R-2020-0346 - 12/3/2020RESOLUTION NO. R-2020-0346
WHEREAS, the City of Round Rock (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, the City Council desires to renew said Agreement for Stop Loss insurance for the
period of January 1, 2021 through December 31, 2021, Now Therefore
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS,
That the Council hereby authorizes renewal of the Administrative Services Agreement with
Aetna for insurance coverage for the guarantee period of January 1, 2021 through December 31, 2021
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
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 3rd day of December, 2020.
CRAIGORA�Q, Mayor
City of tounock, Texas
ATTEST:
&P& 0 VG q
SARA L. WHITE, City Clerk
0112.20202; 00460536
Stop Loss Renewal
City of Round Rock #819919
January 1. 2021 through December 31. 2021
Firm Stop Loss Quote
- This exhibit outlines your Firm renewal rates effective January 1, 2021.
- Pricing assumes plan enrollment of 896 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 shims 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
Renewal
Option 1
1/1/2020
1/1/2021
1/1/2021
STOP LOSS COVERAGE SPECIFICATIONS
Policy Period Length (months):
12
12
12
Number of Employees Covered Under Stop Loss:
874
896
896
Number of Single Covered Under Stop Loss:
416
420
420
Number of Family Covered Under Stop Loss:
458
476
476
Aetna Choice POS Q:
419
438
438
Aetna Select:
455
458
458
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
$2002000
52252000
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 Lasering
No Lasering
No Lasering
Individual Lifetime Stop Loss Payment Amount:
Unlimited
Unlimited
Unlimited
Reimbursement Method:
Immediate
Immediate
Immediate
EXHIBIT
AGGREGATE STOP LOSS COVERAGE SPECIFICATIONS
Aggregate Stop Loss Percentage:
125%
125%
125%
Contract Type:
Paid
Paid
Paid
Maximum Annual ASL Payment Amount:
$12000, 000
$12000, 000
$12000, 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:
$1120982223
$102778,353
$1028842325
Benefits that apply to ASL-Medical:
$8,4122730
$820753,480
$820752480
Benefits that apply to ASL-Drug:
$226852493
$2307022873
$227022873
Lasering Adjustment:
$0
$0
$0
Pooling and Coinsurance Adjustment:
$0
$0
$1052972
FINANCIAL INFORNUTION
Stop Loss Premium at renewal lives:
$126542840
$130770,639
$126022371
State Assessment Fee
$0
$0
$0
Total Stop Loss Premium:
$1306542840
$127701639
$126022371
Total Premium (PEPM) Composite Rate:
$153.91
$164.68
$149.03
Individual Stop Loss premium as % of Total Premium:
95.98%
96.50%
96.08%
ISL rate:
$148.17
$15 8.60
$142.90
ASL rate.
$5.74
$6.08
$6.13
Percentage Premium Increase.
7.0%
-3.2%
Stop Loss Aggregate Limit*:
$1328722779
$1324722941
$1326052406
Stop Loss Aggregate Limit (PEPM) Composite Factor:
$19322.73
$19253.06
$1,265.38
*Minimum Stop Loss Aggregate Limit will be set using the first month enrollment g Stop Loss Aggregate Limit (PEPM) Composite Factor g #
of contract Months.
Premium rates are billed and Aggregate Factors are administered on a composite basis.
„A„
May 2013
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www.aetna.com Page 1