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Home My WebLink AboutItem 13 - Retiree Health InsuranceMEMOTO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL FROM: BRUNO RUMBELOW, CITY MANAGER MEETING DATE: OCTOBER 15, 2019 SUBJECT: APPROVAL TO RENEW ANNUAL CONTRACTS FOR POST -65 RETIREE HEALTH INSURANCE RECOMMENDATION: City Council to consider approval to renew annual contracts with Aetna Inc. and Group Administrative Concepts for post -65 retiree health insurance. FUNDING SOURCE: Funds are available in Retiree Health Premium accounts 100-45670-109- 001, 115-45670-350-001, 117-45670-209-002, 200-45670-533-001 and 210-45670-340-001 in the annual estimated amount of $670,000. BACKGROUND: The City of Grapevine retirees age 65 and over (Medicare eligible) currently have the option of a Medicare Advantage PPO (Part C) and Medicare Rx Plan (part D) with Aetna or a Medicare supplement (Part F) and Medicare Rx Plan (Part D) with Group Administrative Concepts.Both policies provide services and programs beyond the coverage of original Medicare. Retiree premiums for these plans are partially subsidized by the City. This contract will renew both policies. Request for proposals were taken in accordance with Texas Local Government Code Chapter 252.022. The RFP public notice was placed in the Fort Worth Star -Telegram on August 23 and 30, 2016. The contract was for one year with four optional, one year renewals. If approved, this will be the third renewal option. Staff recommends approval. MH/GJ City of Grapevine Summary of Medicare Advantage Renewal January 1, 2020 Current Renewal - Including HIF Limited to 30 day supply Part D is Illustrative Mail Order is through CVS Caremark as of 5/1/2019 If Health Insurer fee (HIF) removed through legislation -would be 3% increase Must provide renewal decision before 10/1/19 or policy will automatcially renew LZ 9 _' .SWr Page 1 Ek" Aetna Aetna Plan Provision: In -Net Non -Net In -Net Non -Net In -Net Non -Net In -Net Non -Net Network Deductible $0 N/A $150 $150 $0 $0 $150 $150 Member Coinsurance N/AN/A N/A NIA N/A N/A N/A N/A Out -of -Pocket Max incl. ded. $0 $0 N/A NIA $0 $0 N/A N/A Combined OOP Max incl. ded. $0 $1,000 $0 $1,000 Preventive $0 $0 $0 $0 $0 $0 $0 $0 PCP/Specialist OV $0 $0 4% 4% $0 $0 4% 4% Urgent Care $0 $0 $25 $25 $0 $0 $25 $25 Emergency Care $0 $0 $65 $65 $0 $0 $65 $65 Ambulance $0 $0 4% 4% $0 $0 4% 4% Hospital, Inpatient $0 $0 $0 $0 $0 $0 $0 $0 Hospital, Outpatient $0 $0 4% 4% $0 $0 4% 4% Skilled Nursing Facility (max 100 days/pd) Das 1-10 $0 $0 $0 $0 $0 $0 $0 $0 Das 11-20 $0 $0 $0 $0 $0 $0 $0 $0 Das 21-100 $0 $0 $0 $0 $0 $0 $0 $0 Home Health $0 $0 $0 $0 $0 $0 $0 $0 Outpatient Rehab $0 $0 4% 4% $0 $0 4% 4% Chiropractic $0 $0 4% 4% $0 $0 4% 4% DME/Prosthetic Devices $0 $0 4% 4% $0 $0 4% 4% Complex Imaging $0 1 $0 4% 1 4% $0 1 $0 4% 1 4% Podiatry $0 1 $0 4% 1 4% $0 1 $0 4% 1 4% RX Deductible $0 $0 $0 $0 RX Cost Sharing Retail Mail (up to 90 Retail Mail (up to 90 Retail Mail (up to 90 Retail Mail (up to 90 Tier 1 Preferred Generic $5 $10 $5 $10 $5 $10 $5 $10 Tier 3 Preferred Brand $40 $80 $40 $80 $40 $80 $40 $80 Tier 4 Non -Preferred Brand $75 $150 $75 $150 $75 $150 $75 $150 Tier 5 Generic Specialty 33% 33% 33% 33% 33% 33%* 33% 33%* Tier 5 Specialty 33% 33% 33% 33% 33% 33%* 33% 33%* 2019 - Cost share after $3,820 2020 - Cost share after $4,020 Tier 1 Preferred Generic $5 $10 $5 $10 $5 $10 $5 $10 Tier 3 Preferred Brand $40 $80 $40 $80 $40 $80 $40 $80 Tier 4 Non -Preferred Brand $75 $150 $75 $150 $75 $150 1 $75 $150 Tier 5 Generic Specialty 33% 33% 33% 33% 33% 33%* 33% 33%* Tier 5 Specialty 33% 33% 33% 33% 33% 33%* 33% 33%* 2019 - RX Cost Sharing after $5,100 OOP 2020 - RX Cost Sharing after $6,350 OOP Generic > of $3.40 or 5% > of $3.40 or 5% > of $3.60 or 5% > of $3.60 or 5% All others > of $8.50 or 5% > of $8.50 or 5% > of $8.95 or 5% > of $8.95 or 5% ,Step Therapy Yes Yes Yes Yes Precertification Yes Yes Yes Yes Total Enrollment 55 5 55 5 Retiree Only $333.95 $273.37 $376.08 $312.66 Total Monthly $18,367.25 $1,366.85 $20,684.40 $1,563.30 Total Annual $236,809.20 $266,972.40 $ difference --- $30,163.20 % difference (Combined Total) ----- 13% Limited to 30 day supply Part D is Illustrative Mail Order is through CVS Caremark as of 5/1/2019 If Health Insurer fee (HIF) removed through legislation -would be 3% increase Must provide renewal decision before 10/1/19 or policy will automatcially renew LZ 9 _' .SWr Page 1 Ek" City of Grapevine Summary of Medicare Supplement Renewal January 1, 2020 Current Renewal United American Hartford United American Hartford Plan Provision: In -Net Non -Net In -Net Non -Net In -Net Non -Net In -Net Non -Net Network Deductible $0 NIA $200 200 $0 NIA $200 200 Combined In- & Non -net Deductible N/A $0 N/A NIA N/A $0 N/A NIA Member Coinsurance 0% 0% N/A NIA 0% 0% N/A NIA Out -of -Pocket Max incl. ded. $0 $0 N/A NIA $0 $0 N/A NIA Combined OOP Max incl. ded. N/A $0 $1,000 N/A $0 $1,000 Preventive $0 $0 $0 $0 $0 $0 $0 $0 PCP/Specialist OV $0 $0 4% 4% $0 $0 4% 4% Urgent Care $0 $0 4% 4% $0 $0 4% 4% Emergency Care $0 $0 4% 4% $0 $0 4% 4% Ambulance $0 $0 4% 4% $0 $0 4% 4% Hospital, Inpatient $0 $0 $0 $0 $0 $0 $0 $0 Hospital, Outpatient $0 $0 $183 $183 $0 $0 $183 $183 Skilled Nursing Facility (max 100 days/pd) Days 1-10 $0 $0 $0 $0 $0 $0 $0 $0 Days 11-20 $0 $0 $0 $0 $0 $0 $0 $0 Days 21-100 >$164.50 x$164.50 $0 $0 >$164.50 >$164.50 $0 $0 Home Health $0 $0 100% 100% $0 $0 100% 100% Outpatient Rehab $0 $0 4% 4% $0 $0 4% 4% Chiropractic $0 $0 4% 4% $0 $0 4% 4% DME/Prosthetic Devices $0 $0 4% 4% $0 $0 4% 4% Complex Imaging $0 $0 4% 4% $0 $0 4% 4% Podiatry $0 $0 4% 4% $0 $0 4% 4% RX Deductible $0 $0 $0 $0 RX Cost Sharing Retail Mail (up to 90) Retail Mail (up to 90) Retail Mail (up to 90) Retail Mail (up to 90) Tier 1 Preferred Generic $5 $10 $5 $10 $5 $10 $5 $10 Tier 2 Non -Preferred Generic $5 $10 $5 $10 $5 $10 $5 $10 Tier 3 Preferred Brand $40 $80 $40 $80 $40 $80 $40 $80 Tier 4 Non -Preferred Brand $75 $180 $75 $180 $75 $180 $75 $180 Tier 5 Specialty 33% 33% 33% 33% 33% 33% 33% 33% 2019 - Cost share after $3,820 2020 - Cost share after $4,020 Tier 1 Preferred Generic $5 $10 $5 $10 $5 $10 $5 $10 Tier 2 Non -Preferred Generic $5 $10 $5 $10 $5 $10 $5 $10 Tier 3 Preferred Brand $40 $80 $40 $80 $40 $80 $40 $80 Tier 4 Non -Preferred Brand $75 $150 $75 $150 $75 $150 $75 $150 Tier 5 Generic Specialty 33% 33% 33% 33% 33% 33% 33% 33% Tier 5 Specialty 33% 33% 33% 33% 33% 33% 33% 1 33% 2019 - RX Cost Sharing after $5,100 OOP 2020 - RX Cost Sharing after $6,350 OOP Generic > of $3.35 or 5% > of $3.35 or 5% > of $3.35 or 5% > of $3.35 or 5% All others > of $8.35 or 5% > of $8.35 or 5% > of $8.35 or 5% > of $8.35 or 5% Step Therapy Yes Yes Yes Yes Precertification Yes Yes Yes Yes Total Enrollment 87 87 Retiree Only $364.00 $339.00 $368.00 $339.00 Total Monthly $31,668.00 $1,017.00 $32,016.00 $1,017.00 Total Annual $392,220.00 $396,396.00 $ difference I --- 1 $4,176.00 % difference (Combined Total) I ----- 1 1% Disclaimer The following summary of coverages is to be used only as an overview of each policy written and in no way should it be used, nor is intended to be used, as a substitute for the original policy provisions. It has been prepared as a guideline for your reference only. The policy/policies contain conditions, limitations and exclusions which may affect or limit coverage to be provided and should be reviewed by the insured to verify that coverage has been written as requested. All of the information contained in this proposal is subject to the terms, conditions and limitations contained in the policies. Values are based on information provided by the client. THIS DOCUMENT IS PROPRIETARY, CONFIDENTIAL AND/OR PRIVILEGED AND IS INTENDED TO BE REVIEWED ONLY BY THE INDIVIDUAL AND/OR ENTITY TO WHICH IT IS ADDRESSED. IF YOU ARE NOT THE INTENDED RECIPIENT OR A REPRESENTATIVE OF THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY REVIEW, COPYING, DISCLOSURE AND/OR DISSEMINATION OF THIS DOCUMENT OR THE INFORMATION CONTAINED HEREIN IS PROHIBITED. McGRIFF, SEIBELS & WILLIAMS, INC. COMPENSATION STATEMENT Our principal remuneration for the placement and service of your insurance policy(ies) will be by commission (a proportion of the premium paid that is allowed to us by the insurance company(ies)} and/or a mutually agreed fee. You should be aware that we may receive additional income from the following sources: Interest or Investment Income earned on insurance premiums. Expense Allowances or Reimbursements from insurance companies and other vendors for (a) educational and professional development programs; (b) managing and administering certain binding authorities and other similar facilities, including claims which may arise; and (c) attendance at insurance company meetings and events; all of which we believe enable us to provide more efficient service and competitive terms to those clients for whom we consider the use of such facilities appropriate. Tier II Commission (sometimes referred to as "extra compensation") is exclusive to the placement of employee benefits insurance and is based on premium volume of new business and/or premium retention. ❑ Contingent Commission (sometimes referred to as "profit sharing") which can be based on profitability, premium volume, premium retention, and/or growth. If any part of your account is on a fee basis, we will not accept contingent commissions related to your account. If you have questions or desire additional information about remuneration and other income, please contact your Agent who will put you in touch with our Chief Risk Manager for assistance. If any part of your insurance program is placed through any BB&T-owned companies (including retail insurance brokers BB&T Insurance Services, Inc. and BB&T Insurance Services of California, Inc.; wholesale insurance brokers CRC Insurance Services, Inc. and Crump Life Insurance Services, Inc.; managing general underwriter AmRisc, LP; insurance premium finance company, Prime Rate Premium Finance Corporation, Inc. or affiliates; or BB&T Assurance Company, Ltd.) disclosure of that income will also be included.