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Home My WebLink AboutRES 23-017RESOLUTION NO. 23-017 BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF BEAUMONT: THAT the City Manager be and he is hereby authorized to execute a contract with BCBS for Stop Loss Insurance in the amount of $1,641,139.00. The meeting at which this resolution was approved was in all things conducted in strict compliance with the Texas Open Meetings Act, Texas Government Code, Chapter 551 PASSED BY THE CITY COUNCIL of the City of Beaumont this the 10th day of January, 2023. A o Mp�, , ell �'L) bRlft�-) �c CIAy it1t19�� - Mayor Robin Mouton - �R eroeak Jv y1 W C-% . . STEALTH PARTNER GROUP Clifton Browning 5949 Sherry Lane, Suite 1170 Dallas, TX 75225 (2141552-3520 GROUP: City of Beaumont EFFECTIVE DATE January 1, 2023 - '4,'rs ea 1 th- �PARTNER GROUP An Amwinc Company IcmnlPna 'BCBS BCBS BOBS BCBS BCBS 0085 BCBS OCES . .TPA: Ppo Nenierk - BCBS Blue Cholm BCBS Blab Choice BCBS Blue choice BCBS Blue Choice BCBS Blue Choice BCBS Blue Chat. BCBS Blue Chalds- BCBS Blue Choice )UR Vender. -BCBS BCBS. BCBS, BCBS . BCBS . BCBS' BCBS BCBS , Pam: _._ .. _ "_FxPress SmPts, ... ._ :..fatPRSs SviPts Express SviPts. - 'Express Scripts . ... 6ipresd5cripts . "Fxpress:ScdPts: �Exprrss Scripts .. E%Pre55 S6iPts. - -.. - _.. _ -_. - SpecificDen art tslncluded: Med+Fix Med+Rx Med+Rx Med+Rx Med+Rx Med+Rx Med+Fix Med+Rx Plan Lifetime Maximum: Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Specific Lifetime Maximum Relmbursement Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited individual Specific Dedudihle: $275.000 $275,000 $275.000 $275,000 $275,000 $275,000 $275,000 $275,000 Specific Contmct 24/12 24/12 24/12 24/12 24/12 24/12 24/12 24/12 Composite 1406 $81 11 $97 27 $91 90 S94 30 S97 7fi $99.04 $109A9 $111.83_ _ Monthly Speeifrc Premium $114.041 $136,762 $129,211 $132,698 $137,451 $139,250 $153.943 $157.233 Additional Laser Claims Liability $0 $250,000 $250,000 $250,000 $250,000 $250,000 $250,000 Annual Specific Premium $1.368,487.92 $1,641,139.44 $1.800,536.80 - $1,042.37936 $1,899,406.72 $1,921.002.89 $2,097315.28 $2,136,795.76 $ Difference Over Current $272,652 $432.049 $473.891 $530,919 $552.515 $728,82.7 $768.308 19.92% 31.57% 34.63% 38.80% 4037% 5326% 56.14% %Difference F6m penanglarge Claim Prndingtame Claim Prndinglaspclaim PmdLgla calm pending faille Claim PsoXwLOW Claim DisdarmeSroms Raviuv Review Review Review Bedew Redraw I —el See below' See stow' Sa belm. See WW No New lasers of Renewal Not Included Not lncluded MENKin-ling Natlncluded Induded vef SOBS Rato Cap lndude4 wf 30% Ra1a CAP Nat Incklded Included w/ SO% Rate Cap Indudad w/ 50%Rate Cep Induded ItKAidod Inchwed Included IticUtdad In"od lududad lack" " •jam ' BCBS�BCBS PirfieiRE F° �ISU� �"'S6PittnvRE l Evofutlan Risk Ameiican FiaA!v1_'_ci_.-= Annual Fved Premium S1368AB8 11.641.139 $1.800.537 S1.B42.379 11.899A07 $530.919 57.921.003 5552.515 $2.097.315 5728.827 S2.136.796 5768308 $ Difference Over Current $272.652 19 92% $432.049 31 57% $473.891 34 63% 38 80% 40.37% 53.26% _ _. 56.14% %DiK rence Maximum Cost Liability $136BABS 91.641.139 $1.800.537 11.842.379 S1.899.407 $1.921.003 $2.097315 $2.136.796 $ Difference Over Current S272.652 $432.049 S473.891 34 $530.919 3880'X $552.515 4037% S728.027 532696 $768308 56"1dY %Difference 1ao % 37 <79f, Fa°.6 r_ seer AR Mre Sr+o�HsoMadiosrwK[BPar�dY+p, flowevr av UiewMwx/ndosfdUwr avurdf»G/Mvwt lr !seen ea tMlrRaw raaetf+.ryld_tRr�ta�..d, rant®r vrttadt.irrax-.€SPII� , m. aen0edx+KdRededictPa� IM= BlueCross BlueShield L of Texas C � Y i t Account, Number:. - Employer Group Number(s): Original Effective Date ofS,jtop Loss Policy Current Policy Effective Date: City of Beaunlont 801 Main Street, Stitle 320 BeatI1110111 State of Situs: Tix 067099 01670199 01/01 11JI-LU11 Current-Rofficy Period The specifications set forth in this Application are for the Policy Period commencing on 0 1/0 1/2023 and' einding on 12/3 1/2021. The specifications, below shall become effective on the date of the Policy Period specified abovie and shall con 'tinue in e full force and eff ct until the earfiest of the following dates- (1);'The l�ast day of the Policy Period; (2) The date the Policy terminates; or (3) The date this Application is, superseded in, whole or in part by a later executed Application. A. Covered Employees: Number of Single Coverage Units* 582 Number of Family Coverage Units* 844 It. Individual Stop Loss Coveragw I., New Coverage Renewal of'Existing Coverage Stop Loss coverage during the Current Policy Period Coverage for Claims incurred frorn to and Claims paid f rorn to If 24/121 18/121 15/12, or 12/112 are selected, Employer Group understands that run -out coive not includeci and Employer Group represents that it intends to purchase run-in coverage from its next carrier. For new coverage only, if a run-in contract as explained in the Stop Loss Policy (24112,, 18/12, or 15/12 coverage period) i's purchased, claims paid by the Employer Group's prior claim administrator will be settled at the time of roup to the Company (Blue Cross and ;the annual stop loss settle�men�t and must, be, report�ed by the, Employer G Blue Shield ofTexas, a Division of Health Care Service Corporation, a Mutual Lega,l Reserve Company) by the end of the Employer Group's Current Policy Period or, stop loss coverage for these run-in claims, will be forfeited. (Paid Renewal Only) Claim Administrators Claims: Claims incurred on or after the Original Effective Date of Policy, andpaid during the Policy Period. 3. CoVered Expenses inicludes: Mediciall Claims- -ess Scripts Prescription Drug Claims Wri th: ESI Expi. TA SLAW Rev. 3.21 A Division of Health Care Service Corporation, a, Mutual Legal Reserve Corn,pany an Independent Licensee of the Blue Cross and' BILie ShieldAssociation For Hospital Employer Groups only: Excludes %, of' Home Hospital'Medical' claims Other (for example DentalNision): 121111 111 Fill FIR13111 3 M= a,., Individual Stop Loss, Deductible* $275,000 0 10, Applies per Covered Person for the Employer Group's Current Policy Peri b. Aggre, ating Specific Deductible (If applicable),: $ 9 c. Lasered Individuals with Individual Stop Loss Deductible (ifapplica,ble'),. Individual identifier, alternate Individual Stop, Loss Deductible. d. Lasiered In, dividuals, excluded from Stop) LoSs Coverage (if appliciable): Individual idientifier: e. If a run-in contract (24/12, 18/12, or 15/12 coverage period) is purchased, per 'Item 2. above, run-ir are covered with a, maximum liability of, $ per, Covered Person. clai 5-Terminal Liability Option i(TLO) (does not apply to Employer Groups with 12/15, 12/18, or 12/24 contracts), 0 yes [:] No The following applies if the answer to item above is "Yes" (Terminal Uability Option dw MEI R An I 6. Individual Stop Loss Premium Monthly Individual Stop Loss Premium shall be equal to the amounts, obtained by multiplying the number, of Covered Employees for a particular Month byL $97.27 Composite, or $ for each Single Coverage Unit. $ for each Family Coverage Unit C. Aggregate Stop Loss Coverage: Yes F1 No'H It yes, complete Items 1,Ahrough 5. Below. 1 New Coverage [j Renewal of Existing Coverage 2. Stop, Loss Coverage during the current, Policy Period', ■ Choose an item Coverage for Claims incurred from to and Claims paid fron-i to If 24/12, 18/12t 15/12, or 12/12 are selected,, Employer Group understands that, run -out coverage is not included, and Employer Group, represents that, it intends to purchase runin coverage from its next carrier., 2 TX SLAP P Rev. 3.21 A Division of Health Care Service Corporation, a Witua] Legal Reserve Company an Independent Licensee of the Blue Cross and Blue Shield Association if a run-in contract as, explained in the policy (24/12, 18/12, or 115/12 coverage period) is For new� coverage only, Purchased, claims, paid by the Employer Group s, prior claim administrator will be settled at the time of the annual stop, loiss, settlement and must be reported' by the Employer Group to the Company (Blue Cross and Blue Shield of 'Texas, a Division off Health Care Service Corporation, a Mutual Legal Reserve Company) Ity,by the end of the Employer Group I s Current Policy Period or stop loss coverage for these rLin-in claims will be forfeited., X (Piaid Renewal Only) Claim Administrators Claims- Claims incurred on or after the Original Effective DIate III of Policy and paid during the Policy Period. El Medical Claims F-1 Claim Administratoir's, Provider Access Fees 0 Prescription Drug Claims with- Choose, an itern El For Hospital Employer Groups only:,, Excludes % of'Hl,olme Hospital Medica,l claims Other (for example Derut alNision).: a. Attachment Factor % of the Average Claim Value b. Aggregate Claim Factors* 5. Terminal Liabil'ity Option JLO) (does not apply to Employer Groups with, 12/15, 12/18, or 12/24 contracts): L1 Yes 0, No The following applies if the answer to item above is "Yes" (Terrninal Liability Option): or the Must be elected at Policy inception or renewal. Premlium, cost is calculated by taking thef average enrollment f due at the time last two months multiplied by three, times pre -termination Aggregate Stop Loss, ratei(s). PremIum IS of termination, payable; by lump surn within 10 days, of receipt of bill. 6. Aggregate Stop Loss Premium, [j Monthly Premium: Monthly Aggregate Stop Loss Premium shall be equal to the amounts obtained by multiplying the number of'Covered Employees for a particular Month by: Composite; or for each Burgle Coverage Usnit for each Family Coverage Unit N TX KAPP Rev. 3.21 A Division of Health Care Seivice Corporation,, a Mutual Legal Reserve Company a.n, lindependent Licensee of the Blue Cross and Blue Shield Association Annual Premilum (Due on the first day of the Current Policy P;eriocl): low 1=0 M � 111111111 0 I I Retirees, Govered (seleclt If included): Pre-65: [] or Plost-65: Ej 2. Home Hospital Employer Groups Only: Home Hospital Provider Number(s) subject to exclusion percentage per Item 13,3. & C.3.: No 3. Monthly Aggregate Accommodation: Yes 4, Additional information: dr w mil dk Galan me James Sales, Representative Signature of Authorized Purchaser Title of Authorized Purrhastir WOW, Date IH 'TX SLAW Rev., 3.21 A, Division of Health:, Care Service Corporation, a MILItual, Legal Reserve Cornpany an Independent Licensee of the Blue Cross and Blue Shield Association