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R-97-11-25-10E - 11/25/1997!TEM 11 CLASS & ITEM DESCRIPTION QUANTITY UNIT MAKE /MODEL UNIT PRICE EXTENSION REINSURANCE(STOP -LOSS) IN ACCORDANCE WITH SPECIFICATION NUMBER 18 -95 -0001 REVISED OCTOBER, 1997, 9 PAGES ATTACHED AND EXHIBITS A THROUGH H 1 SPECIFIC RATE: 1.1 EMPLOYEE 376 EE 1.2 DEPENDENT 118 DEP 2 AGGREGATE RATE INCLUDING MONTHLY REIMBURSEMENT 376 EE 3 CLAIMS LIABILITY FACTORS (125% CORRIDOR) 3.1 EXPECTED EE &DEP 3.2 MAXIMUM EE&DEP 4 CLAIMS ATTACHMENT POINT MAXIMUM 4.1 TOTAL MONTH EE &DEP 4.2 TOTAL ANNUAL EE &DEP FACTORS AND ATTACHMENT POINTS SHALL NOT BE AFFECTED BY THE INCREASE OR DECREASE OF EMPLOYEE OR DEPENDENT COUNTS BIDS SHALL ARRIVE IN THE OFFICE OF THE CITY PURCHASER AT THE ADDRESS SHOWN (HEREIN BY 2:00 P.M. ON :11 -14 -07 '8!ilb disk /excel INVOICE TO: City of Round Rock Finance Department 221 East Main Street Round Rock, Texas 78664 -5299 BID F.O.B. DESTINATION UNLESS OTHERWISE SPECIFIED BELOW DESTINATION: City of Round Rock 221 E. MAIN ST. ROUND ROCK, TX 78664 j3idder agrees to comply with all conditions below and on reverse side of this IFB INVITATION FOR RID (IFR) CITY OF ROUND ROCK 221 E. Main Street Round Rock, Texts 78664 -5299 FACIMI1E RESPONSES SHAI.L NOl RE ACCEPFED DATE: 11 3 97 SHOW BID OPENING DATE s BID NUMBER IN LOWER LEFT HAND CORNER OF SEALED 810 ENVELOPE B SHOW RETURN ADDRESS OF BIDDING FIRM ADDRESS: CONTACT: TELEPHONE NO.: PAGE 1 OF 1 PAGES Return Original and One Copy of Bid BIDDER SHALL SIGN BELOW BID OPENING DATE 2:00 P_M.:I 1 -14 -97 Bid Nureh :1 8-95-0001 F a //// / � / f // AuthorizedSignature Matt McCuen Printed Name shall disqualify bid BUSINESS ENTITY TYPE: Stop Loss Carrier 11 -13- , _ Dat SEE 1.6 ON BACK FOR INSTRUCTIONS: TAX ID NO.: LEGAL BUSINESS NAME: Southland Life TInsurance Co. ADDRESS: 5780 Powers Ferry Rd NW Atlanta, GA 30327 -4390 Matt MCCue11 972- 422 -6957 DELIVERY IN DAYS By the signature hereon affixed, the bidder hereby certifies that neither the bidde nor the entity represented by the bidder. or anyone acting for such ntity has violated the antitrust laws of this State, codified in Section 15.01 et seq., Texas Business and Commerce Code, or Federal antitrust Iws, nor communicated directly or indirectly, the bid made to any competitor or ar y other person engaged in such line of business." SOUTHLAND LIFE INSURANCE COMPANY PROPOSAL OF MEDICAL EXCESS RISK FOR City of Round Rock Effective December 1, 1997 Claims Administrator: HBI Based on 374 employees 255 single, 119 family PPO Option Included? Yes Brokerage Commission: 15% Specific Stop Loss Coverage: Medical, Prescription Drug Contract Basis: Incurred in 15/ Paid in 12 All claims must be paid during the policy year and incurred during the policy year or during the three months prior to the policy effective date, Monthly Rates Specific Monthly Annual Deductible Single Family Composite Premium Premium $30,000 16.77 41.68 24.70 9,237 110,855 Aggregate Stop Loss Coverage: Medical, Dental, Prescription Drug Contract Basis: 15/12 All claims must be paid during the policy year and icurred during the policy year or during the three months prior to the policy effective date. Monthly Attachment Factors Specific Expected Annual Minimum Deductible Single Family Composite Annual Claims Attachment Pt Attachment Pt $30,000 150.43 373.82 221.51 795,309 994,136 845,016 Risk Corridor: 25% Aggregate Premium Payment: $2.75 per participant per month Monthly Aggregate Accommodation: Yes Run -In Limit: N/A Cost Summary Assumes constant enrollment for 12 months. Excludes administration fees and any other fees. Specific Annual Annual Annual Aggregate Estimated Annual Deductible Specific Premium Aggregate Premium Attachment Level Maximum Liability $30,000 +13;964 12,342 994,136 171-20 110, 855 i l r7 35 NOTE: QUOTE IS SUBJECT TO THE CONDITIONS, TERMS AND QUALIFICATIONS ON PAGE 2 SOUTHLAND LIFE INSURANCE COMPANY PROPOSAL OF MEDICAL EXCESS RISK FOR City of Round Rock Effective December 1, 1997 Specific Stop Loss Conditions Specific Lifetime Maximum: 100% of the eligible claims up to a maximum of $1,000,000 per covered person, less the Specific Deductible for that person, shall be reimbursed by Southland Life Insurance Company. -Actively-at-Work Option: A -A -W will be waived subject to satisfactory Disclosure Statement - Advanced Funding Option: Included - Pre - existing Conditions: lithe pre - existing condition wording in the underlying plan document has been in effect for a minimum of 12 months and does not limit benefits due to a pre- existing condition, the Stop Loss policy will follow the plan document. Otherwise, a 3/12 pre - existing conditions limitation will apply subject to any exceptions allowed under the Health Insurance Portability and Accountability Act. Aggregate Stop Loss Conditions - Aggregate Maximum: 100% of the eligible claims for covered expenses of the Aggregate Attachment Point, up to a maximum of $1,000,000, shall be reimbursed by Southland Life Insurance Company. - Aggregate Stop Loss Reinsurance cannot be purchased without Specific Stop Loss Reinsurance. Underwriting Terms - Proposal is valid for fifteen days following the proposed effective date of coverage. -Agent does not have the authority to bind or modify the terms of this quotation or the policy to be issued without prior approval of Southland Life Insurance Company. - Composite rates/factors are illustrative and cannot be sold. -Any unfunded claims balance must be disclosed, otherwise such claims will not be considered eligible under the Stop Loss Policy. Qualifications This quotation is based on standard policy provisions, limitations and exclusions and is subject to change upon receipt of final enrollment, plan design changes, a completed Disclosure Statement, and the following information: - Current Plan Document. - Documentation of Claims Experience. -Paid claims and enrollment: Within 2 months prior to the effective date, including any unfunded claim balance. -Shock loss information (diagnosis /prognosis) for ongoing claims in excess of $15,000 including monthly and projected expenses. NOTE: All qualified information is subject to receipt within 31 days from the proposed effective date. Additional Qualifications Rates and factors are illustrative and are subject to change upon receipt of an enrolled census with an accurate single/family split. Please clarify why the census is indicating a different single/family split than the most recent month on the claims report. This proposal is subject to confirmation that no more than 40% of plan participants are employed by the fire ad police departments. This proposal is based on the current Blue Choice PPO plan design. Please confirm BlueChoice is the PPO to be quoted. City of Round Rock `Qualifications, continued Please provide diagnosis and prognosis for all ongoing claims, in particular claimants with the folio ving claim amounts $54,000 and 527,045. Rates are subject to confirmation participants age 65 and older are Medicare primary, please confirm this is correct. Aggregate is subject to confirmation that the claims total of $934,471 for the prior year are gross of specific reimbursements. Please verify that monthly dental and medical enrollment are the same. If HBI continues as the claims administrator, we will agree to offer a 24112 specific contract at the same quoted rates as the 15/12 contract. The run -in limit per individual will be set equal to the specific deductible. Increase aggregate factors 4% for a 24112 aggregate contract. The aggregate run -in limit for a 24/12 is $196,000. WHEREAS, the City of Round Rock has duly advertised for bids for the City's EL,. Loss Re- insurance, and WHEREAS, EL,. 61.4.64J/6& t has submitted the lowest and best bid, and WHEREAS, � the City Council wishes to accept the bid of 662,(10441/25L4 ,� 4 ,AutLd.i J , Now Therefore, BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS, /Q��� �� That the bid of .elitG� &0442 / 1,W1. 21.Aig is hereby accepted as the lowest and best bid for the City's Stop Loss Re- insurance. 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, and the Act. RESOLVED this 25th day of November., 1997. ATTEST: n:\WPDoS\ncsoiuxx \RS2i12se.weu /spy E LAND, City Secretary RESOLUTION NO. R- 97- 11- 25 -10E CHARLE 'CV - •'J"ER, Mayor City of Round Rock, Texas Current Renewal Alternate 1 Alternate 2 Alternate 3 Alternate 4 ING** Southland Alternate 5 Blue Cross ** Blue Shield Blue Cross** Blue Shield John Alden ** Risk SL[ / ** Commonwealth RAS / ** TransAmerica ING Southland Paid Paid 15/12 15/12 15/12 15/12 24/12 Paid Paid 15/12 15/12 15/12 15/12 24/12 530,000 530,000 530,000 $30,000 $30,000 $30,000 $30,000 522.27 $24.50 $22.83 $20.01 $19.08 516.77 516.77 $60.15 $66.17 556.94 $49.65 $47.40 541.68 541.68 125% 125% 125% 125% 125% 125% 125% 52.54 $2.54 52.60 53.13 53.21 52.75 52.75 $219.00 5240.90 5226.67 5234.74 5128.47 5150.43 5156.45 $2I9.00 5240.90 $226.67 $234.74 5319.25 $373.82 5388.77 541,403.00 545,431.40 545,431 40 $45,431.40 545,431.40 S45,431.40 545,431.40 54,476.00 54,476.00 54,476.00 54,476.00 54,476.00 54,476.00 $4,476.00 $6,714.00 56,714.00 56,714.00 $6,714.00 $6,714.00 $6,714.00 56,714.00 $7,833.00 $7,833.00 57,833.00 $7,833.00 $7,833.00 57,833.00 57,833.00 $153,773.16 $169,166.76 $150,896.16 $131,890.68 $125,843.04 5110,634.00 5110,634.00 511,369.04 511,369.04 $11,637.60 514,009.88 $14,367.96 512,309.00 512,309.00 5225,568.20 5244,990.20 5226,988.16 5210,354.96 5204,665.40 $187,397.40 $187,397.40 5980,244.00 51,078,268,40 51,014,574.90 51,050,696.20 5847,465.56 5992,325.60 51,032,023.16 51,205,812.20 $1,323,258.60 51,241,563.00 $1,261,051.10 51,052,130.90 $1,179,723.00 51,219,420.56 Specific: Aggregate: Employee Only Employee Family Aggregate Corridor Aggregate Premium Attachment Point Factor (ee) Attachment Point Factor (el) Medical Admin Dental Pre - Certification SI. David's PPO Specific Stoploss Premium Aggregate Stoploss Premium Total Fixed Cost Annual Attachment Point Total Maximum Plan Cost *Actively -At -Work applies * *Actively -At -Work is waived Calculation is based on Employee Only City of Round Rock 254 Analysis of Alternate Quotations Employee 4 Family 119 Assumptions: BC/BS + 10% on Fixed Factors and Attachment Paint BCIBS + $0.90 on 'Medical Admin and +50.00 on Dental Admin Alt Sloploss rates include a 15% commission paid directly by the carrier to TRG. Note: Southland was also included in the preliminary spread but was misquoted without dental coverage in the aggregate. The Southland numbers shown here were received by the City in the invitation for bid process. 0 0 N DATE: November 20, 1977 SUBJECT: City Council Meeting, November 25, 1997 ITEM: 10. E. Consider a resolution awarding the bid for Stop Loss Reinsurance. STAFF RESOURCE PERSON: David Kautz The stop loss reinsurance provides coverage for the City's health plan claims payments which exceed limits established by the City. This coverage protects the City's self- funded plan from catastrophic losses. Staff recommends awarding the bid to Southland Life Insurance Company for the Stop Loss Reinsurance for the plan year which begins December 1, 1997. A spreadsheet of comparative reinsurance costs is attached along with a summary of the Southland Life Insurance Co. bid. The recommended bid is listed as Alternate 5 on the attached spreadsheet. A presentation will be made at the Council meeting.