Department
Finance
Requested Action (Identify appropriate Action or Motion, purpose, cost, timeframe, etc.)
title
Request approval to renew an existing contract - Finance Department, 19RFP10172019C-BKJ, Healthcare Benefit Consulting and Benefit Claims Audit Services in the amount of $207,478.00 with Segal Group, Inc. (Atlanta, GA) to provide Healthcare Benefit Consulting Services. This action exercises the second of two renewal options. No renewal options remain. Effective January 1, 2022 through December 31, 2022. (APPROVED)
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Requirement for Board Action (Cite specific Board policy, statute or code requirement)
In accordance with Purchasing Code Section 102-394(6), the Purchasing Department shall present all renewal requests to the Board of Commissioners at least 90 days prior to the contract renewal date or 60 days if the contract term is six (6) months or less.
Strategic Priority Area related to this item (If yes, note strategic priority area below)
Open and Responsible Government
Commission Districts Affected
All Districts ☒
District 1 ☐
District 2 ☐
District 3 ☐
District 4 ☐
District 5 ☐
District 6 ☐
Is this a purchasing item?
Yes
Summary & Background (First sentence includes Agency recommendation. Provide an executive summary of the action that gives an overview of the relevant details for the item.)
Scope of Work: The Finance Department requests approval to renew contract with Segal Company to provide healthcare benefits consulting and benefit claims audit services. This contract will provide professional healthcare consulting services including: premium rate development benefit analysis, financial analysis, review of plan documents for compliance, claims analysis, cost projections, plan design/cost share recommendations and associated estimated savings, determine annual healthcare budget, draft healthcare benefits Request for Proposal (RFP) specification and provide technical assistance, coordinate benefits education/training sessions, coordinate communication efforts, provide notification of regulatory requirements/changes, assist with statutory benefit forms and filings, and all other efforts needed to administer the County's medical, dental and vision self-insured and fully insured programs. In June 2021, the BOC approved an amendment to the contract scope to include audit of benefit claims and administration services. The plans for audit are: the self-funded medical and Pharmacy plans administered by Anthem/IngenioRx; self-funded dental PPO, administered by Aetna; and, the Fully-Insured Kaiser HMO Plan. The audit scope includes but is not limited to: adjudication procedures review, statistical and target sample claims review, performance standard validation, financial review (only for self-funded plans) and a Report of Findings. Claims Audit Timeline Audits taking place during the 2021 plan year will evaluate claims paid during the 2020 plan year. Audits taking place during the 2022 plan year will evaluate claims paid during the 2021 plan year. The audit for the self-funded Medical/Rx and Dental Plans is underway. The audit of the Kaiser fully-insured HMO plan will begin in 2022 based on Kaiser’s audit schedule.
Community Impact: None
Department Recommendation: The Finance Department recommends renewal of contract with Segal to provide healthcare benefits consulting and claims audit services from 1/1/2022 to 12/31/2022.
Project Implications: None
Community Issues/Concerns: None
Department Issues/Concerns: None
Contract Modification
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Current Contract History |
BOC Item |
Date |
Dollar Amount |
|
Original Award Amount |
20-0222 |
3/18/2020 |
$195,568.00 |
|
1st Renewal |
|
12/2/2020 |
$201,435.00 |
|
2nd Renewal |
|
12/15/2021 |
$207,478.00 |
|
Total Revised Amount |
|
|
$604,481.00 |
Contract & Compliance Information (Provide Contractor and Subcontractor details.)
Contract Value: $207,478.00
Prime Vendor: Segal Group, Inc.
Prime Status: Non-Minority
Location: Atlanta, GA
County: Fulton County
Prime Value: $207,478.00 or 100.00%
Total Contract Value: $207,478.00 or 100.00%
Total M/FBE Value: $-0-
Exhibits Attached
Exhibit 1: Contract Renewal Agreement
Exhibit 2: Contract Renewal Evaluation Form
Exhibit 3: Contractor Performance Report
Contact Information
title
Ray Turner, Deputy Finance Director (404) 612-7737; Melissa Barnett, Benefits & Payroll Manager (404) 612-4243
Contract Attached
title
No
Previous Contracts
title
Yes
Total Contract Value
|
Original Approved Amount: |
$195,568.00 |
|
Previous Adjustments: |
$381,435.00 |
|
This Request: |
$207,478.00 |
|
TOTAL: |
$577,003.00 |
Grant Information Summary
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Amount Requested: |
|
☐ |
Cash |
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Match Required: |
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☐ |
In-Kind |
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Start Date: |
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☐ |
Approval to Award |
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End Date: |
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☐ |
Apply & Accept |
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Match Account $: |
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|
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Fiscal Impact / Funding Source
Funding Line 1:
426-999-S200-1160: Group Insurance Stabilization, Non-Agency, Professional Services
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Key Contract Terms |
|
Start Date: 1/1/2022 |
End Date: 12/31/2022 |
|
Cost Adjustment: 3% increase to the original approved amount at each annual renewal |
Renewal/Extension Terms: No renewal options remain |
Overall Contractor Performance Rating:
Would you select/recommend this vendor again?
Yes
|
Report Period Start: |
Report Period End: |
|
1/1/2022 |
12/31/2022 |