R-2025-315 - 12/4/2025 RESOLUTION NO. R-2025-315
WHEREAS, the City of Round Rock (the "City") previously entered into an Administrative
Services Agreement ("Agreement") with United Healthcare Insurance Company ("United Healthcare")
for Stop Loss insurance on December 16, 2021 by Resolution No. R-2021-333, and
WHEREAS, the City Council desires to renew said Agreement for Stop Loss insurance for the
period of January 1, 2026 through December 31, 2026, 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
United Healthcare for insurance coverage for the guarantee period of January 1, 2026 through
December 31, 2026, as set forth in the Stop Loss Renewal document from United Healthcare attached
as Exhibit"A," and authorizes the execution of any related documents.
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 4th day of December, 2025.
CRAOR N,Mayor
City Uoun ock, Texas
ATTEST:
r))�M
ANN 9RXWLIN, City Clerk
0112.20252;4935-7876-8507
�JII United CITY OF ROUND ROCKIStop Loss Exhibit
Healthcare
Effective Date:1/1/2 02 6-1 2131/2 026
Firm Offer
This document may contain protected health information(PHI)and should only be shared with individuals designated to view such information per HIPAA regulations.
Current ISL ISL Proposed Option 1 ISL Proposed Option
Individual Stop Loss
ISL Total Quoted Subscribers 1,007 1,050 1,050 1,050
ISL Rate PEPM $161.41 $193.69 $185.17 $175.50
ISL Deductible $200,000 $200,000 $225,000 $250,000
ISL Liability Limit(per individual) Unlimited Unlimited Unlimited Unlimited
ISL Contract Basis P12 P12 P12 P12
ISL Includes Earty Retirees Yes Yes Yes Yes
ISL Includes Medicare Retirees No No No No
ISL Includes RX Yes Yes Yes Yes
Lasered Claimants" No No No No
Current ASL ASL Proposed Option I ASL Proposed Option 2 ASL Proposed Option 3
Aggregate Stop Loss
ASL Total Quoted Subscribers 1,007 1,050 1,050 1,050
ASL Rate PEPM $3.80 $4.30 $4.32 $4.35
ASL Corridor 125% 125% 125% 125
ASL Liability Limit(per policy period) $1,000,000 $1,000,000 $1,000,000 $1,000,000
ASL Contract Basis P12 P12 P12 P12
ASL Includes Eary,Retirees No No No No
ASL Includes Medicare Retirees No No No No
ASL Includes Rx Yes Yes Yes Yes
ASL Includes Commissions No No No No
Monthly Accommodation Yes Yes Yes Yes
Total Stop Loss Premium PEPM $165.21 $197.99 $189.49 $179.85
Monthly Stop Loss Premium Cost $166,363 $207,889 $198,964 $188,844
Annual Stop Loss Premium $1,996,361 $2,494,671 $2,387,568 $2,266,130
Expected Claims PEPM $1,162.76 $1,455.98 $1,462.66 $1,471.22
Composite Attachment Factor PEPM(Illustrative) $1,453.45 $1,819.98 $1,828.33 $1,839.03
Projected Monthly Aggregate Liability $1,463,624 $1,910,974 $1,919,741 $1,930,976
Projected Annual Aggregate Attachment Point $17,563,490 $22,931,685 $23,036,895 $23,171,715
Monthly Maximum Stop Loss Liability $1,629,988 $2,118,863 $2,118,705 $2,119,820
Annual Maximum Stop Loss Liability $19,559,851 $25,426,356 $25,424,463 $25,437,845
Confidential/Proprietary/Competitively sensitive Information 1 of 3
Stop Loss Rating Assumptions
■ The stop loss attachment points and premium rates provided by UnitedHealthcare in this quotation will be effective from 1/1/2026-12/31/2026.
• Our quotation is based on claims with dates of loss on or after when CITY OF ROUND ROCK enrolled with UHC and paid on or after the effective date of 1/1/2026.
■ Aggregate Stop Loss applies to medical claims after the effective date of the stop loss policy,before the policy year and. Paid claim accumulations are based on cashed claim drafts.
• Aggregate Stop Loss applies to medical and pharmacy claims,i.e.Healthcare dollars only.The pharmacy plan must be administered by UnitedHealthcare.
• UnitedHealthcare will be the exclusive health care administrator.
• Participation of at least 75 percent of the eligible enrollees is required.
■ COBRA enrollees do not make up more than five percent of the total covered population.
■ The benefits or service requirements requested and/or quoted do not change prior to or after the effective date.
■ Changes in federal,state or other applicable legislation or regulation do not require changes to this proposal.
• Stop loss protection benefits are based on the proposed plan of benefits.CITY OF ROUND ROCK will provide UnitedHealthcare®with a copy of the plan document when finalized.UnitedHealthcare®reser
ves the right to change the rates for the stop
loss policy if the plan of benefits in the finalized plan document differs from the proposed plan of benefits.
• Individual Stop Loss claims will accumulate toward the stop loss on an issued basis.
■ Under aggregate stop loss,the minimum annual aggregate attachment point will be 95%of the monthly aggregate attachment point for the first month of the policy period times 12.
■ The offer of Aggregate Stop Loss is contingent upon the purchase of Individual Stop Loss from UnitedHealthcare
• The claims of an individual who has been excluded from individual coverage will not accumulate toward the aggregate attachment point.
■ Individual claims above the individual stop loss level will not accumulate toward satisfaction of the aggregate attachment point.lf individual stop Loss is not in-force,claims
above$200,000 will not accumulate toward the satisfaction of the aggregate
attachment point.
• The aggregate stop loss maximum benefit is$1,000,000 per policy period.
■ Aggregate Stop Loss Factors are administered on a composite basis. Any attachment points quoted by product or sub-group in this proposal will be used to establish a composite
attachment point on the basis of the final enrollment levels.
• This proposal is contingent upon the review of claims information(including large claims)updated within 120 days of the effective date.
■ UnitedHealthcare may pay the selling broker for the promotion,sale,and renewal of the products and services offered in this proposal.In addition to our standard compensation,we
may make additional cash payments or reimbursements to selling
brokers in recognition of their marketing and distribution activities,persistency levels,and volume of business.
For New York situs business,we may pay reduced compensation where fewer services are offered and increased compensation where more services are provided.Producers must comply
with the specific compensation disclosure requirements of
New York Regulation 194.
General Exclusions Provisions
UnitedHealthcare will not reimburse Policyholder for any of the following:
■ Any payment which does not strictly comply with the terms and conditions of the Plan Document;
■ Any payment for claims that are not covered as part of the underlying plan design(i.e.FSA,HRA&HSA dollars are excluded).
■ Any payment or expense caused by or resulting from war,declared or undeclared or international armed conflict;
■ Any payment for litigation costs and expenses,extra-contractual damages,compensatory damages,interest,exemplary and punitive damages or liabilities,including but not limited
to those resulting from negligence,intentional wrongs,fraud,bad faith
or strict liability on the part of the Policyholder,Plan,Administrator or any agent or representative of the Policyholder,plan or Administrator;
• Any payment for occupational accidents or illnesses which are also eligible expenses covered by Workers'Compensation or Occupational Disease law,or similar legislation,whether
or not coverage under such law is actually in force.
■ Any payment associated with benefits not covered by the underlying employee benefit plan,which are nevertheless paid by the employer.
UnitedHealthcare reserves the right to revise this quotation under the following circumstances:
• An award is not made on or before 11/04/2025.
■ If the number of covered medical employees varies by more than ten percent from our quoted level of 1050
■ The average contract size,defined as the total number of enrolled members divided by the total number of enrolled employees,varies by ten percent or more from the assumed average
contract size of 2.22
■ The actual enrollment by product varies by ten percent or more from the following:
Product Subscribers
EPO 599
.......................................__.._...._.....................
Choice+PD 451
If CITY OF ROUND ROCK elects to purchase integrated Dental.Vision,or Short Term Disability coverage with UnitedHealthcare,additional claim savings may apply.
Confidential/Proprietary/Competitively Sensitive Information 2 of 3
United CITY OF ROUND ROCK 2026 ASO Expense Summary Exhibit
Healthcare
Proposed Option 1 Proposed Option 2 Option 3
Subscribers I 1050 1050 1050
Members 2328 2328 2328
jAdministration
Composite Administration Fee-PEPM $12.31 $12.31 $12.31
Monthly Fees $12,926 $12,926 $12,926
Annual Fees $155,106 $155,106 $155,106
Credits ($30,000) ($30,000) ($30,000)
Annual Net Administration i6 $125,106 $125,106
Stop Loss
ISL Deductible $200,000 $225,000 1 $250,000
ISL Rate-PEPM $193.69 $185.17 $175.50
ASL Corridor 125% 125% 125%
ASL Rate-PEPM $4.30 4.32 $4.35
Total Stop Loss Rates-PEPM $197.99 $189.49 $179.85
Monthly Premium $207,889 $198,964 $188,844
Annual Premium $2,387,568 $2,266,130
Expected Claims-PEPM $1,455.98 $1,462.66 $1,471.22
Attachment Point-PEPM $1,819.98 $1,828.33 $1,839.03
Total Expected-Monthly $1,528,779 $1,535,793 $1,544,781
Total Expected-Annual $18,345,348 $18,429,516 $18,537,372
Total Maximum-Monthly I $1,910,974 $1,919,741.25 $1,930,976.25
TotalMaximum-Annual ''- $22,931,685 $23,036,895.00 $23,171,715.00
Total Cost Summary
Expected Annual $20,965,125 $20,942,190 $20,928,608
Expected Maximum L $25,551,462 $25,549,569 $25,562,951
Imprest Balance
Current Req.Deposit Required Medical Deposit"
Imprest Balance $330,000 $367,000
Option Weekly ACH Weekly ACH
Frequency 5 5
"If additional lines are sold(ancillary,HRA,FSA,etc.),additional imprest amounts could be needed
Confidential/Proprietary/Competitively Sensitive Information 3 of 3