Department
Finance
Requested Action (Identify appropriate Action or Motion, purpose, cost, timeframe, etc.)
title
Request approval to renew existing contracts - Finance Department, 19-RFP060519C-MH, Employee Healthcare Benefit Plan with Aetna Insurance Company Inc. (Atlanta, GA) to provide medical and pharmacy benefits as a fully-insured option to Medicare eligible retirees/beneficiaries and dependents. The plans administered are: (1) Basic Medicare Advantage Plan and (2) Enhanced Medicare Advantage Plan (Buy-Up Option). This action exercises the fourth of four renewal options. No renewal options remain. Effective dates: January 1, 2024, through December 31, 2024. (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: Aetna insures the County’s Basic and Enhanced Medicare Advantage Plans. Under a fully insured arrangement, the carrier pays claims from their own funds and sets premium rates to support expected payments. This contract provides all-inclusive medical, pharmacy, wellness and disease management and claims administration. Eligible Medicare retirees and dependents have the option to buy-up and pay the cost difference to enroll in the Enhanced Medicare Advantage Plan which pays 100% for medical benefits, with $0 cost share. For 2024, Aetna’s MAPD offering includes a $15,000 communication allowance. The Medicare Advantage plans have been effective in holding down costs while providing competitive benefits to our retirees.
Community Impact: None
Department Recommendation: The Finance Department requests approval to renew existing contract with Aetna to insure the Basic and Enhanced Medicare Advantage plan enrollees. The 2024 premium rates for the Basic and Enhanced Medicare Advantage Plans are presented as a separate agenda item for approval.
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 |
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Original Award Amount |
19-0619 |
0/7/2019 |
Monthly premium rates per enrolled Medicare-eligible member. |
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1st Renewal |
20-0828 |
11/18/2020 |
Monthly premium rates per enrolled Medicare-eligible member. |
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2nd Renewal |
21-0646 |
09/01/2021 |
Monthly premium rates per enrolled Medicare-eligible member. |
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3rd Renewal |
22-2487 |
09/07/2022 |
Monthly premium rates per enrolled Medicare-eligible member. |
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4th Renewal |
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08/16/2023 |
Monthly premium rates per enrolled Medicare-eligible member. |
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Total Revised Amount |
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Contract & Compliance Information (Provide Contractor and Subcontractor details.)
Contract Value: Based on enrollment per approved rates.
Prime Vendor: Aetna Life Insurance Company
Prime Status: Non-Minority
Location: Alpharetta, GA
County: Fulton County
Prime Value: Based on enrollment per approved rates
Subcontractor: SCR Consulting
Subcontractor Status: African American Male Business Enterprise
Location: Atlanta, GA
County: Fulton County
Contract Value: TBD (Enrollment Services & Education)
Subcontractor: PMI Solutions, LLC
Subcontractor Status: African American Male Business Enterprise
Location: Atlanta, GA
County: Fulton County
Contract Value: TBD (Enrollment Services)
Total Contract Value: $TBD (Estimate, based on June 2024 enrollment)
Total Certified Value: $TBD (Enrollment & Education Services
Exhibits Attached (Provide copies of originals, number exhibits consecutively, and label all exhibits in the upper right corner.)
Exhibit 1: Contract Renewal Agreement
Exhibit 2: Contract Renewal Evaluation Form
Exhibit 3: Contractor Performance Report
Contact Information (Type Name, Title, Agency and Phone)
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Verna Thomas, Benefits Manager (404) 612-7639 or Ray Turner, Deputy Finance Director (404) 612 -7737.
Contract Attached
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Yes
Previous Contracts
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Yes
Total Contract Value
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Original Approved Amount: |
Based on enrollment per approved rates. |
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Previous Adjustments: |
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This Request: |
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TOTAL: |
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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, General Fund, Administrative
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Key Contract Terms |
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Start Date: 1/1/2024 |
End Date: 12/31/2024 |
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Cost Adjustment: |
Renewal/Extension Terms: Fourth of Four |
Overall Contractor Performance Rating: 88%
Would you select/recommend this vendor again?
Yes
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Report Period Start: |
Report Period End: |
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1/1/2023 |
6/30/2023 |