R-2019-0497 - 12/19/2019 RESOLUTION NO. R-2019-0497
WHEREAS, the City of Round Rock (the "City") has advertised for proposals to provide a
Stop Loss Insurance Policy for the City's self-funded employee benefits plan (the "Plan") for the
period of January 1, 2020 through December 31, 2020; and
WHEREAS, the City previously entered into an Administrative Services Agreement
("Agreement")with Aetna Life Insurance Company ("Aetna") for Stop Loss insurance on December 7,
2017 by Resolution No. R-2017-4987, and
WHEREAS, Aetna has submitted a proposal to continue to provide said services, and said
proposal has been determined to be the most advantageous to the City considering the price and other
evaluation factors included in the request for proposals; and
WHEREAS, the City Council desires to accept the proposal of Aetna for the period of January
15 2020 through December 31, 2020,Now Therefore
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS,
That the proposal of Aetna Life Insurance Company for provision of Stop Loss Insurance
Policy for the City's self-funded employee health benefits plan is hereby accepted, as the proposal
determined to be the most advantageous to the City considering the price and other evaluation factors
included in the request for proposals.
BE IT FURTHER RESOLVED
That the Council hereby authorizes renewal of services with Aetna for insurance coverage for
the guarantee period of January 1, 2020 through December 31, 2020 as set forth in the Stop Loss
Renewal document from Aetna attached as Exhibit"A."
The City Council hereby finds and declares that written notice of the date, hour, place and
subject of the meeting at which this Resolution was adopted was posted and that such meeting was
open to the public as required by law at all times during which this Resolution and the subject matter
0112.1902;00436463
hereof were discussed, considered and formally acted upon, all as required by the Open Meetings Act,
Chapter 551, Texas Government Code, as amended
RESOLVED this 19th day of December, 2019.
CRAIGORGA , Mayor
City of Round R k, Texas
ATTEST:
of
SARA L. WHITE, City Clerk
2
EXHIBIT
Stop Loss Renewal rrA»
City of Round Rock
January 1.2020 through December 31.2020
Firm Stop Loss Quote
-This exhibit outlines your firm renewal rates effective January 1,2020.
- Pricing assumes plan enrollment of 874 employees. If actual enrollment varies by more than 10%in
total and/or the plan design changes we reserve the right to readjust the stop loss premium.
- In an environment where healthcare costs are increasing,maintaining the same deductible shifts more of the claim
cost to the stop loss provider.
-To help reduce the effect of leveraging,it is recommended that a plan sponsor consider increasing their
Stop Loss deductible to keep pace with medical trend.
- Please refer to the stop loss policy for detailed Stop Loss information.
Current Firm Renewal Option 1
01/01/2019 01/01/2020 01/01/2020
STOP LOSS COVERAGE SPECIFICATIONS
Policy Period Length(months): 12 12 12
Number of Employees Covered Under Stop Loss: 835 874 874
Producer Compensation: 0.0% 0.0% 0.0%
Terminal Liability Option: None None None
Claims Paid Basis for Medical Coverages: Cleared Cleared Cleared
Claims Paid Basis for APM Rx coverage is on a cleared basis
INDIVIDUAL STOP LOSS COVERAGE SPECIFICATIONS
Individual Stop Loss Level: $200,000 $200,000 $250,000
Contract Type: Paid Paid Paid
Coinsurance%: 100% 100% 100%
M/N Claims Apply to ISL(Aetna Administered only): Yes Yes Yes
Rx Claims Applied to ISL(Aetna Administered only): Yes Yes Yes
Individual Specific Stop Loss Limits(Lasering): No No No
Individual Lifetime Stop Loss Payment Amount: Unlimited Unlimited Unlimited
Reimbursement Method: Immediate Immediate Immediate
AGGREGATE STOP LOSS COVERAGE SPECIFICATIONS
Aggregate Stop Loss Percentage: 125% 125% 125%
Contract Type: Paid Paid Paid
Maximum Annual ASL Payment Amount: $1,000,000 $1,000,000 $1,000,000
Reimbursement Method: Monthly Budget Feature Monthly Budget Feature Monthly Budget Feature
Prior Carrier Runoff Cap: $0 $0 $0
Total Claims Applied to Aggregate Stop Loss: $10,087,175 $11,098,223 $11,273,981
Benefits that apply to ASL-Medical: $7,380,237 $8,412,730 $8,412,730
Benefits that apply to ASL-Drug: $2,706,938 $2,685,493 $2,685,493
Lasering Adjustment: $0 $0 $0
Pooling and Coinsurance Adjustment: $0 $0 $175,758
FINANCIAL INFORMATION
Stop Loss Premium: $1,430,656 $1,614,208 $1,299,883
State Assessment Fee $0 $0 $0
Total Stop Loss Premium: $1,430,656 $1,614,208 $1,299,883
Total Premium(PEPM)Composite Rate: $142.78 $153.91 $123.94
Individual Stop Loss premium as%of Total Premium: 95.98% 96.30% 95.40%
Stop Loss Aggregate Limit*: $12,608,969 $13,872,779 $14,092,476
Stop Loss Aggregate Limit(PEPM)Composite Factor: $1,258.38 $1,322.73 $1,343.68
ISL rate: $137.04 $148.17 $118.20
ASL rate: $5.74 $5.74 $5.74
*Minimum Stop Loss Aggregate Limit will be set using the first month enrollment x Stop Loss Aggregate Limit(PEPM)Composite Factor x#
of contract Months.
Premium rates are billed and Aggregate Factors are administered on a composite basis.
May 2013
www.aetna.com Page 1