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HomeMy WebLinkAboutPR 22747: BLUE CROSS AND BLUE SHIELD Estop .- City of a)! } Texas INTEROFFICE MEMORANDUM Human Resources Department Date: September 14, 2022 To: Ron Burton, City Manager Trameka Williams, Director of Human Resources From: Elizabeth Diaz, Assistant Director of Human Resources Re: BCBS Renewal Effective 11/1/2022 P.R. No. 22747 - A Resolution Authorizing the City Manager to Execute Contracts Between Its Third-Party Administrator (Administrative Services Only) For the City of Port Arthur Group Medical, Dental Insurance, For Basic Life, For Basic Accidental Death and Dismemberment, And Excess Loss Indemnity with Blue Cross and Blue Shield of Texas, Inc. Nature of the request: The City of Port Arthur is self-insured and contracts with a third party administrator to administer its Health Insurance Plan for major medical health and dental insurance, basic life insurance, and basic accidental death and dismemberment insurance are also provided for employees and City Council appointees. Additionally,the City provides access to its major medical health insurance coverage, including prescription drug coverage, for its retirees under age 65. Medicare retirees as well as their Medicare dependent(s) transitioned to the Blue Cross Medicare Advantage PPO and Prescription Drug Plan 11/1/2016. The upcoming renewal initially offered a +18% funding adjustment over last year's funding level; however,with continuous negotiations it reduced health renewal rate to+9.5%as an overall suggested funding adjustment. The City's claim experience summary reflects an approximate 13% increase from the most recent experience period health claims. The increase in claims relates to members scheduling doctor's visits and elective surgeries that may have been cancelled during peaking times of the pandemic and the eight (8) high-dollar claims that exceeded the 125K specific stop loss level. The favorable news is that the prescription rebate credit increased significantly this year and as a result, overall costs (administration, individual stop loss, and aggregate stop loss) decreased slightly. The dental coverage is being offered with a one-year rate guarantee and no change to current cost or benefits. Basic Life insurance and AD&D rates remained constant with no increase through 11/1/24. Staff Analysis, Considerations: The City of Port Arthur has a Preferred Provider Organization (PPO) insurance format which provides participants great latitude in selection of health care providers. This format has been deemed most beneficial for plan participants and most compatible with our organizational culture. The City also offers a lower cost Health Savings Account (HSA) option. The City is self-insured for major medical health insurance coverage. As we reviewed the upcoming renewal with Blue Cross and Blue Shield of Texas,data supports the move to a Medicare Advantage plan for its Medicare retirees and/or Medicare dependents in November 2016 has attributed to substantial savings to the City's health insurance fund over the past few years. Each renewal year comes with additional elements of the Affordable Care Act impacting the City's health insurance that must be taken into account. This year's renewal reflects a 9.5%increase in recommended premium funding, Attachment "A", is an analysis of this year's renewal proposal from Blue Cross Blue Shield of Texas as presented by the City's insurance consultant,Mr. Mickey Moshier. In order to continue to offer this benefit to employees and dependents in the most cost-effective manner, the following changes are being recommended: 1. $140K Individual Stop Loss • Moving from 125K ISL to 140K ISL,this change will reduce premiums level at approximately$200K less than the renewal of the 125K ISL. 2. Move to full Wellbeing Management Program • This will allow more services and other wellness programs 3. Pharmacy—two(2)programs that have no impact on member • Adding RX Specialty Accumulator Program • Multi-Category Split Fill Program 4. Balanced Drug List • Approximately 28 members of 700+are impacted with implementing this program Additional efforts regarding wellness and education (e.g., emphasizing use of Employee Health Clinic, telehealth, exercise/gym programs) regarding plan usage and alternatives will be a significant initiative in the upcoming renewal year. The 2022-2023 Open Enrollment period will be from October 1 to October 31,2022. Recommendation: It is recommended that the City Council adopt P. R. No. 22747 which authorizes the City Manager to execute contracts between its third party administrator (administrative services only) for the City of Port Arthur group medical, dental insurance; for basic life, for basic accidental death and dismemberment, and excess loss indemnity with Blue Cross and Blue Shield of Texas, Inc., and Dearborn National Life Insurance Company for its 11/1/2022- 10/31/2023 plan year. Budget Considerations: Approval of P. R. No. 22747 which authorizes the City Manager to execute contracts with the following budgetary impact for which funds are available: Fund No. 614-11-025-5411-00-00-00 (Health Insurance Fund) Expected claims $9,651,225 Administration/Stop Loss $1,158,372 Dental $385,353 Basic Life/AD8cD $ 30,000 Total $11,224,950 P. R. No. 22747 09/14/2022--evd RESOLUTION NO. A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE CONTRACTS BETWEEN ITS THIRD- PARTY ADMINISTRATOR (ADMINISTRATIVE SERVICES ONLY) FOR THE CITY OF PORT ARTHUR GROUP MEDICAL, DENTAL INSURANCE, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT, AND EXCESS LOSS INDEMNITY WITH BLUE CROSS AND BLUE SHIELD OF TEXAS, INC. FUND NO: 614-11-025-5411-00-00-00 (HEALTH INSURANCE) WHEREAS, the City Council of the City of Port Arthur deems it necessary and appropriate to provide major medical health care benefits for its City's employees, City Council appointees, and its retirees under the age of 65 effective on 11/01/2022; and, WHEREAS, the City Council deems it in the best interest of the citizens of Port Arthur to be self-funded and to accept the renewal from Blue Cross and Blue Shield of Texas, Inc. as a third party administrator at an estimated cost of $484,992 and a prescription drug and medical rebate of $738,365 leaving a net administrative fee credit of $253,373 (administrative charge based on the present number of employees) as well as at a cost of $1,389,725 per year for stop loss premium (excess indemnity) per recommendation of the City's insurance consultant, Mickey Moshier, listed hereto as Attachment "A"; and, WHEREAS, the City's group health plan coverage encompasses the enactment of the Patient Protection and Affordable Care Act (PPACA) effectuated on March 23, 2010, with continuing provisions enacted annually, and do hereby affirm to continue to make changes to its existing health plan policies or products as required to comply with the law; and, current language P. R. No. 22747 09/14/2022--evd ties the City of Port Arthur to specific disaster declaration by the President in which the City wishes to modify to a more standard term; and, lies with coin Inc.WHEREAS, such contracting with Blue Cross and Blue Shield of Texas, Inc. p Sections 252.021(b), Competitive Requirements for Certain Purchases. 252.024, Section of Insurance Broker, and 252.048,Change Orders,respectively,of the Local Government Code;and, WHEREAS, the nature of the premiums to be charged by the City and the summary of benefits are as delineated in Exhibit"A",which reflects the costs for administration by Blue Cross and Blue Shield of Texas, Inc., the stop loss premium, and the expected reserve; and, WHEREAS, the Basic Life Insurance will also be continued per Dearborn National Life which includes provisions to provide basic life insurance coverage to Fire Civil Service personnel at a rate of one times his/her base annual salary in accordance with the IAFF Collective Bargaining Agreement between the City $.22/per thousand dollar unit, and all other eligible employees' coverage will remain a $6,000 death policy, which will cost the City $.19/per thousand dollar unit/per employee/per month and attached as Exhibit"B"; and, WHEREAS, as part of the Dearborn National Life proposal, the City is also obtaining Accidental Death and Dismemberment Insurance on behalf of its employees which will remain at a cost of $.04/per thousand-dollar unit/per Employee (for a $5,000 accidental death and dismemberment policy for all eligible Employees) per month as attached Exhibit "B"; and, WHEREAS,the current year's renewal provides a 9.5% increase in premium to the City, to employees, City Council appointees, and to retirees under the age 65. It is being recommended that effective 11/01/2022 all impacted plan participants will incur a 2.375%premium increase. P. R. No. 22747 09/14/2022--evd NOW,THEREFORE,IT BE RESOLVED BY THE CITY COUNCIL OF THE CITY OF PORT ARTHUR, TEXAS: Section 1. That, the City Council of the City of Port Arthur hereby accept the following contracts to Blue Cross and Blue Shield of Texas, Inc., attached hereto and made a part hereof, as is fully delineated herein: INSURANCE COVERAGE ADMINISTRATIVE SERVICES EFFECTIVE DATE Administrative Services Blue Cross and Blue Shield November 1, 2022 City of Port Arthur's Group Medical and Stop Loss Dental Blue Cross and Blue Shield November 1, 2022 Basic Life &AD&D Dearborn National Life November 1, 2022 Section 2. 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 (Administrative Services Only) and the Contracts for Insurance attached hereto as required effectuate said services; and, Section 3. That, the City Manager is hereby directed to take all actions necessary to ensure proper funding of the City of Port Arthur's Employee Health Insurance Fund; and, Section 4. That, a copy of the caption of this Resolution be spread upon the minutes of the City Council. P. R. No. 22747 09/14/2022--evd READ, ADOPTED AND APPROVED this day of A.D. 2022 at a Regular Meeting of the City Council of the City of Port Arthur, Texas by the following votes: AYES: Mayor Councilmembers Noes Thurman Bill Bartie, Mayor ATTEST: Sherri Bellard, TRMC, City Secretary APPROVED AS TO FORM: Vid Val Tizeno, t Atto ey APPROVED FOR ADMINISTRATION: Trameka Williams, Director of Human Resources Ron Burton, City Manager P. R. No. 22747 09/14/2022--evd APPROVED AS TO THE AVAIABILITY OF FUNDS: CA--/\__`J 'nGV•J'0 Kandy Daniel, iterim Director of Finance P. R.No. 22747 09/14/2022--evd ATTACHMENT "A" J.S. Edwards Sherlock City of Port Arthur Benefit Renewals Active Employees and Under Age 65 Retirees 11/1/22 Life INSURANCE: The City's renewal from Dearborn National/BCBSTX reflects NO CHANGE to current rates for either life insurance classification. We are in the middle of a rate guarantee that extends to 11/1/24. DENTAL INSURANCE: The City's renewal for your fully insured dental coverage plan is being offered at NO CHANGE to current rates for the upcoming 1 year renewal period. This is the 2nd year in a row that this has been the case. Open enrollment provisions apply which will allow employees to add/delete dependents on your 11/1/22 renewal date. Please remember that only ACTIVE employees and their dependents are eligible for dental coverage. 4155 Phelan Boulevard • Beaumont,TX 77707 • P.O. Box 22237, 77720-2237 Beaumont(409)832-7736 • Fax(409)833-1721 • Houston(713) 224-8723 HEALTH PLANS: The City offers 2 health plans for active employees and under age 65 retirees to choose from. Both plans are funded via the City's ASO (Administrative Services Only) arrangement, a partially self-funded financial design via BCBSTX. Annual costs are comprised of fixed monthly fees (administrative and stop loss premiums) and actual claim costs. Current Stop loss coverage offers a maximum liability level of $125K for each covered individual as well as total maximum liability for your plan as a whole. For the most recent claim experience period, there have been 8 claims that have exceeded the $125K specific stop loss level and all but one of the large claims continue to be ongoing. The specific stop loss premium for the experience period totaled approximately $1,670,000 while claims reimbursements equate to approximately $2,100,000. BCBS has offered increased specific stop loss levels from $140K to $160K which would positively impact fixed costs by as much as $400K. We are recommending an increase from the current $125K Stop Loss to $140K. Premiums for that level would be approximately $200K less then renewal of the $125K level. By adjusting the stop loss level, the City's claim responsibility would increase from the current $125K per member to $140K per member. Overall paid health claims increased from $8,293,000 to approximately $9,357,000 this past year. That increase equates to approximately 13%. While the original renewal rate development showed a funding increase of approximately 12%, review and updated funding levels have been reduced to approximately 10.5%. BCBS is willing to offer a one time credit of $100K which can be used on the health plan as the City determines appropriate. Employee contributions toward their part of the premium can be reduced, or the City can use the credit toward lowering monthly fixed costs as billed by BCBS. The most recent 2 years of suggested funding levels reflected .45% (2020-2021) and 3.85 (2021-2022) adjustments, respectively. Due to the significant claims increase this past year, suggested funding levels before any benefit adjustments reflect the 10.5% indicated above. While this figure is above recent, based on the City's claim experience, it is realistic and fair, IMO. Remember, if claims are less than anticipated, the City retains those dollars. We briefly discussed adjusting employee contribution levels based on employee tobacco usage. Speaking with BCBS as well as other carriers, increased cost to tobacco using employees is typically set between +10 and +15%. While always part of a renewal offer, BCBS has indicated they will be paying close attention to the timeframe provisions for review and acceptance of their offer. I remain at your service 24/7. Mickey Moshier MHP JS Edwards and Sherlock Insurance c/01z P. R. No. 22747 09/14/2022--evd EXHIBIT "A" 0 J O U) r CO enc J m g r ce) i r N o ° 3 O r COco To°' L to 2 e �g C CD O m 0„ m a i O _ 0 ` fo 0 Q ' N o a�i .� �- N Q a 6 N o aa) m N 0) >• s s v°U_ i N a_ g z ' o Q O - �, F.. N 9 �01 w N 0co — 6 Cl. I •� M= Dii! 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No. 22747 09/14/2022--evd EXHIBIT "B" qe , V BlueCross BlueShield orTexas r n 701 E.22nd Street,Suite 300—Lombard,IL 60148 CITY OF PORT ARTHUR ATTN: ELIZABETH VILLARREAL PO BOX 1089 PORT ARTHUR TX 776411089 June 17,2021 Subject: Renewal Analysis Group Policy Number: G31118 Anniversary Date:November 1,2021 1 Dear Policyholder: 1 We would like to thank you for allowing us the opportunity to provide you and your employees with Group insurance products. We have reviewed the current demographics of your group insurance programs. We are pleased to inform you that there will be no change in the existing rates for the upcoming renewal period. Rates will be guaranteed until November 1,2024. Products Current Rates Renewal Rates Basic Life(Class 1) $0.19 per $1,000 $0.19 per $1,000 Basic Life(Class 2) $0.22 per $1,000 $0.22 per $1,000 Basic AD&D $0.04 per$1,000 $0.04 per$1,000 If you have any questions pertaining to your renewal, or would like more information including the availability of other products as well as a quote for additional benefit programs,please contact your local Blue Cross and Blue Shield of Texas Ancillary sales office or insurance broker. We value our relationship with you and look forward to providing quality service to you in the future. Sincerely, Ancillary Underwriting Department I Cc Mickey Moshier J I Insurance products Issued by Dearborn Life Insurance Company,701 E.22nd St.Suite 300,Lombard,IL 60148.Blue Cross and Biue Shield of Texas is the trade name of Dearborn Life Insurance Company,an Independent licensee of the Blue Cross and Blue Shield Association.BLUE CROSS',BLUE SHIELD'and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association,an association of Independent Blue Cross and Blue Shield Plans. 1 d !C >, b c r •• • • L 0 U 0 C.) + * * I 3 as a cu CD Q • • • • • d d • • • • a, • • • • • • ` ` ` 6..LLI w Wa w w w t d '- ai a) a a) a) a) co A in W ti W U a) U U. IDI- • • • co co cv •• cv • • LL •• •• •• •• •• ev (o L L L. 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