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HomeMy WebLinkAboutPR 23923: CONTRACT WITH BLUE CROSS AND BLUE SHIELD OF TEXAS £wel 0h- CDKsc,n4' Cdtrof c"v ort rthur Tc i u% INTEROFFICE MEMORANDUM Human Resources Department Date: September 13, 2024 To: Ron Burton, City Manager Trameka Williams, Director of Human Resources From: Elizabeth Diaz, Assistant Director of Human Resources Re: BCBS Renewal Effective 11/1/2024 P.R. No. 23923 - 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 +23% funding adjustment over last year's funding level; however,with continuous negotiations it reduced health renewal rate to+7.4%as an overall suggested funding adjustment. The City's claim experience summary reflects an approximate 11% increase from the most recent experience period for health claims. The increase in claims relates to the eight(8) high- dollar claims that exceeded the 140K individual stop loss level and one (1) more claim that will likely exceed that prior 11/01/2024. Although for the last couple of years, the city has experienced eight (8) high-dollar claims, it is anticipated that next year, of the eight (8) high- dollar claims, will be reduced to six (6) high-dollar claims. Other favorable news is that the Pri prescription rebate credit increased significantly this year and as a result, overall costs (administration, individual stop loss, and aggregate stop loss) decreased slightly. BCBSTX includes a$200,000 credit for the city to use as deemed appropriate towards funding of monthly cost. The dental coverage renewal reflected a 5.9% increase but continuous negotiations, it was lowered to +2.3% funding adjustment. Basic Life insurance and AD&D rates remained constant with no increase through 11/1/25. 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. This year's renewal reflects a 7.4%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,no change to the level of benefits is being made to the employee. BCBS of Texas has offered a bit higher stop loss corridor, $175k, which will lower the premium to approximately$345K per year.BCBSTX also offered the one-time stipend/credit of$200K to assist in the potential additional claim liability for the next year if the City chooses to move to the higher stop loss. Overall, the city implemented the following changes last year that did assist with minimizing RX claims: 1. Performance Select Drug List • The most robust drug list that drives optimal savings by selectively excluding high-cost drugs with minimal value,driving utilization to generics, and drugs with the over the counter (OTC)alternatives. Utilization Management Programs applies. • Approximately 33 members impacted of 700+ 2. Advantage Network(removing CVS) • Narrow pharmacy network that excludes CVS and other pharmacies to offer competitive rates to drive savings. Includes Walgreens and many regional,local,and independent pharmacies. • Members impacted: 84 or 5.9% of membership. 3. Weight Loss Drug Prior Authorization • Clinical programs encourage safe and appropriate medication use and provide safe and effective ways to minimize risk and reduce the cost of treatment. 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 2024-2025 Open Enrollment period will be from October 1 to October 31,2024. Recommendation: It is recommended that the City Council adopt P. R. No. 23923 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 11/1/2024- 10/31/2025 plan year. Budget Considerations: Approval of P. R. No. 23923 which authorizes the City Manager to execute contracts with the following budgetary impact for which funds are available: Health Insurance Fund No. 614 Expected claims $11,470,595 Administration/Stop Loss $1,345,713 Dental $397,015 Basic Life/AD8cD $ 30,000 Total $12,581,334 ATTACHMENT "A" J.S. Edwards Sherlock INSURANCE AGENCY City of Port Arthur Benefit Renewals Active Employees and Retirees under age 65 11/1/24 LIFE INSURANCE: The City's renewal with Dearborn National/BCBSTX reflects NO CHANGE to current rates for either life coverage classification. DENTAL INSURANCE: The original renewal received on the City's fully insured dental plan reflected a 5.9% upward adjustment. Negotiations were able to reduce that number to an acceptable level of 2 . 3%. The City's open 4155 Phelan Boulevard ° Beaumont,TX 77707 • P.0. Box 22237,77720-2237 Beaumont(409)832-7736 • Fax(409)833-1721 • Houston(713) 224-8723 enrollment provisions allow employees to add or delete dependents annually with no questions asked on your 11/1/24 renewal date. Please remember that only active employees and their dependents are eligible for dental coverage. HEALTH PLANS: The City offers 2 health plans for active and under age 65 retirees. Both plans are funded vis the City's ASO (Administrative Services Only) arrangement, a partially self- insured financial design, via BCBSTX. Annual costs are comprised of administrative fees, stop loss premiums and actual claims costs up to stop loss limitations. Current stop loss coverage affords a maximum City liability of $140K for each covered life as well as a total claims maximum liability for the City as a whole. The maximum liability is, of course, based on the number of covered lives. For the most recent 12 month claim experience period, there have been 9 claims exceeding the $140K level and all are still active except 1 who is no longer on the plan. BCBSTX has offered a bit higher stop loss corridor, $175K, which would lower the premium approximately $345K per year. BCBSTX has also offered a one time stipend/credit of $200K to assist in the potential additional claim liability for the next year if the City chooses to move to the higher stop loss level . It only makes sense to accept this as the most cost effective option . Overall claims for the most recent 12 month period increased approximately $750K. The average claim cost per employee per month (PEPM)increased approximately 11% from $1, 168 PEPM to $1,296 PEPM . After including the stop loss premium reduction and the $200K stipend, overall projected costs for the upcoming contract year total +7.4%. Stop loss premiums are adjusted +.3%, and total fixed costs are decreased 13.7%. All said, the suggested renewal figures seem fair and accurate. It is important to fund such that your plan maintains its financial viability. Mickey Moshier MHP J.S. Edwards and SherlockAgency P. R.No. 23923 09/13/2024--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 (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 for its City's employees, City Council appointees, and its retirees under the age of 65 effective on 11/01/2024; 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 $478,210 and a prescription drug and medical rebate of $817,278 leaving a net administrative fee credit of $475,544 (administrative charge based on the present number of employees) as well as at a cost of $1,522,478 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. 23923 09/13/2024--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, WHEREAS, such contracting with Blue Cross and Blue Shield of Texas, Inc. complies with 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 7.4% increase in premium to the City, to employees, City Council appointees, and to retirees under the age 65. It is being recommended that effective 11/01/2024 all impacted plan participants will incur a 2.4%premium increase. P. R. No. 23923 09/13/2024--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, 2024 City of Port Arthur's Group Medical and Stop Loss Dental Blue Cross and Blue Shield November 1, 2024 Basic Life &AD&D Dearborn National Life November 1, 2024 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. 23923 09/13/2024--evd READ,ADOPTED AND APPROVED this day of A.D. 2024 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: 6€16"V oxann Cotro o, City Attorney APPROVED FOR ADMINISTRATION: L//%1/4) Trameka Willi Director of Human Resources Ron Burton, Cit nager P. R. No. 23923 09/13/2024--evd APPROVED AS TO THE AVAIABILITY OF FUNDS: _ Lynda Boswell, Director of Fiance P.R.No. 23923 09/13/2024--evd EXHIBIT "A" N r _ a I ! x .747! .:' '.. : L ^ uJ Ei lim i O � t t 1 '.+ i O {J -. - 0 lm „� - i - t Ql O C1 T 13 c , (!; Y C L _ S tn k 't •!. : i o o II O xC N 4bL a) N 2 I CI .,,,f 4 . A :."..., I a 1 z. fitZT, � �� •T i1 .r, .,..„..._ ,,, , , . �. Q Z m E z 6 z it! L) i 8 i S ` t 2% P,, I 't' i z g 1. Uv Iy Q m S „ }Fes. / ` a • ‘ . ..i'/ l! '_' z. � , o ns j ( o ...... 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O , NCdd . y y C p O 2 E - _ LtU L 2 y Ca Z O8 - r < 22 mLL r r _ r r < 7 EXHIBIT " B " BlueCross BlueShield of Texas April 4, 2024 Trameka Williams City of Port Arthur PO Box 1089 Port Arthur, TX 77641 Group Policy Number: G31118 Anniversary Date: November 1, 2024 Dear Trameka, We at Blue Cross and Blue Shield of Texas (BCBSTX) appreciate the opportunity to continue providing benefits for you and your employees. We are pleased to inform you that we will be extending your rate guarantee. City of Port Arthur's current rates will be extended until November 1, 2027 and are outlined with a rate table attached to this letter. It's our pleasure to it be of service to you, and we would like to confirm the extension of your benefits. To learn more about our products and services, please visit us at www.bcbstx.comtancillary. Thank you for choosing Blue Cross and Blue Shield of Texas. If you have any questions or need assistance, please let me know. I am happy to help. Sincerely, 47 Angie Hardy Your Ancillary Account Executive Insurance products issued by Dearborn Life Insurance Company,701 E.22n0 St.Suite 300,Lombard,IL 60148.Blue Cross and Blue 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,as an association of independent Blue Cross and Blue Shield Plans. BlueCross BlueShield of Texas Rate Table: R � Basic Life—Class 1 $0.19!$1,000 $0.19/$1,000 Basic Life—Class 2 $0.22/$1,000 $0.22/$1,000 Basic AD&D $0.04/$1,000 $0.04/$1,000 I Insurance products Issued by Dearborn Life Insurance Company,701 E.22"St.Suite 300,Lombard,IL 60148.Blue Cross and Blue Shield of Tenas 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,as an association of Independent Blue Cross and Blue Shield Plans.