HomeMy WebLinkAboutPR 21594: BLUE CROSS MEDICARE ADVANTAGE RENEWAL EFFECTIVE 01/01/2021 4tkis
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INTEROFFICE MEMORANDUM
Human Resources Department
Date: September 21, 2020
To: Ronald Burton, City Manager
From: Elizabeth Diaz,Assistant Director of Human Resources
RE: Blue Cross Medicare Advantage Renewal Effective 1/01/2021
P. R. No. 21594 - A Resolution Authorizing The City Manager To Execute Contracts
Between Its Third Party Administrator(Blue Cross and Blue Shield of Texas, Inc.)For
The City of Port Arthur Blue Cross Medicare Advantage PPO and Prescription Drug
Plan for its Existing Medicare Eligible Retirees and/or Their Medicare Eligible
Dependent(s)
Nature of the request:
The City of Port Arthur provides access to their Medicare eligible retirees and/or their Medicare
eligible dependent(s) to the Blue Cross Medicare Advantage PPO and Prescription Drug Plan for
major medical health insurance coverage, including prescription drug coverage. Medicare eligible
retirees and their Medicare eligible dependent(s) transitioned to the Blue Cross Medicare Advantage
PPO and Prescription Drug Plan effective on 11/1/2016.
Staff Analysis, Considerations:
The City of Port Arthur has a Preferred Provider Organization (PPO) insurance format which
provides participants in the selection of health care providers. This format has been deemed most
beneficial for plan participants and most compatible with our organizational culture.
The upcoming 1/1/2021 renewal has presented an increase of 1.99% over last year's renewal. Per
the attached, it has been determined that this year's 1.99% increase was principally due to high
utilization of claims experience incurred during the current plan year to date. There are
approximately 103 Medicare eligible retirees and/or Medicare dependents on the plan.
P.R. #21594
Staff views the health insurance benefit as an earned as well as deserved benefit for its City retirees,
and will continue to strive to provide the best health plan available at the best price to all of its plan
participants. The City will continue to pay 50% There are a number of updates to the medical grid
for next year, and items that are in the inclusions are Virtual Visits by MDLive for certain categories
of treatment. In addition, Opioiod treatment and Acupunture treatments have been added by CMS
for next year. There are minor changes that are required of the plan to maintain CMS compliance, all
highlighted changes are CMS mandated,which are beneficial changes for the retiree.
No change in the current benefit levels as follows:
• $0 Annual Deductible
• Maximum Out-of-Pocket$1,500
• Level Copays
• SilverSneakers Program(i.e. YMCA, Curves,World Gym, etc.)
• Hearing Aid Benefits
• Incentives totaling$100/per year for Wellness Benefits
It is recommended that the City continue to share the premium cost with the medicare eligible
retiree.Medicare eligible retirees are required to pay 50% of the proposed monthly premium cost
and/or their Medicare eligible dependent(s)are required to pay 100%of their premium cost..
Recommendation: It is recommended that the City Council adopt P. R. No. 21594 authorizing
the renewal of the Blue Cross Medicare Advantage PPO and Prescription Drug Plan for its
Medicare eligible retirees and/or their Medicare eligible dependent(s), and authorizing the City
Manager to execute all documents necessary for its 1/01/2021-12/31/2021 plan year.
Budget Considerations: Approval of P. R.No.21594 will have a budgetary impact of$85,000
which is available in the FY 2020-2021 Health Insurance Fund(614-1701-583.18-03).
"Remember we are here to serve the Citizens of Port Arthur
P.R. No. 21594
09/21/2020—evd
RESOLUTION NO.
A RESOLUTION AUTHORIZING THE CITY MANAGER
TO EXECUTE CONTRACTS BETWEEN ITS THIRD PARTY ADMINISTRATOR
(BLUE CROSS AND BLUE SHIELD OF TEXAS, INC.) FOR THE CITY OF PORT
ARTHUR'S BLUE CROSS MEDICARE ADVANTAGE PPO AND PRESCRIPTION
DRUG PLAN FOR ITS MEDICARE ELIGIBLE RETIREES AND/OR MEDICARE
ELIGIBLE DEPENDENT(S),AND AUTHORIZING THE CITY MANAGER TO
EXECUTE ALL DOCUMENTS
FUND NO: 614-1701-583.18-03 (HEALTH INSURANCE FUND)
WHEREAS, the City Council of the City of Port Arthur deems it necessary and
appropriate to provide major medical health care benefits along with a prescription drug
benefit to its Medicare eligible retirees and/or Medicare eligible dependent(s) effective
01/01/2021; and,
WHEREAS, inasmuch as the upcoming year's renewal reflects a 1.99% increase
over last year's renewal, the City recommends acceptance of the BC/BS Medicare
Advantage PPO Prescription and Drug Plan renewal as presented with minor positive
changes in its current benefits levels, as fully delineated in Exhibit"A"; and,
WHEREAS, Blue Cross and Blue Shield of Texas will take the necessary actions
to comply with the Centers for Medicare and Medicaid Services' (CMS) requirements to
continue the provisions enacted annually,and do hereby affirm to continue to make changes
to its existing health plan policies or products required to comply with the law; and,
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY PORT ARTHUR, TEXAS:
Section 1. That, the City Council of the City of Port Arthur hereby accepts the
contract proposal from Blue Cross and Blue Shield of Texas, Inc.,to renew the Blue Cross
Medicare Advantage PPO and Prescription Drug Plan for its Medicare eligible retirees and/
P.R. No. 21 594
09/21/2020 evd
Page 2 of 3
or their Medicare eligible dependent(s) for the 01/01/2021 plan year which includes a
renewal rate of 1.99% over last year's renewal.
Section 2. That, the City will be billed 50% of the proposed premium cost of
$210.10/month for all impacted Medicare eligible retirees (approximately 67 Medicare
retiree participants). The City's monthly premium cost which equates to $105.05/per
member/month, for all impacted Medicare eligible retirees for the 01/01/2021 —
12/31/2021 plan year as is fully delineated in Exhibit"B".
Section 3. That, the City Manager is hereby further authorized to execute the
necessary contracts and other documents on behalf of the City of Port Arthur subject to the
approval of the City Attorney, and to make payment of necessary premium and
administrative charges to bind coverage subject to the terms and conditions of the contract
for Third Party Administrator(Blue Cross and Blue Shield of Texas,Inc.)and the Contracts
for Insurance attached hereto as required to effectuate said services.
Section 4. That, a copy of the caption of this Resolution be spread upon the minutes
of the City Council.
READ, ADOPTED, AND APPROVED this day of
AD, 2020, at a Regular Meeting of the City Council of the City of Port Arthur, by the
following vote: AYES: Mayor
Councilmembers:
NOES:
Thurman Bartie, Mayor
P.R. No. 21594
09/21/2020 evd
Page 3 of 3
ATTEST:
Sherri Bellard, City Secretary
APPROVED AS TO FORM:
Valecia Tizeno, City Attorney
APPROVED FOR ADMINISTRATION:
CLUX LL--)
Trameka Williams, Director of Human Resources
Ron Burton, City Manager
APPROVED AS TO AVAILABILITY OF FUNDS:
Kandy Danielnterim Director f Finance
Exhibit "A"
J.S. Edwards
Sherlock
INSURANCE AGENCY
City of Port Arthur Medicare Advantage Renewal
Over age 65 Retirees
1/1/2021
The City implemented a Medicare Advantage Health/RX plan
effective on 11/1/2016. In order to maintain easier compliance
with regulations, the annual renewal date was moved to
January first annually.
The Plan is administered by BCBS and is a fully insured contract.
Currently the City pays 50% of the monthly premium. The
1/1/2021 renewal numbers reflect a 1.99% increase in
premium, moving the rates from $206.00 to $210.10 per
month. The renewal Plan offer mirrors the current plan with
the exception of CMS required mandates/adjustments. All of
the CMS changes are benefit enhancements and are highlighted
on the attached grid. These enhancements keep money in a
retiree's pocket by reducing or eliminating their cost for newly
mandated benefit coverages.
4155 Phelan Boulevard• Beaumont,TX 77707 • P.O.Box 22237, 77720-2237
Beaumont(409)832-7736 • Fax(409)833-1721 • Houston(713) 224-8723
After a "learning curve" typically experienced by anyone with a
new health plan, City HR staff indicates that retirees are
pleased with both the benefits and the cost of the Medicare
Advantage plan. The new enhancements effective in 2021
along with the minimal price adjustment should continue that
trend.
I am at your service for any additional info or clarifications.
Cordially,
)11
Mickey Moshier, MHP
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