Item Coversheet

CITY OF RIVIERA BEACH CITY COUNCIL
AGENDA ITEM SUMMARY

Meeting Date: 8/26/2019 
Agenda Category:
Subject: 

Resolution to award the City's Health Insurance coverage to Aetna Health Care of Florida for FY 2019-2020.

Recommendation/Motion: Staff recommends approval of the award of the City's health insurance coverage to Aetna Health Care of Florida and authorization of payments for such services.  
Originating Dept HUMAN RESOURCES   Costs $7,231.920 Annually 
User Dept.HUMAN RESOURCES Funding SourceVarious departmental accounts
AdvertisedNo Budget Account NumberVarious City Departments
Date   
Paper   
Affected PartiesNot Required   
Background/Summary: 

Currently, the City of Riviera Beach has Aetna as its health insurance provider. Due to our high claim experience, Aetna provided a quote of  21.5% rate increase for the FY 2019-2021. 

 

This fiscal year the City's utilization rate has increase to 104% (Aggregated Premium billed $6,285,013 vs. Aggregated Incurred Claims $6,443,458).  The utilization rate is based on utilization of emergency room, hospitalization, and pharmacy which are the cost drivers. Based on the 104% utilization rate. the City is trending at a 21.5% rate increased.

 

 As a result, Staff discussed with the Broker additional measures to decrease our claims experience and stabilize our utilization. See the attached report: claim vs premium paid.   In order to stabilize the rates various options were reviewed with a focus to reduce the City's and employee's costs.

 

The City of Riviera Beach decided to go out for an RFP. Five (5) vendors placed a bid for the health insurance. Cigna, Aetna, Blue Cross and NHP/ United Health.

 

Based on results of the RFP completed by the Ghering Group, staff's analysis and continuous negotiations by GEHRING GROUP they are recommending Aetna Health Plan of Florida for 2019-2020 Fiscal Year with minimal plan changes and the least impact to the City's and employee contribution.

 

s a results of further discussion at the City Council Workshop, all bidders were afforded a second look to provide best and final offer.  Based upon the final offers received by the Gehring Group Aetna proposed a 6.7% rate increased. 

 

Below are the proposed changes to achieve rate 6.7% for FY 2019-2020 Fiscal year:

 

1.    Maintain partnership with Aetna.

2.    Introduce High Deductible Health plan with a Reimbursement Account (HRA) as the base Plan design with Aetna contributing

$500 single/ $1,000 family.

3.    Maintain existing buy-up HMO plan as a Buy up option.

4.    Maintain existing buy-up POS plan as a Buy-Up option.

5.    Maintain the current Flexible Spending Account (FSA) Plan

 

 In addition, Aetna is offering an additional $10,000 towards Wellness bring the yearly total to $30,000 and adding bi-weekly visits of a wellness coach to assist staff with their health needs.

 

All final recommendations would lean out the health plan, moving the City in the same direction with comparable City's within the area (see exhibit 1).

 

 
Fiscal Years
Capital Expenditures
Operating Costs
External Revenues
Program Income (city)
In-kind Match (city) 
Net Fiscal Impact
NO. Additional FTE Positions
(cumulative)

III. Review Comments

A. Finance Department Comments:
 
B. Purchasing/Intergovernmental Relations/Grants Comments:
 
C. Department Director Review:
Contract Start Date 
Contract End Date
Renewal Start Date
Renewal End Date
Number of 12 month terms this renewal
Dollar Amount
Contractor Company Name
Contractor Contact
Contractor Address
Contractor Phone Number
Contractor Email
Type of Contract
Describe
ATTACHMENTS:
File NameDescriptionUpload DateType
HEALTH_RESOLUTION_-8-13-19_3.docxHEALTH INSURANCE RESOLUTION8/23/2019Cover Memo
2019-08-26_-_Riviera_Beach_-_Renewal_Presentation_for_Budget_Workshop_(Updated).pdf2019-20 Health Presentation Workshop 8/23/2019Cover Memo
2019-08-21_-_Riviera_Beach_-_Medical_RFQ_Evaluation_(BAFO_UPDATED)_(00000004).pdfRFQ EVALUATION FY2019-208/23/2019Cover Memo
2019-07-30_-_Riviera_Beach_-_CLAIMS_EXPERIENCE.pdfCLAIMS EXPERIENCE 20198/9/2019Cover Memo
Copy_of_2019-07-24_-_CRB_-_Aetna_-_Large_Claims_(May_2018_-_April_2019).xlsxLARGE CLAIMS 20198/9/2019Cover Memo
Survey_Premium_Rates.pdfMunicipal Benefit Surveys (exhibit 1)5/31/2018Cover Memo
REVIEWERS:
DepartmentReviewerActionDate
Human Resources Monroe, LuecindaApproved8/24/2019 - 11:00 AM