Department
Finance
Requested Action
title
Request approval to renew existing contracts - Finance Department, 24RFP050124C-MH, Employee Healthcare Benefits Plans with (A) Anthem Blue Cross Blue Shield (Atlanta, GA) to administer the self-insured Point of Service (POS), Health Maintenance Organization (HMO), HMO Medicare, Medicare Indemnity and PPO Plus (Closed) Plans and Consumer Driven Health Plan (CDHP) including pharmacy for all self-insured active and under 65 plans; and including a fully-insured pharmacy for all over 65 (Medicare eligible) plans; (B) Metropolitan Life Insurance Company (MetLife) to administer the Health Savings Account (HSA); (C) Metropolitan Life Insurance Company (Superior Vision) to administer self-insured vision benefits; and, (D) Kaiser Permanente (Atlanta, GA) to administer the fully insured HMO Plan to provide Medical and Pharmacy coverage for eligible active employees, retirees (Under 65 and Over 65 (Kaiser Senior Advantage), beneficiaries and covered dependents. Effective date: January 1, 2026, through December 31, 2026, with three renewal options remaining.
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Requirement for Board Action
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
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 proposals will provide medical and pharmacy coverage to eligible active employees and retirees. Fulton County currently offers and is recommending to continue to offer (A) a self-insured Point of Service (POS), Consumer Driven Health Plan (CDHP), and the following Medicare Supplement Plans (HMO Medicare, Medicare Indemnity and PPO Plus [closed]) administered by Anthem; a continued (B) Health Savings Account (HSA) that would now be administered by MetLife, (C) vision benefits that would be administered by Metlife (Superior Vision), (D) Kaiser Permanente (Atlanta, GA) to continue to administer the fully insured HMO Plan for both actives and retirees (Under 65 and Over 65 Kaiser Senior Advantage). A new fully-insured Part D Employer Group Waiver Plan for all Medicare retirees enrolled in the Anthem plans will be implemented for 2026. The Employer Group Waiver Plan enables the County to take advantage of greater subsidies from the Centers for Medicare and Medicaid Services (CMS). This plan will replace the Retiree Drug Subsidy program in which the county currently participates.
Community Impact: This contract provides medical and pharmacy as well as vision benefit coverage to eligible Fulton County active employees, retirees, beneficiaries and covered dependents. The pharmacy benefit will be improved for retirees, with essentially no change to slight reductions to 30-day retail copays, but significant savings on 90-day retail and mail-order copays. After careful evaluation of this plan, only minimal disruption is expected (less than 1%), however the Finance Benefits team and Anthem will coordinate any issues with age 65 and over retirees on this switch to the employer group waiver plan for pharmaceuticals.
Department Recommendation: All the benefit administrators went through a formal procurement process to ensure that Fulton partners with the highest quality vendors at the most effective price. The Finance Department recommends approval of the above options.
Project Implications: Approval is needed immediately to begin premium rate development, implementation and communication to employees, retirees and beneficiaries for planning of open enrollment.
Community Issues/Concerns: None
Department Issues/Concerns: None
Contract Modification: The Anthem Group D over 65 pharmacy employer group waiver plan is a new contract modification, all other items are renewals.
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CURRENT CONTRACT HISTORY |
BOC ITEM |
DATE |
DOLLAR AMOUNT |
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Original Award Amount |
24-0594 |
9/18/2024 |
$52.82 Administrative fees per employee/retiree per month Anthem Blue Cross/Blue Shield |
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1st Renewal |
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$45.73 Administrative fees per employee/retiree per month Anthem Blue Cross/Blue Shield |
Contract & Compliance Information
Contract Value: Medical plans with Anthem administration fee are paid from the health care stabilization fund and are separate from the “premium” cost to employees. The administrative fees per enrollee(employee/retiree) per month for 2026 is $45.73 per member per month (PMPM). The COBRA administrative fees per enrollee, per month will remain flat at $11.61. The EAP administrative fees per prescriber, per month is $2.23 for the 2026 plan year.
(A)
Contract Value: $45.73 Administrative fees per employee/retiree per month Anthem Blue Cross/Blue Shield
Prime Vendor: Anthem Blue Cross/Blue Shield
Prime Status: Non-Minority
Location: Atlanta, GA
County: Fulton County
Prime Value: $45.73 per employee/retiree per month
Subcontractor: Brown Financial Group, LLC
Subcontractor Status: African American Male Business Enterprise
Location: Conyers, GA
County: Rockdale County
Contract Value: TBD (Employee Engagement and Wellness)
Subcontractor: SCR Consulting
Subcontractor Status: African American Male Business Enterprise
Location: Smyrna, GA
County: Cobb County
Contract Value: TBD (Actuarial Consulting/Overnight Management of Wellness Fund)
Subcontractor: Resurgens Risk Management
Subcontractor Status: African American Male Business Enterprise- Non-Certified
Location: Atlanta, GA
County: Fulton County
Contract Value: TBD (Cobra Administration)
Subcontractor: Aegias Corporation
Subcontractor Status: African American Male Business Enterprise- Certified
Location: Atlanta, GA
County: Fulton County
Contract Value: TBD (New Hire Orientation, Open Enrollment Support & Wellness Program Support)
Total Contract Value: $45.73 per employee/retiree per month
Total Certified Value: TBD
(B)
Contract Value: $0.00 Administrative fee per employee/retiree per month MetLife HAS
Prime Vendor: Metropolitan Life Insurance Company (MetLife) HAS
Prime Status: Non-Minority
Location: New York, NY
County: New York County
Prime Value: $0.00 per employee/retiree per month
(C)
Contract Value: $0.45 per enrolled employee/subscriber per month
(to administer: Superior Vision)
Prime Vendor: Metropolitan Life Insurance Company aba/MetLife
Prime Status: Non-Minority
Location: Atlanta, GA
County: Fulton County
Prime Value: $0.45 per enrolled employee/subscriber per month
(to administer: Vision Benefits)
(D)
Contract Value: $0.00 Administrative fee per employee/retiree per month
Prime Vendor: Kaiser Permanente
Prime Status: Non-Minority
Location: Atlanta, GA
County: Fulton County
Prime Value: $0.00 (per insured admin fees included in premiums)
Subcontractor: All Supply Company
Subcontractor Status: African American Female Business Enterprise
Location: Atlanta, GA
County: Fulton County
Contract Value: TBD (Copiers, Fax, Printers, Sales and Services)
Subcontractor: Fuentes Enterprise dba Interprint Communications
Subcontractor Status: Hispanic Female Business Enterprise
Location: Decatur, GA
County: DeKalb County
Contract Value: TBD (Copiers, Fax, Printers, Sales and Services)
Subcontractor: Union Latina, Inc.
Subcontractor Status: Non-Minority
Location: Lawrenceville, GA
County: Gwinnett County
Contract Value: TBD (Translation & Interpretation)
Subcontractor: Americare
Subcontractor Status: African American Male Business Enterprise
Location: Suwanee, GA
County: Gwinnett County
Contract Value: TBD (Medical Supplies)
Total Contract Value: $0.00 per employee/retiree per month
Total Certified Value: TBD
Grand Contract Value: TBD
Grand Certified Value: $00.00 or 00.00%
Exhibits Attached
Exhibit 1: Contract Renewal Agreements
Exhibit 2: Performance Evaluations
Contact Information (Type Name, Title, Agency and Phone)
titlHak
Ray Turner, Interim Director, Department of Finance, (404) 612-7737
Sabrinna McTier, Interim Deputy 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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Yes
Total Contract Value
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Grant Information Summary
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Amount Requested: |
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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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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: 1/1/2026 |
End Date: 12/31/2026 |
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Cost Adjustment: Click here to enter text. |
Renewal/Extension Terms: 3 renewal options |
Overall Contractor Performance Rating:
Kaiser Permanente 85
Anthem 85
MetLife 85
Would you select/recommend this vendor again?
Yes
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Report Period Start: |
Report Period End: |
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4/1/2025 |
6/30/2025 |