Agenda

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County Administrator's Report 10. 15.

BCC Regular Meeting

Budget & Finance Consent

Meeting Date:	11/05/2020
Issue: Group Medical Insurance
From:	Jana Still
Department:	Human Resources
CAO Approval:

RECOMMENDATION:

Recommendation Concerning Group Medical Insurance - Jana Still, Human Resources Department Director

That the Board takes the following action concerning Group Medical Insurance:

A. Approve the renewal action with Great Midwest Insurance Company as the County's Stop Loss Carrier from January 1, 2021, to December 31, 2021; and

B. Authorize the County Administrator to sign the Great Midwest Insurance Company Health Benefit Plan Excess Loss Coverage Signature Page.

[Funding Source: 501, Internal Service Fund, Cost Center 150108, Object Code 54501]

BACKGROUND:

Stop Loss premiums are negotiated on an annual basis. USI solicited the market again this year.

Stop Loss Costs - 2021 Renewal

Initial stop loss renewal (spec and agg./rates) (fixed costs) with no contract or plan provision changes increased by 27.3% or $993,750 over current amount of $779,293 for a projected annual increase of $214,457.
Final and firm negotiated fixed cost rates represent an increase of 8.2% or $63,943 ($2.97 per employee per month).
This minimal increase does not warrant reworking of the 2021 approved budget as it only adjusts to a downward percentage of .25%.
If we equate this to the amount spent on 1792 employees enrolled in medical plans, the increase per employee per year (PEPY) is $1,827 or $152 per employee per month (PEPM).

Stop Loss Provisions 2021

Specific stop loss per individual remains at $275,000.
No lasers have been applied. - This is the practice of assigning a higher specific deductible for an individual with a known condition that is likely to exceed the specific deductible. It is essentially used when an individual on a plan possesses a higher pre-disposition for illness or higher health care cost than other employee.
The Contract maintains its “Paid” reimbursement status, which is the most favorable type of Contract due to the protection it provides to an employer.
The Contract maintains a $100,000 aggregating specific deductible.
2022 stop loss provisions, if coverage renews with Great Midwest, offers a rate cap of no more than a 50% increase on specific and aggregate premiums, as well as no lasers will be imposed in 2022.
The value of these two provisions will continue to protect large or catastrophic RX claim spending, as the medical programs under Affordable Care Act (ACA) have unlimited coverage for services covered on the medical plan.

Timeline/Delivery of Renewal

As medical plans continue to have unlimited reimbursements for services covered on medical plans, stop loss carriers continue to request additional months of claim data, as they want to ensure their exposures and losses are protected.
Thus, firm rates often require the review of claims through October by stop loss vendors.
USI was able to negotiate the review of claims through September and secure firm rates without the need for additional claim data review.
Claims are provided in arrears meaning claims paid for the month of August are not available until the middle or end of September and this trends progressively forward, meaning September claims are not available until the end of October.
Through August, there are six claimants over $200,000 with the top claimant at $245,482.

BUDGETARY IMPACT:

[Funds are available in Fund 501, internal Service Fund, Cost Center 150108, Object Code 54501]

LEGAL CONSIDERATIONS/SIGN-OFF:

This is in accordance with Florida Statutes 112.09 and 112.0801.

PERSONNEL:

N/A

POLICY/REQUIREMENT FOR BOARD ACTION:

N/A

IMPLEMENTATION/COORDINATION:

The Human Resources Department will coordinate with Legal, the Office of Purchasing, and USI to distribute the Agreement.

Attachments
No file(s) attached.