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, for Employee Healthcare Benefit Plan for fully self-insured HMO Plan with: (A) Anthem (BCBS) of Georgia to administer the Health Maintenance Organization (HMO), Point of Service (POS) Plan and CDHP with Health Savings Account (HSA) Plan on a self-insured basis to active employees and Pre-65 (Non-Medicare) retirees/beneficiaries as well as the HMO Medicare, Medicare Indemnity PPO and PPO Plus (Closed) Plans to Medicare eligible retirees/beneficiaries; and, (B) for Kaiser Permanente (Atlanta, GA) to administer to active employees and Pre-65 (Non-Medicare) retirees/beneficiaries and the Senior Advantage Plan to Medicare retirees/beneficiaries. This action exercises the second of four renewal options. Two renewal options remain. Effective date: 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: This contract is for employer-sponsored group medical and pharmacy benefits coverage. The contract provides Medical Plan Administration, Claims Adjudication, Reporting¸ Wellness and Disease Management Programs, Employee Assistance Program (EAP), Mental Health and COBRA Administration and Pharmacy Benefits to eligible employees and retirees/beneficiaries. The medical plans administered by Anthem are under a self-insured arrangement and the Kaiser HMO plans are under a fully-insured arrangement. Anthem: The 2022 admin fees for Anthem’s plans will remain fixed over the five year contract cycle at the current rate of $40.34 per employee/retiree per month. Anthem will continue to provide annual prorated wellness fund dollars at the rate of $71.81 per enrolled employee and Pre-65 (Non-Medicare) retiree. Anthem has offered a $100,000 annual subsidy towards communication, implementation and technology. Anthem also administers COBRA and Employee Assistance Program (EAP) at the rate of $0.63 and $2.04, respectively, per enrollee/per month. This administrative fee is guaranteed to remain flat over the duration of the contract with an annual one month premium administrative fee holiday. Anthem’s network continues to offer the greatest estimated discount based on the utilization patterns of members and the greatest network discount guarantee. Kaiser: Kaiser Permanente’s staff model is highly touted for health management in terms of efficiency and their holistic approach to health care. Kaiser’s fully insured HMO and Senior Advantage Medicare Plans continue to offer the best value in terms of cost.
Community Impact: None
Department Recommendation: The Finance Department recommend renewal of existing contracts with Anthem and Kaiser Permanente to administer medical and pharmacy benefits eligible employees, beneficiaries, retirees and covered dependents from January 1, 2022 - December 31, 2022 based on the admin fee and rate structures displayed above.
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 |
19-0618 |
8/7/19 |
per approved admin fees (Anthem) and approved tiered rates (Kaiser) |
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1st Renewal |
20-0841 |
11/18/2020 |
per approved admin fees (Anthem) and approved tiered rates (Kaiser) |
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2nd Renewal |
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Total Revised Amount |
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Contract & Compliance Information (Provide Contractor and Subcontractor details.)
(A)
Contract Value: Self-insured HMO Plan
Prime Vendor: Anthem
Prime Status: Non-Minority
Location: Atlanta, GA
County: Fulton County
Prime Value: Self-insured HMO Plan
Subcontractor: SCR Consulting
Subcontractor Status: African American Male Business Enterprise- Certified
Location: Atlanta, GA
County: Fulton County
Contract Value: Rate per employee
Subcontractor: Aegias Corporation
Subcontractor Status: African American Male Business Enterprise- Certified
Location: Atlanta, GA
County: Fulton County
Contract Value: Rate per employee
Subcontractor: Resurgens Risk Management
Subcontractor Status: African American Male Business Enterprise- Non-Certified
Location: Atlanta, GA
County: Fulton County
Contract Value: Rate per employee
Total Contract Value: Self-insured HMO Plan
Total M/FBE Value: TBD
(B)
Contract Value: Plan Rates As Specified
Prime Vendor: Kaiser Permanente
Prime Status: Non-Minority
Location: Atlanta, GA
County: Fulton County
Prime Value: Plan Rates As Specified
Subcontractor: All Supply Company
Subcontractor Status: African American Male Business Enterprise- Certified
Location: Atlanta, GA
County: Fulton County
Contract Value: TBD
Subcontractor: Copy One
Subcontractor Status: African American Male Business Enterprise- Non-Certified
Location: Powder Springs, GA
County: Cobb County
Contract Value: TBD
Subcontractor: Americare
Subcontractor Status: African American Female Business Enterprise- Non-Certified
Location: Norcross, GA
County: Gwinnett County
Contract Value: TBD
Subcontractor: Interprint Communication
Subcontractor Status: Hispanic Female Business Enterprise- Non-Certified
Location: Decatur, GA
County: Dekalb County
Contract Value: TBD
Subcontractor: Union Latina, Inc.
Subcontractor Status: Non-Minority
Location: Norcross, GA
County: Gwinnett County
Contract Value: TBD
Total Contract Value: Plan Rates As Specified
Total M/FBE Value: TBD
Exhibits Attached (Provide copies of originals, number exhibits consecutively, and label all exhibits in the upper right corner.)
Exhibit 1: Contract Renewal Agreements
Exhibit 2: Contract Renewal Evaluation Form
Exhibit 3: Contractor Performance Reports
Contact Information (Type Name, Title, Agency and Phone)
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Ray Turner, Deputy Finance Director, 404-612-7737
Melissa Barnett, Employee Benefits Manager, Finance Department 404-612-4243
Contract Attached
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Yes
Previous Contracts
title
Yes
Total Contract Value
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Original Approved Amount: |
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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: 1/1/2022 |
End Date: 12/31/2022 |
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Cost Adjustment: |
Renewal/Extension Terms: 2nd of Four Renewals |
Overall Contractor Performance Rating:
Would you select/recommend this vendor again?
Yes
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Report Period Start: |
Report Period End: |
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1/1/2022 |
12/31/2022 |