HomeMy WebLinkAboutItem 17 - Admin Services Agreement MEMO TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
FROM: BRUNO RUMBELOW, CITY MANAGER V�"
MEETING DATE: JANUARY 17, 2017
SUBJECT: APPROVAL TO RENEW HEALTH PLAN ADMINISTRATIVE
SERVICES AGREEMENT
RECOMMENDATION:
City Council to consider approval to renew an annual contract for Third-Party
Administrative Services with UMR for the City's Self-Funded Health Plan.
FUNDING SOURCE:
Funds are available in account 100-45674-109-1 (Health Insurance Premium) in the
estimated amount of $330,000.
BACKGROUND:
The purpose of this contract is to establish annual pricing for Third-Party Administration
for the City's Self-Funded Health Plan. UMR has agreed to a flat renewal rate on all
administrative and access fees for the next three years. They will also provide disease
management services at no charge for the first year. UMR has provided these services
to the City in the past with successful results.
Staff recommends approval.
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Customer Name: City of Grapevine
Plan Renewal Date: 70/1/2017
A//fees shown as per emp/oyee per month(PEPM)un/ess otherwise noted
Proposed renewa/fees assume all existing products and services written with UMR will be retained throughout
the renewal period.New products and services may be added however proposed fees are subject to change and/or
and/or additiona/fees may app/y lf any existing products or services are discontlnueal.
Renewal Fees Renewal Fees Renewal Feef
Administration and access fees Subscribers Current Fees 10/1/2017 10/1/2018 70H/2019
Medical claims-excludes run-in 615 $18.16 $18.16 $18.16 $18.16
Medical ciient advisor commission Net Net Net Net
Required stop loss interface fee 615 Included InGuded InGuded Included
Stop loss interface-If a non-preferred vendor is selected,this 615 $1.82 $1.82 $1.82 $1.82
surcharge fee will also apply
UnitedHealthcare Choice Plus�network-access fee 615 $16.87 $16.87 $16.87 $16.87
Utilization and case management(includes NurseLine)-per 615 $3.36 $3.36 $3.36 $3.36
employee per month savings of$0.64
Matemity management(MM) 615 $0.67 $0.67 $0.67 $0.67
Disease management(DM) 615 N/A Waived $1.75 $3.50
Emergency Room Decision Support 615 Waived Waived Waived Waived
Truven Health Analytics reporting-three licenses included 615 Included Included Included Included
Health reimbursement account-per participating employee 366 $3.75 $3.75 $3.75 $3.75
per month
Medical and pharmacy integration-per participating employee 615 $1.00 $1.00 $1.00 $1.00
per month
Flexible spending-health care account(HCA)-per employee 69 $4.16 $4.16 $4.16 $4.16
per account per month
Healthy Back 615 N/A Waived $0.25 $0.50
Incentive Solutions:Custom-Advanced 615 Included Included Included Included
Cost reduction and savings program-large bill review/fee 615 30% 30% 30% 30%
negotiation and secondary/travel network-%of savings
Pharmacy credit: In order to qualify for incentivized rebates,plan designs must be two-tier closed,or three-tier with a minimum of$10.00 difference in
copayment or 10%difference in coinsurance between preferred and non-preferred branded drugs.
Non-preferred vendor surcharge: An additional stop loss interface fee surcharge of$1.82 PEPM applies if stop loss coverage is not placed with a
UMR preferred vendor. This fee is in addition to the"Required stop loss interface fee"which applies for ali groups. Consult your UMR representative
for a list of preferred vendors.
UnitedHealthcare Choice Plus assumes that the benefit plans will meet the steerage requirements of the networks proposed or will be changed to
meet the requirements,including but not limited to:deductible,out-of-pocket,coinsurance and plan limitations.Usage of the Choice Plus network
requires employer participation in Value Based Contracting payment methodologies.
Extemal PBM Vendors are subject to prior approval and may require additional fees. For groups with less than 100 subscribers,OptumRx is required.
City of Grapevine
Eff Date: 10/1/2017 Proprietary/Trade Secret/Confidential Competitive Sensitive Information A���,y