Department
Finance
Requested Action (Identify appropriate Action or Motion, purpose, cost, timeframe, etc.)
title
Request approval to renew existing contract - Finance Department, 25RFPMAPD052325C-MH, Employee Healthcare Benefit Plan- MAPD with Emphesys Insurance Company, a Humana affiliate (Atlanta, GA) to administer: (1) Basic Medicare Advantage Plan and (2) Enhanced Medicare Advantage Plan to provide medical and pharmacy benefits as a fully insured option to Medicare eligible retirees/beneficiaries and dependents. Effective dates: January 1, 2027, through December 31, 2027, with three renewal options.
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Requirement for Board Action (Cite specific Board policy, statute or code requirement)
In accordance with Purchasing Code Section 102-375, all competitive sealed proposals shall be forwarded to the Board of Commissioners for approval.
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
Scope of Work: The recommended proposal will provide Employee Healthcare Benefit Plan - MAPD with Emphesys Insurance Company, a Humana affiliate (Atlanta, GA) to administer: (1) Basic Medicare Advantage Plan and (2) Enhanced Medicare Advantage Plan to provide medical and pharmacy benefits as a fully insured option to Medicare eligible retirees/beneficiaries and dependents.
Community Impact: This contract provides a Medicare Advantage plan (MAPD) benefit coverage to eligible Fulton County retirees, beneficiaries and covered dependents.
Department Recommendation: Decoupling the Medicare Advantage (medical) with Emphesys Insurance Company, a Humana affiliate (Atlanta, GA) and the Part D Plan (pharmacy) will allow Fulton County to take advantage of this year’s Premium Stabilization Demonstration subsidy, in addition to the typical subsidies and manufacturer rebates, as the pharmacy portion will now be a stand-alone prescription drug plan (PDP).
Project Implications: Humana’s NISCO (Non-integrated Sole Carrier Option) for 2027 will generate 13.6% savings for the Basic plan and 8.8% savings for the Enhanced plan
Community Issues/Concerns: None
Department Issues/Concerns: None
Contract Modification: This is a new procurement.
Contract & Compliance Information (Provide Contractor and Subcontractor details.)
Contract Value: Based on enrollment per approved rates.
Prime Vendor: Humana
Prime Status: Non-Minority
Location: Atlanta, GA
County: Fulton County `
Prime Value: TBD (Agreed to Rate)
Subcontractor: PB Marketing Group LL, dba Printing and Branding
Subcontractor: African American Male Business Enterprise
Location: West Palm Beach, FL
County: Palm Beach County
Contract Value: TBD (Agreed to Rate)
Subcontractor: SCR Consulting
Subcontractor Status: African American Male Business Enterprise
Location: Smyrna, GA
County: Cobb County
Contract Value: TBD (Agreed to Rate)
Subcontractor: LL AMIS
Subcontractor Status: African American Male Business Enterprise
Location: Buford, GA
County: Gwinnett County
Contract Value: TBD (Agreed to Rate)
Total Contract Value: $TBD (Agreed to Rate)
Total Certified Value: $TBD (Agreed to Rate)
Exhibits Attached (
Exhibit 1:Renewal Form Humana
Exhibit 2: Vendor Performance
Contact Information (Type Name, Title, Agency and Phone)
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Ray Turner, Director, Department of Finance, (404) 612-7747
Sabrinna McTier, Director, Department of Finance (404) 612-7646
Verna Thomas, Benefits Manager, Department of Finance (404) 612-7639
Contract Attached
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No
Previous Contracts
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No
Total Contract Value
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Fiscal Impact / Funding Source
Funding Line 1:
426-999-P003-1560: Group Insurance Stabilization, Non-Agency, Administrative
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Key Contract Terms |
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Start Date: 1/1/2027 |
End Date: 12/31/2027 |
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Cost Adjustment: |
Renewal/Extension Terms: 3 renewal options |
Overall Contractor Performance Rating: New Vendor
Would you select/recommend this vendor again?
Yes