workforce in a Positive, Supportive Organization
1.4 Maintain a fair and competitive compensation package
Summary:
Approval of these amendments provides medical benefits to County employees, dependents and retirees for the 2016 calendar year. The 2016 financial renewal includes administrative and stop loss fees approximating an increase of nine (9%) percent from the previous year. The Medicare Advantage plan increased approximately three (3%) percent. Medicare Advantage is a fully-insured product, and premiums are established annually per the Centers for Medicare and Medicaid Services with consideration given to the County’s claim history.
UHC is not permitted to place guarantees into a contract for a period greater than twelve (12) months from the date of initial agreement. The original agreements provided for the annual restatement of terms and guarantees. These amendments fulfill UHC’s requirement to provide notice detailing restated financial terms and performance guarantees, and provides an updated Stop Loss Extended Term Rider.
Background/Explanation:
The original Administration, Stop Loss and MA-PD agreements were approved by the Board of County Commissioners on August 9, 2011 for a thirty-six (36) month term beginning January 1, 2012, with a provision for two (2) additional twelve (12) month term extensions. This is the last term extension and a new request for proposal will be issued in early 2016 to obtain future services.
Fiscal Impact:
Estimated Annual Expenditure Stop-Loss and Administrative Fees
Not to Exceed: $2,286,482.00
Estimated Annual Expenditure Medicare Advantage Administrative and Claims Fees
Not to Exceed: $8,508,125.00
Total Annual Expenditure Fees for Calendar Year 2016
Not to Exceed: $10,794,607.00
Delegated Authority:
Authority for the County Administrator to sign the Stop Loss Extension Rider and Amendment to Medicare Advantage with Prescription Drug Benefit Group Agreement is granted under Code 2-62(a)(2).
Staff Member Responsible:
Beverly Waldron, Interim Director, Human Resources
Joe Lauro, Director, Purchasing
Partners:
N/A
Attachments:
2016 Financial Renewal
Policy Rider No. 11
Amendment to Medicare Advantage with Prescription Drug Benefit (MA-PD) Group Agreement