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HomeMy WebLinkAbout1999-099C-1 O Client References Palm Beach County Sheriffs Office 3228 Gun Club Road West 'Palm Beach, FL 33406 Georgette Carroll, Assistant Director of Administration Employees: 2,400 + (561)688-3135 City of West Palm Beach 200 2nd Street West Palm Beach, FL 33402 Hugh Summers, Risk Manager E=mployees: 900 + (561) 659-8000 City of Delray Beach 100 N.W. 1st Avenue Delray Beach, FL 33444 Frank Babin, Risk Management Officer Employees: 800 + (561)243-7150 City of Vero Beach 1053 20th Place Vero Beach, FL 32961 Barbara Morey, Employee Benefits Administrator Emplcyees: 700 + (561) 978-4923 Okeechobee County 304 N.W. 2nd Street, Room 109 Okeechobee,FL 34972 George Long, County Administrator Employees: 200 + (941)763-9312 Martin County School District 500 East Ocean Blvd.. Stuart, FL 34994 Jim Matthews, Risk Manager Employees: 2000 + —(561) 219-1200 Ext. 206 "(ri 0"a. -Qi n,. ..:, 40 4a Scope of Services The Gehring Group will assist the County in the selection process to procure health care services, i.e., group medical, dental, vision, and life insurance for Indian River County employees and retirees. The consulting services shall include, but are not limited to, the development of Requests for Proposals; preliminary evaluation of proposals; provision of technical support to the Evaluation Committee; assistance in contract negotiations with top-ranked firm(s) and preparation of final contract. We understand the scope of services and responsibilities as outlined in the Information to Companies to include the following: A. Audit of past and current health insurance claims and the review of these data to determine their appropriateness. B. Review of the benefits program and identify any element which is not in accord with current State or Federal law. C. Determine whether the present health care program is competitive and if the programs provide the most value. D. Make written and oral presentation of recommendations responding to items A. through C. above. Presentations will be made to the County Health Care Committee and to the Board of County Commissioners at regular meetings. E. Prepare detailed bid specifications as appropriate to be sent to vendors by the County. F. Evaluate the bids received and recommend a vendor to the County. G. Work with the selected vendor on Indian River County's behalf and follow through to execution of a contract for services. H. Prepare a realistic timetable for project completion and a fee schedule. The timetable must include a final completion date of all elements. Special Provisions As stated in Special Provisions Section A. on page 2 of the Information to Companies, The Gehring Group agrees not to release any documents or information to any person, agency or company without the express written permission of the County Administrator or the Director/Personnel. The Gehring Group agrees to Special Provisions Section J. and shall not assign or transfer any of the work to another entity without prior written consent from the County. 40 40 According to Speciaf Provisions Section N., The Gehring Group holds harmless the County and representatives thereof from all suites, actions, or claims of any kind brought on account of any injuries or damages sustained by any person or property in consequence of any neglect in safeguarding contract work, or on account of any act or omission by the consultant or its employee, or from any claims or amount arising or uncovered under any law, by -taw, ordinance, regulation, or decree. Approach taken and methods to be used: All reputable agenticonsulting firms should be able to provide the basic requirements of this bid. However, The Gehring Group strives to separate ourselves from our competition. We encourage the County to contact our references because we are confident that they will emphasize the outstanding service The Gehring Group provides on a daily basis. Service is the cornerstone of what we provide as consultants. We strive to be the best in this area. The Gehring Group has extensive experience in the public sector market coordinating health, vision, life, dental, disability and various other insurance programs; therefore, we are confident. that our services will meet and exceed the expectations and goals of the County. The first step of the approach requires The Gehring Group to make recommendations concerning which options should be evaluated in an effort to save the client money or provide a more comprehensive benefit program. Once an agreement has been reached as to what programs are to be evaluated, we then formulate a Request for Proposal package containing the complete history of the client in addition to the programs to be quoted. We then submit the names and addresses of those companies which we feel could competitively bid on the requested programs. A list of the companies we have previously solicited and their A.M. Best ratings are located in Exhibit It. We will also solicit proposals from various third party administrators. Upon receiving the proposals, the Gehring Group's top priority involving the evaluation of health, life, dental, disability, and other coverages is to simplify bids so that the information needed in order to make an educated decision is presented in a clear, precise manner. The Criteria used when evaluating proposals are as follows 1. Company must provide verification that all of the services requested can be provided. 2. Financial rating of the company must be acceptable to the client. 3. Rates and schedules of benefits of proposers are considered. 4. Network of providers is compared to current network. 5. References are then considered. & Positives and negatives are presented. f. Recommendation proposed. Proiect transition schedule and schedule of deliverables: Exhibit I displays a Projected Schedule for the 'Request for Proposal process. Kurt Gehring, KlIf Gehring and Cindy Pinder will be involved throughout the process of formulating the RFP, submitting it to the market, negotiating with carriers, etc., until the recommendation has been made. Upon approval of the recommendation, The Gehring Group will be available to aid the 1'?,' 1-:1 171 ` 40 F-3 County in coordinating employee open enrollment meetings. In addition, if there are employees currently experiencing issues regarding the processing of claims under the current health plan, we will also arrange meetings to discuss these problems and collect the information necessary to provide a resolution. Proposed fee schedule: Health Care Review Consultant ',tfc hod of pgymen( negnrkllile $30,000 The above contract fee of $30,000 is inclusive of all required visits to the County for the purpose of formulating a Bequest for 'Proposal, evaluating bids received, negotiating with finalists, making recommendations, presenting to the Board and all other visits deemed necessary by the County. It also includes the negotiation of the renewal costs for the following plan year. Please note that there is no hourly charge for ongoing services. In the experience of The Gehring Group, it is more convenient and cost effective for our public entity clients to budget for a specific amount rather than attempting to estimate the number of on-site visits or hours for which a Consultant will be able to charge. We can, however, propose an hourly rate upon request, if preferred. List of any assistance the County may be requested to provide. The County will be expected to provide The Gehring Group with copies of any contracts, claims information, or documentation that they may have regarding their current programs. The County would also assist in the setting up of enrollment meetings should the County decide to make a switch in carriers or plan of benefits. The County would also have the responsibility of submitting premium payments directly to the insurance carriers; however, The Gehring Group would assist in any discrepancies of premium billed. Additional Data Exhibit III includes several letters of recommendation from local municipalities and public entity clients for review. 40 Consultants Certification I (we) hereby certify that if the contract is awarded to me, our firm, partnership, or corporation, that no members of the elected governing body of Indian River County, or any professional management or administrative official of the County, or members of his or her immediate family, including spouse, parents, or children or any person representing or purporting to represent any member or members of the elected governing body or other official, has received or has been promised, directly or indirectly any financial benefit, by way of fee, commission, finder's fee or political contribution for executing this contract under a Request for Proposals. I (we) further certify that this firm is independent, not engaged directly or indirectly with due sale of insurance in any manner whatsoever and receives no commissions from the sale of any insurance, and the same applies to each employee individually. I (we) additionally certify that if this firm is engaged directly or indirectly in providing any of the goods or services which are elements of the health care program, I (we) will not compete for award of any of those elements either directly or by assignment, transfer or subcontract. Handwritten Signature of Authorized Principal(s): Name: Title: President Name of Firm: The Gehring Group Date: March 25 1999 G-] 40 Exhibit I Project Organizational Chart 40 F-3 Indian River County Projected Request for Proposal Schedule 1) Collect informallon for Request for Proposal ^� 2) Determine Counly's Coals for RFP - 3) Set up employee meetings to discuss current Claim issues 1 ■ Formulate Reques! for Proposal f— ■ --- 0' Review RFP with County Contact for Approval Make any necessary changes to RFI' and Submit �— to Insurance Carrier Market. Upon receipt of proposals, evaluate and prepare 4 preliminary spreadsheets. Review preliminary spreadsheets with County to o �► select finalists and determine negotiating strategy (if necessary). Negotiate with proposal finalists (if necessary) and prepare updated spreadsheets tvilh any new information. F Review draft of evaluation and final 1 sprendsheets; present recommendation to County contact anti prepare pre5entation for the Board. ■ —► PRESENTATION TO BOARD Schedule of Open Enrollment nttelings. The Gehring Group will provide representation at 4�— County enrotimeni meetings to ensure a smoulh transition if there are any plan changes. f In'u1�rc+'kJttdfd. +.•Ur++l,rlt.J 1'!'; +irlirur,.r-i,rlrJun'1 :, ... ��: :Erfr,+„+.r+{,r. rr, r,'nr,-.lwr, +r.r.. 1'rr. .. �•�nr '� rLr r•. :, ! CI 410 Exhibit II A.M..Best Company Ratings 711r G, 41 rr::( Gy u8i, r 1 11 40 do A.M. Best Ratings 771e foflowitig list irrclrreles hilt is 1101 liniitec1 to Mose carriers to tiirhorri pie Gehring Croup srrhmits requests for proposals (TI"A's are rrat fxcfrrderf Orr tfri.s fLst ,since lliey are not rates! by A.M. Best). Paramount Dental plan, Inc. Principal Health Gare - -- --- provident life & Accident Insurance Company Life of Canada _ Guardian Life Insurance CumpanY Prudential ed Healthcare iii. r.u, 1:. .1+' zu Not Rated A A A++ A 4etna _ -- - - -- -- A+ UG Life _ Imerican Dental Flan _ Not Rated 4nthem Marketing Services - - - A - kvlVled Heaflh Plan - - Not Rated 31ue Cross & Blue Shield - A _ --- — :;a ado Llfo _ _ -- _ A++ CIGNA Health Care _ A+ -- _ Delta Dental - - - - - -- Not Rated Not Rated DenliCare -- - Flor`ida Combined Life insurance Company .- - A Florida Leaque of Cities - -- Not Rated - Fortis Benefits Insurance CompanY Foundation Health Care -- _ Not Rated Guarantee Lile Insurance Company — A HIP Health Plan of Florida Not Rated Humana Health Gare A _- ff Haword -- A+ - John Alden- --��A-- -- MetLife J -- — A+ - oral Health Services Not Rated Paramount Dental plan, Inc. Principal Health Gare - -- --- provident life & Accident Insurance Company Life of Canada _ Guardian Life Insurance CumpanY Prudential ed Healthcare iii. r.u, 1:. .1+' zu Not Rated A A A++ 40 `l ROBERT W. NEUMANN ,, .�,:•' PALM REACH COUNT SHERIFFHERIFF'S OFFICE T��, r... , , 1 P.O.PA. SOX 24681 PALM BEACH COUNTY frAft", 1 WEST PALM BEACH. FL33416.4681 (561) 688-3000 October 14, 1997 To Whom It May Concerts: I have been professionally associated with Mr. Kurt Gehring, President of The Gehring Group, for the last four years. During that time I have found hies to be very knowledgeable, personable, and thorough in his relationship with tlse Sheriff's Office. Mr. Gehring has always been readily available for consultation, and quick with his responses. 'fhv office staff at The Gehring Group is extremely reliable and professional, and provides a Significant base or support. I have had an opportunity to sheet with each of the staff, and round theist to be extremely valuable assets to The Gehring Group's overall mission. d Mr. Gehring's ability to provide rapid follow up, and his reliability in providing direct contact, has proven to be a valuable resource to ine as the Sheriff's Office Risk Manager. His evaluations are complete, and prepared according to specifications. Mr. Gehring has always presented his proposals and recommendations in person, and [Wade himself available to answer cluestions. He has often had to make adjustments to his schedule on relatively short noticc. IT, essence, Mr. Gehring has the ability to make his clients feel its though lie has only one client! That its an admirable trait, and one which demonstrates a great deal of expertise and commitnsent to his clients. I would highly recoTisnielld Mr. Gehring to anyone seeking a professional consultant hs the field of health, life, and accideut insurance.. rtcerely, David W. Ferebee Risk Manager HEADQUARTERS 5328MUHCLUBRP WEST PAW BEACH, FL 3406-3041 1561}60&9000 DISTRICT i1'STPIr.T0 172AGUN("I 4AD "l.. ' - COURT SEnV CES 2245 NO COX it HICf1i1WAY W 5t PALM 5EACH. FL V01 I56$p S55 2760 rilTA"T ill IV STRICT IV t)ISTRICT V t)IqTRICT'11 ..4 ,i' ,;"0',".V .C, 0 .'- 5.'9; ,.0_o-": 40 40 EITY OF UELRRY BEREH PEUR BEACIi All-ArnedcaUty October 17, 1997 ri�ns� I'o Wlnont it May Concem: Mie City of Delray Beach has had Mr. Kurt Gehring, of the Gehring Group, as their agent of record for our group health, life, and disability plans for the past year and have been extremely satisfied wide his efforts and Use efforts of his associates. Mr. Gehring and his associates have proven to be knowledgeable, responsive, and effective in both their relationships with individual employees and our Risk Managernert Division. Special efforts are shade drrotsgliout the competive 'bidding process to involve all employees through ermployee surveys, individual interviews, and presentations at intental Insurance Committee nneeti» gs. This teclx»que has proven to be extremely helpful in finalizing decisions in the health insurance bid process. The reports submitted by die Gehring Group are detailed, complete, and accurate. Especially noteworthy has been their efforts to track and resolve outstanding claints from previous carriers as well as the present tarsier in a timely manner. I licir consistent tracking acid persistent follow-up work associated with this process has been commendable. Their firm maintains a professional working relationships with both Incaldi care insurers and providers which has beam effective in both processing nornsal claims asid resolving outstanding claints in a timely manner and providing for additions to our health care delivery network consistent witli the desires expressed in our employe; surveys. The Gehring Group does an excellent job analyzing the local heal i. insurance networks of doctors and hospitals as well as tate administrative capabilities and past reputations of individual companies to insure the City will receive both compatitive pricing and professional, responsive delivery of health care services. Their bidding process has been well developed providing several alternative plan designs for each potential carrier and their analysis of bids is well formatted and professionally presented. We would highly recommend die Gehring Group in this capacity to any potential firm. Sincerely, il "'� I . /� "IN. David T. Harden City Manager C-1 F> 5�P1 RI'1It1\1111t114 lttl IIIH 1tiEl utll Iln\\ October 14, 1997 To Whom It May Concern Kurt Gehring and The Gehring Group has provided the Solid Waste Authority of Palm Beach County with exceptional employee benefit consulting services for the paste three years and it is my pleasure to provide this letter of recommendation. Kurt and his staff consistently deliver outstanding and professional service to the Authority and I rely on his expertise and guidance for every aspect of our employee benefit programs. Evaluations, proposals and recommendations prepared by The Gehring Group are professional, complete, easy to follow and presented on time. And, due to Kurt's efforts, the Authority streamlined several internal procedures which has resulted in greater efficiency and easier administration. Kurt's expert knowledge, professional services and dedication to his clients is exemplary! Sincerely, Debra (Laster, PHR Director Employee Relations & Records Management L-1 40 Rich CITY OF PALM BEACH GARDENS y 10500 N. MILITARY TRAIL • PALM BEACH GARDENS. FLORIDA 33410-4898 August 29, 1997 Dear Sir or Madam: I have had the pleasure of knowing Kurt Gehring for 'the past four years in his capacity as the City's health insurance agent. During that time, Kurt has always been very helpful explaining to our employees exactly what their benefits are as well as serving as an effective liaison with the inzurunca carrier to resolve disputes. Kurt has also been very quick to respond to inquiries from myself and other City staff. The City has solicited proposals for health, life and dental insurance in each of the last four years. Each year, Kurt has invaluable by developing a detailed Bequest for Proposai document, comparing the data from up to fifteen different health plans and organizing the data in such a way to draw logical conclusions about the proposals. Kurt has been extremely helpful analyzing the data and -in securing the most advantageous program for city employees, often squeezing concessions from the successful carrier. Kurt Gehring has served the City of Palm Beach Gardens extremely well. I am certain he will put his energy, responsiveness, dedication and insight to work for you, too. Sincerely,. Kent R. Olson Finance Director i 4D 210 Military Trail Jupiter, Florida 33458 To Whom It May Concem: Town of Jupiter 561 1746.5134 FAX 5611575-7785 It is with respect and pleasure that I am taking this opportunity to recommend Mr. Kurt Gehring and his staff at The Gehring Group based on the exemplary performance, service and professional assistance that has been made available to the Town of Jupiter following his appointment to Agent of Record status in May of 1994. Mr. Gehring and his staff have continually proven to be extremely competent and service oriented. His knowledge of the incessant changes and opportunities that occur within the insurance industry has become a valuable asset to Town management enabling us to make precise and educated decisions in the ever changing health care market. Mr. Gehring has guided the Town of Jupiter through the entire RFP process beginning with the compilation and production of the actual bid package following through with a recommendation to the Town Manager which enabled us to offer a richer and more desirable schedule of benefits to all employees with an additional savings to the Town of over $200,000 throughout the first calendar year. Kurt has been consistently available to intervene and rectify all problems that have surfaced regarding both the current benefit plan and subsequent renewal options. I highly recommend The Gehring Group to any corporation or establishment that is in need of a more structured, efficient or comprehensive employee benefit plan and I welcome any inquiries regarding their performance and professional abilities. TOWN OF JUPITER adenhead Risk Management officer 4b 40 Ak EXECUTIVE OFFICE: October 10, 1997 Seacoast- Urilit�y Authority/viAiH °�A109: PO Boxt09002 Palm peach Gardens. Fronda 33410.9602 To Whom It May Concern: This will confirm that Mr. Kurt Gehring has serval as Seacoast Utility Authority's group licaldr insurance agent -of -record for approximately six years. Mr. Gehring's performance has been consistently exemplary, and I strongly recommend your favorable consideration of his Finn, The Gehring Group. In addition to his considerable knowledge of the health insurance industry, Kurt's personal attributes arc also of enormous value to the client, He is responsive and patient in dealing with flLe Inevitable difficulties associated with licalAn care delivery. He is well liked and trusted by our personnel. If your organization is considering scouring the service of n dependable and competent group liealth insurance agent, i ant pleased to suggest that you consider Kurt Gehring. and The Geltring Group, Clearly, Seacoast Utility Authority is pleased with his performance Sincerely, SEACOAST UTILITY AUTHORITY �1,1 �13w':113 —P Executive Director Idsh. CA 40 'i ., Village of Royal Palm Beach, Florida RpYAL phL�.1 ngAcu 1050 Royal palm Beach Boulevard Royal Palm Beach. Florida 33411 Telephone (561) 790.5103 Fax (561) 791-7087 October 10, 1997 TO WHOM IT MAY CONCERN. In 1993 the Village of Royal Palm Beach was fortunate to ince[ with Mr. Kurt Gchring who was assigned to bid our health, dental and life insurance for renewal. At that time, 1 was gully involved with the processing; of all renewals arld 1 had the most outstanding support front Mr. Gehring. In October 1996, we had renewal again, and the process was so smoothly handled both by Mr. Gehring; and his support staff, that 1 cart proudly say that l ant happy to have ]lira as our agent and hope that he will conlilluc serving; the Village of Royal Paint Beach with los insurance expertise. Sincerely, "yam 04[_{w�.r�lSc�f•t-',_..� Rookmin Rantsaran Assistant to the Accounting; Manager do Exhibit N - Sample evaluation I'Martin County School District Insurance Evalluation" i;. (,.•lp., ,r f r f 40 Martin Ctmnty School District Health, Dental, Vision & Life Insurance Evaluation Effective fate: March 1, 1999 Prese aired bY: Kurt Gehring Benefits Consultant The Gehring Group 1645 Palm Beach Lakes Blvd., Suite 300 West Palm Beach, FL 33401 40 Table of Contents Executive Summary of Recommendations.................................................................................. 3 Summary of Recommendations..........................................................................................3 TotalCost Analysis............................................................................................................. 4 Overview & Background Information........................................................................................ 5 Funding. History...................................................................................................................7 Health Insurance Claims Experience History ...................................................................... S Health & Vision Insurance Evaluation.................................................................................... 10 Health Insurance Benefit & Cast Comparison.................................................................. 17 Requested Physicians Comparison........................................................................................... 21 Dental Insurance Evaluation..................................................................................................... 31 Dental Insurance Benefit & Cost Comparison..................................................................33 Life Insurance Evaluation......................................................................................................... 35 Life Insurance Rate Comparison....................................................................................... 37 a i Executive Summary Health Insurance Recommendation Upon the evaluation of each of the proposals for health insurance submitted in response to the Request for Proposal, The Gehring; Group recommends that MCSD renew its contract with CIGNA HealthCare for the plan year beginning March 1, 1999, for the following reasons: :• Competitive rate structure, Most extensive HMO/POS network in Martin County, Higher level of benefits provided to retirees on Medicare,. $• Increased Lifetime Benefit Maxinizini from $1 million to $2 million. Vision Insurance Recommendation Due to the limited number of proposals for vision insurance received in response to the Request for Proposal, The Gehring Group recommends that MCSD renew the vision insurance program With CIGNA HealthCare for March 1, 1999, The only other vision proposal received was front Vision Care Plan, the premiums for which generated an 82% increase in cost in comparison to CIGNA's 1G°/n rate increase. Dental Insurance Recommendation Upon review of the dental insurance proposals received, The Gehring Group recommends that MCSD renew its dental insurance program with CIGNA for the plan year beginning March 1, 1999. CIGNA's premiums were not the lowest submitted, however the savings generated from the implementation of even the lowest bidder would not justify the cost of re -enrolling all of the non - instructional employees into a new dental program. Life Insurance Recommendation Upon review of the various proposals for life insurance received in response to the Reriuesi frrr Proposal, The Gehring Group recommends that MCSD cancel its life insurance contract with CIGNA and place the life insurance with Provident Life & Accident for the March 1, 1999 effective date. Due to the significant savings generated by the Provident proposal and the rate guarantee of three years, Provident best meets the needs of MCSD at this time. CA Total Cost Analysis TOTAL ANNUAL COST ANNUALTOTAL % INCREASE *.91t rrcmlurns reflecr Uavintum 0W. Current Program $7,808,184.87 Recommendation $8,960,178.12 14.8% Current Premium Recommendation Current CIGNA (Current) CIGNA (Renewal) HEALTH INSURANCE Enrollment Minimum Premium* Minimum Premium" PPO Employee 530 $280.00 $323.85 Dependent 68 $308.20 $357.13 POS Employee 634 $244.50 $283.41 Dependent 178 $256.34 $296.97 HMO Employee 434 $195.61 $226.76 Dependent 286 $+194.21 $225.03 MONTHLY TOTAL $610,436.35 $707,171.21 ANNUAL TOTAL $7,325,236.20 $8,486,054.52 %a INCREASE 15.8%0 Current CIGNA (Current) CIGNA (Renewal) VISION INSURANCE EW0111nent Minimum Premium* Minimum Premium' Employee Only 773 $2.04 $2.37 MONTHLY TOTAL $1,576.92 $1,832.01 ANNUAL TOTAL $18,923.04 $21,984.12 % INCREASE 16.2% Current CIGNA (Current) CIGNA (Renewal) DENTALINSURANCE Lnrothuent Minimum Premium' Minimum Premium' Employee 712 $19.04 $22.05 Dependent 176 $29.71 $34.50 MONTHLY TOTAL $18.785.44 $21.771.60 ANNUAL TOTAL $225,425.28 $281,259.20 %o INCREASE 15.9% LIFE INSURANCECIGNA (Current) Minimum Premium' Provident Life & Accident Life Ratel$1,000 $0.26 $0.21 AD&D Ratel$1,000 $0.03 $0.022 Total Ratei$1,000 $0.29 $0.23 Current L".5 6111aled i'ulunle $68.56.3.318 568,563,31N MONTHLY TOTAL $19,883.36 $15,906.69 ANNUAL TOTAL $238,600.35 "$190,880.28 % INCREASE -20.0% TOTAL ANNUAL COST ANNUALTOTAL % INCREASE *.91t rrcmlurns reflecr Uavintum 0W. Current Program $7,808,184.87 Recommendation $8,960,178.12 14.8% 40 40 Overview & Background Information The Martin County School District recently requested proposals for Health, Dental and Life Insurance for the effective date of March 1, 1999. Requests for Proposals were sent to the following insurance Carriers and were due on Thursday, December 10, 19911; Aetna Neighborhood Health Partnership AIG Life MetLife Allied Brokerage Services Oral Health Services American Dental Plan Paramount Dental Pian, Inc. Anthem Marketing Services Phoenix Home Life AvMed Health Plan Principal He0b Care Blue Cross & Blue Shield ProtectiveoentiCare Canada Life Provident Life & Accident CIGNA Health Care Relieslar Life Insurance Della Dental SafeGuard Health Plans Florida Combined Lifo Insurance Co, Signature Dental Plan Florida Health ChoicelPreferred Choice Standard Insurance Company Florida League of Cities Sun Life of Canada Fortis Benefits Insurance Company The Guardian Lite Insurance Co. Foundation Health Care The Prudential Guarantee Life Insurance Company Trans•General Life HIP Health Plan of Florida United HealfriCare Humana Heafth Care Plans Unum ITT Hartford Vision Care Inc.Nision Service Plan SELF 1 ■ ADMINISTRATORS Commercial Risk Management, Inc. McCreary Corporation F.A. Richard & Associates PCs Health Systems FCCI Insurance Group Poe & Brown Galla har Benaid Administralors Soulhoast Health Plan Alternatives, Inc. MEDICARE -■ r American Pioneer National States insurance Co. Blue Cross & Blue Shield Physicians Mutual Insurance Co. Celtic Life Insurance Co- Pioneer Life Insurance Co. Continental General Insurance Co. Principal Mutual Life Insurance Co. Conlinental Life Insurance Union Bankers Insurance Co. Life Investors Insurance Oom a WVerld Insurance Co. MCS D -DEPARTMENT Behavioral Health, Inc. McKinley Financial Sery DOE Millon Godwin Doran•Eldridge Ins. Man. O'Neil, Lee & Wasl, Inc. Easlcoasi Medical Network Parker & Parker Ins. Educators Financial Services PCA Solutions, Inc. Gary Insurance Agency Pharmacy Benefit Admin Insurance Servicing & Adl. Schools InSUrall,e Fund J. Halle Davis Insurance Sunbelt Benerrls. inc Johns Eastern Co. The Virrcam Group. Inc. Mathar Behavioral Health Systems WhiP fieaBh Inrlialives Maxon Organization 4 v '['he following carriers submitted proposals for the coverages indicated below: Aegon Blue Crass & Blue Shield x x x Canada We x Cigna Health Care x x x x Delta Dental x Humane, Inc. x x MotLife x x Oral Health Services x Paramount Dental Plan x Preferred Choice x Provident x SafeGuard Dental Plans x Schools Insurance Fund x Standard Insurance x The Hartford Vision Care Plan x P-1 _Walgreens Health_ Initiatives x x x 4D 40 I m 8 LO Q7 +�t�t ams' hl Vl H vj! 19 N U# Nto too sC M 6V 10 N N l6 tR � � 64 C7 - Cog N G C C 60 in to W Q m lC Q C l6 @ 3ft jL @ OL C Q d d O @ TL E o a ca = 4Y C Qy d :C Q c o c ?EL a, E O d CA. C C] N C 0.W c Q� 0 2W 0 I- r N L7WD d JJQ C y�y d7 d pp�� N U] 4d1ID p�77 W 1J1 u+ d F 0 O c dC G O 1 Q IL n� aE E dp o N 6W Q ©WC] W L3 W yWCl J IL D i7 Q O 00 Q O G N G R 4tl c c td SV LO co Cd C6 ww nw W, 10 40 Nto too sC M 6V 10 N N l6 tR � � 64 C7 - Cog N G C C 60 in to W Q m lC Q C l6 @ 3ft jL @ OL Q 0 3 Q d d i @ TL E o a ca = 4Y C Qy d :C Q c o c ?EL a, E O d CA. C C] C 0.W c Q� 0 2W 0 I- r N L7WD d JJQ N Nto too sC M 6V 10 N N l6 tR � � 64 C7 - Cog N G C C 60 in to W Q m N Q C l6 @ 3ft jL @ OL R. d d d i -00 TL E o a ca N@ ❑ N@ to d C E d :C 4w op N N N f�V N N N 1 1 m � � 9 If! M n Sit j.. N tptyy�1Y [T h Y9 4A ymy�� � N SYgI qp p1 M 40 f a-<�^ v- n� 19 V �.eo�ao-eoeoss��ooeo ppp��� uF W N n A N ii IN/! �M1 IlY N fl1 IN/t VAUi V1 N M1 N N h N m N N N N N N N N N N N N W 7Mi C[1 f� A A h c�ry t~fl fYi Vl N U7 VN 6 d Qi 0 �hIg 1: I- A A O� Ifl Ii1 uAY r^lF 4'1 ei! ih V9 U� VF (by t� r tai N N {V d � �a w uutT m m m 'fi v ry � v o VNi N r�fF IN// fN/l VNF i. yr � vNr yr uN'r cNn eN.F ftl N to 10 N N N N vF vF C b a ry m r n, ry tMvp, ..1 OI I� If1 r�'1 M gg 9b r�pp N pp T [+1 ttpp N V ❑1 � w N v y�j U inn •N~r - I� W W W m Qi LP tl�yyl QF fI+ M {r{�- W 7Mi C[1 f� A A h c�ry t~fl fYi Vl N U7 VN 6 d Qi 0 �hIg 1: I- A A O� Ifl Ii1 uAY r^lF 4'1 ei! ih V9 U� VF (by t� r tai N N {V d � �a w uutT m m m 'fi v ry � v o VNi N r�fF IN// fN/l VNF i. yr � vNr yr uN'r cNn eN.F ftl N to 10 N N N N vF vF C 4 N m rn m o m� N N N u+ I`ii N N vF vF ry m r n, ry tMvp, 4 N 40 Martin County Schooi District Health &Vision Evaluation C> C-1 Health & Vision Evaluation HEALTH INSURANCE Proposals for health insurance were submitted by Blue Cross & Blue Shield. Humana, Preferred Choice and the incumbent, CIGNA HealthCare. Upon review and careful consideration of each program proposed by each carrier, The Gehring Group presented its recommendation to eliminate Humana and Preferred Choice as options for the health coverage to the MCSD Insurance Committee during the December 17, 19913 Committee meeting. At that time, the Committee made and passed the motion to name CIGNA and Blue Cross & Blue Shield as finalists for the health insurance. ELIMINATION OF NON -FINALISTS Humana proposed a triple option program (FPO, POS, HMO) with premiums that generated an approximate 8.2% cost increase, assuming current enrollment. This was the least costly program received, however, several issues prevented Humana Irom being named a finalist for the health insurance. One of the main concerns taken into consideration in the recommendation to eliminate Humana as a viable option was the lack of physicians participating in I lumana's Martin County network. Humana's recent exit from the Medicare market in Martin County quickly reduced the size of its physician network. In addition, Humana was very open about [lie status Of its current negotiations with Martin Memorial Hospital stating that they were unable to guarantee that Martin Memorial would still be a participating network hospital upon the District's health plan renewal date of March 1, 1999. Flumana's proposed program benefits are in line with the current program; however, due to the loss of network physicians and the uncertainty regarding the contracting status of Martin Memorial Hospital, Humana is not the best choice for MCSD at this time. Preferred Choice proposed a stand-alone 11MO option for MCSD to offer side by side with a triple option program offered by the other proposers. The cost for this option is 31.5% higher than the current HMO rates and approximately 15% higher than all ofthe HMO options proposed in response to the RFI'. Preferred Choice was eliminated as a finalist due to its uncompetitive rate structure. In addition, both finalists, CIGNA and Blue Cross & Blue Shield, expressed chill due to the sire of the group, they were unable to allow an additional I IMO option to be offered along side their own. Suclt an offer is usually available to groups larger than MCSD. C-1 171 FINALIST EVAJLATION CIGNA and Blue Cross & Blue Shield were named as the two finalists for health insurance; m therefore, all aspects of their programs were analyzed in greater detail. Both carriers proposed triple option programs (PPO, POS, HMC) with similar benefits and premiums generating an approximate 16% increase over the current rates. Since both carriers proposed programs similar in cost and coverage, the MCSD Insurance Committee iaadc and passed the motion to have both carriers give presentations to the Committee on January 11. 1999. FINALIST PRESENTATIONS Both carriers gave impressive and convincing presentations to the Committee; however, upon further consideration and discussion, the Committee came to the conclusion that CIGNA was better able to provide a more comprehensive level of benefits to MCSD for the following reasons: i ) CIGNA has a larger I•iMO/POS physician network in Martin County than Blue Cross & Blue Shield. This is a significant benefit because 75% of the active employee population are HMO/POS participants. To further limit the number of participating physicians in the local area will result in an increased number of employee complaints regarding the benefit program. 2) There is no significant cost savings associated with switching the Health program to Blue Cross & Blue Shield. Both CIGNA and l3lue Cross & Blue Shield proposed premiums generating an approximate I5%a rate increase for the upcoming plan year. 3) There are no significant benefit enhancements associated with switching the health program to Blue Cross & Blue Shield. Both finalists proposed programs with benefits that mirror the current program. 4) Blue Cross & Blue Shield's PPO program, however, does reduce the benefit payable to retirees for whom Medicare is primitry and the CIGNA Ppo is secondary. Under the current CIGNA program, retirees on Medicare receive full benefit coordination. hider the proposed BC&BS program, all benefits payable to retirees on Medicare will be reduced by the amount paid by Medicare. `Phis is a significant benefit reduction in comparison to the existing coverage. 40 • HEALTH CARRIER RECOMMENDATION For the reasons outlined above, the Insurance Committee made and passed the motion, to renew the District's contract with CIGNA inclusive of the following plan enhancements: 1) The Maximum Lifetime Benefit will be increased from $1 million to $2 million. 2) The coverage for TMI (Temporo -Mandibular .point Disorder) will be transferred from the dental program to the health program with no rate adjustment to the health premium. TERMINAL LIABILITY AMOUNT In addition to the above plan enhancements, The Gehring Group has also received a guarantee from CIGNA that the Terminal Liability amount in the Supplemental Premium Agreement will be $1,772,138 for the plan year ending February 29, 2000. This is a $44,140 increase to the recently negotiated Terminal Liability amount of $1,727,998 for the plan year ending February 28, 1999. PRESCRIPTION DRUG FORMULARY The option of implementing a formulary in the prescription drug program was also considered during the evaluation process; however, implementing the formulary would reduce the renewal premiums by only 1%. It was then decided during the January W" Insurance Committee meeting, that the minimal savings generated by this plan change in addition to the number of employee claim issues that would arise due to such a change does not make the implementation of a drug formulary a viable option for MC:SD at this time. EMPLOYEE SURVEY RESULTS In addition to the interview process, a general survey was circulated to the employees for the purpose of determining which physicians were the most utilized by MCSD employees and their dependents. Of the 1,800 active employees who received the survey, 630 responded. The results of the survey are listed in the Reyuesled Phyvicians Copnpetrison and list each physician requested as well as the number of employees who listed that physician on their survey form. The list of physicians was then forwardcd to cuch of the two finalists who then indicated which physicians were participating in their networks. C-1 The following chart shows that Blue Cross & Blue Shield's P]'O network matched 85% of the PPO requests while CIGNA matched 79%. However, CIGNA's 1-IMO/POS network matched 64% of the employee requests while Blue Cross & Blue Shield's HMO/POS network matched 57%. 100%n 80% 60% 40% r^.0%a 0% 79% 64% 57% 50% 41% 42% X CIA IM _003y p ¢ y O M o The results of this survey indicate that Goth carriers are able to provide an adequate physician network to MCSD. However, since 75% of the MCSD active employee population participate in either the HMO or PDS program, and more employees are likely to migrate to those more cost effective programs during the upcoming open enrollment period, CIGNA's larger I-IMOfPOS network is better able to support the needs of the MCSD employees at this time. In addition to requesting physicians, the survey also requested employees to "grade" their health insurance program by indicating whether they felt their plan was "Excellent", "Very Good", "Good", "Fair", or "Poor". The following graph shows that the nyajority of those who responded to the survey felt that the health 9% coverage currently provided is 18 °1 Excellent at a satisi'actory level. In Very Good 1016% addition to these employees, 19 Good there are approximately 1,200 ° dFair other active employees who did 3a% not turn in their survey fonts. 27% OPoor If there was significant concern regarding the level of bencfits or the performance of the current health care provider, the above chart would reflect a greater level of dissatisfaction with the plan, and more of those additional 1;200 employees wvould have responded to express their concent. 40 40 0 The survey also included a section for employee comments. The following graph illustrates the areas of concern expressed by MCSD employees. The train areas of concern include the selection of available specialists and primary care physicians in Martin County. 80 70 60 50 40 30 20 10 0 Martin County School District Analysis of Health Insurance Survey Comments 0Limited number of specialists in Martin County (emphasis on Dermatologists). ■ Limited number of PCPs and Internists in Martin County. ENumber of employees that stated that the switch to Cigna ]cad to decreased benefits. []Number of employees that stated coverage is too expensive (cost of adding dependents). C3Numbcr of employees that are not satisfied with the current plan design. OlNumber of employees that complained about pharmacies (Walgreens requested). MNumber of employees that expressed satisfaction with Cigna health insurance. ■ Limited number of lab facilities. ENumber of complaints regarding claims issues. A N umber of employees that stated that their doctors were not satisfied with Cigna. Although this is a concern, the Requested Physicians Survey indicates that there would be no significant increase in physician selection if MCSD were to switch its health coverage from CIGNA to Blue Cross & Blue Shield. MEDICARE SUPPLEMENT The Gehring Group issued an RSP for a Medicare Supplement to explore the possibility of providing an alternative to those retirees eligible for Medicare. The RPP requested only those supplements that included coverage for prescription drugs in order to be a comparable option to the current PPCA plan. However, date to the lack of responses from Medicare providers for a group program that included coverage for prescription drugs, the Insurance Committee determined that MCSD should continue to offer its retirees the existing program pursuant to Florida Statute 112.0801.. C� VISION INSURANCE The current CIGNA contract includes a Vision program with benefits outlined below. The RFP requested that carriers provide a Vision program comparable to the current plass due to the fact that the employee survey produced no complaints or even comments regarding the current vision program. CIGNA and Vision Care Plan were the only carriers that submitted proposals for vision. coverage. Frequency for Lenses oau per calendar year once tees calendar year Once per Calendar year Frequency for Frames Once every 2 years since every 2 years Once every 2 years Vision Analysis $30 (once per year) $30 (once per year) 100% Up to $35 Single Vision Lenses $20 $20 1000/0 Up to S20 Bifocal Lenses $40 $40 100% Up to $40 Trifocal Lenses $60 $60 100°/a Up to S60 LenticularLenses SIM $f00 100% Upto$l00 Contact Lenses Medicallv Necessary $150 $150 100%n Up to $150 Cosmetic $80 $80 Upto$100 U to $100 exam * Ica5C5 p Frames $30 $30 100% Up to $30 sciccted'F t s I1t1MIUM(limpinvueOnly -773) 52.04 62.37 $3.72 Monthly Premium $1.576.92 $1.832.01 $2,875.56 Annual Premium $18.9$3.04 $21,984.12 $34,506.72 $ Increase 83.0$1.08 '$15,583.68 In .r , s . 161% Switching the Vision program from CIGNA to Vision Care Plan would generate an approximate $12,500 increase in cost in comparison to CIGNA's renewal. Therefore, The Gehring Group recommends that MCSD continue its vision coverage with CIGNA. The Vision Care program would utilize a network of doctors and provide a higher level of benefits for in -network services. However, switching the vision coverage at this time is not the best option for MCSD due to the cost associated with re -enrolling the entire raon-instructional employee papulation, in addition to the 82% rate increase proposed. • 4D fp cuC 7 C 6 L4 Q. f/] E C � 29 E G 3 E t1 C. U C tip i N C i iG C7 O n co " � w O M C es# qIf qD m M m r� oo m cow w� omi *D m co N ? C3 [h N *d N w M N N(o N N C N M 7 fA t+} m N q"7q7. p O r ti a a N N-: (V m N B M q+3 i t6 �C n �.. M qtr N cM'i n N Vi �! C] N. prppp Ql xN- N {��pqq r m N qp pp d; '7 O a rM u7 r N w s� N N 4 N co N M CH Oq N MY 87 M N N © N a [] �q N c"7 a m � r. 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W m i e A � ar Y c2 C L y b m It MS 25 S O + yVp 8"u i $w Z O E � © Z 7- V v! w w a0 .�'. m Y Yr M de ewe edo Y� 4*/�r vl W1 O CL CL 7Z Z Z L v A• ?• E� g . n o o xa ao �' w vi w m ee ao wi +�ell C W m i e A � ar Y W m i CI iM rim zg CZ0 0 0 U ss�V) - —'5er z z - -1 O 0 0 DI , V; 8 to cE I z z z z to to D wil oo-! 17L :E R C5 -5 U) VI n C� C, a 0 C� C4 G z Z Z;7, 06 r © C 0 T u > IT gL > d c ra CD E p 0 z 7 - 0 YL A > 3E Fn (A Z7, 69 (A 0 V M ls� > -? Cr w ('4 ii, u0 C) ?L F 9 F O (A -n 0 Z• > > > :E > zx S2 > > IF �u b " R VL z z cl!R 4 � tA w Vi !,a V) V, 0 I CL > •> q P C5 n k C, C> CA tA u U ZZ 4V, C3 > "4 > 14 ^y Z3 7- z o Q x- /. C4 IA Vi Vn V) V) (11 rl to 31 0 2 E E 46 r 0. >u Z' -E Tl t —t V 5: V w E tj c A �t v - s is E LL k .9 U. M L) • 4 Q' -t' Go 4D Martin County School District Requested Physicians Comparison a 0 a[7 r U') Cl)r C'7 xfl ti'i C r r V %C7 r N N CN T" IL N N 0 w r t!] M 0. i ywrv7Mr [*7 (A t7�• r�T-rr flrrN N r [l. 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L m,x-m._ moo m. ro`° _ mr� mm a ^ m a S mcDmC]�c5c" LC -:: LL u75mapC7Vi7 �CCCCc v)�Fr ❑cnooa�t7 4w Fl COL § °° 2 wm I S _@ 2% $( c t0 3: (L 0 \�\��w�w�a�\} kU a \k� 5 'fn \ j 0- E t$ # f�\mm7 * (£§\42#�Amg � � . . . • C> Martin County School District Dental Insurance Evaluation • CA T]EPi1iTAL INSU(JE Sight insurance carriers submitted proposals for Indemnity Dental programs in response to the RFP. (See Mental Benefit and Rune Comparison for outline of all proposed dental plans.) The initial concern associated with the request for dental coverage was the provision for coverage for TMJ (Temporo -Mandibular Joint Disorder). However, this concern was alleviated when both of the health insurance finalists, CIGNA and blue Cross & Blue Shield, agreed to include the $750 lifetime benefit amount for TMJ under the health program at no additional increase to the proposed health insurance premiums. This allowed us to examine and compare the programs proposed with the current dental program in order to maintain consistency in dental benefits. The Deptal Benefit and Rate Comj)arison shows that the majority of the proposals mirrored the current dental benefits (excluding coverage for TMJ). MetLife was the lowest bidder proposing a 3.8% increase over the current premiums, Humana was second with a 14.4% Increase and CIGNA was the third Iowest bidder proposing a 15.9% increase. CIGNA CIGNA MetLife Humana Deductible Individual $50 $50 S50 $50 Family $l00 $100 $100 sl0o Annual Maximum Benefit $1,000 $1,000 $1,000 $1,000 100% 100% 1000/0 100% Preventive Services trleduciibh asegm(ll !deductible araivedl &deductible waiv&* (deductible araived) Basic Services 80% 80%a 80% 80'/° Maiar Services 50% 50% 500/0 50% RATES Employee (712) $19.04 $22.05 $19.84 $20.89 Dependent (176) $29.71 $34.50 530.54 $37.61 Monthly Premium $18,785.44 521,771.60 $19,501.12 $21,493.04 Annual Premium $225,425.28 S261,2+9.20 $234,013,44 $257,916.48 $ Increase $35,833.92 $8,588.16 $32,491.20 %4 Increase 15.9%n 3,8%0 14.4% Since each ofthe plans provide the same benefits, the Insurance Committee made and passed the motion to renew the dental coverage with CIGNA. CIGNA`s dental program is approximately $27,000 hither in cost, however, the cost to re -enroll all of the employees who currently participate in CIGNA Indemnity dental program would exceed the renewal increase. i 40 CM Q CD r4+ 4 u C 0�0 Q b C11 _ Rt' CS e} rl C? QG R o r�. QCD Vy o ria ;L p 00 0 �n 8 ri t• i+T .. l� rl C7 �• O i n w+ fi w CL w 0 0 � o Ob `++� CA er v C �. 0 'r; O y CA sA -U a 141 ry u+a b y, o q 00 y (j o c o a o v e s' a 00 o a o: n 00 N m (� a O L. C 'a 03 LL) CM Q 40 i 4s � rvl O j +'1 N N o C} J 06 L4 rr W V �- In In lk K C v d a e _ W o a g tf3 C as coo a G y Q ti.j e j a u Ist u' ov ''+ d o � V 'c � +iA v rn ti "•a r; ea � t 4.. 174 a G o � ro m o 0 a an d C -It In v ee1� 'n kP 1'4 v o ti N \ a N by6 o0 rh G. 4s � rvl O j +'1 N N o C} J 06 L4 rr W V �- In N E e � } J p�. �• L4 rr W V �- In In lk K C N E e � } J p�. �• L4 rr W R V �- In In lk N e O CL M I4 u Ly p�. �• L4 rr W R V va q' 4 N 40 4p Martin County School District Life Insurance Evaluation • 40 LIFE INSURAI' CT The current life insurance program with CIGNA has been included in the Minimum Premium contract since the plan's inception. The amount of life insurance claims have continued to exceed the premium collected for the past two years and continue to add an approximate $100,000 to the MCSD deficit each year in addition to the health insurance deficit. Therefore, it is The Gehring Group's recommendation to cancel the life insurance contract under CIGNA HealthCare and fully insure this benefit for the upcoming plan year(s). The following chart shows the two lowest bidders as well as CIGNA's renewal proposal for the current life insurance benefit of $35,000 for full time employees and two times annual salary ($75,000 maximum) for administrative personnel: *Slamkird s proadurrt cull Ix, guaranicerl for cur arldifir rml levo years if elcrrrrr.s experience Is trader 100% after the first Iwo Years` It is apparent that CIGNA'S renewal is uncompetitive in comparison to the two lowest bidders. Therefore, the Insurance Committee made and passed the motion to switch the MCSD life insurance coverage from CIGNA to Provident for the March 1, 1999 effective date. Provident provided a rate guarantee of three years for the proposed premium. Standard provided a two year rate guarantee with the option to renew at the same rate for an additional two years providing the claims experience for the group is less than 100% during the first two years of coverage. The Committee felt that Provident was the best option for MCSD because its proposal produced a guaranteed cost savings of approximately $44.000 per year over the current rate for the next three years. In addition, history has shown that the life insurance claims for (his group have exceeded the premium collected for the past two years. Accepting Provident's proposal will guarantee a consistent life insurance program for three. years. CIGNA Current CIGNA Renewal Provident Life & Accident Standard lfi-4T-" Life Rate Per $1,000 50.26 $0.41 $0.21 $0.20 AD&D hate Per $1,000 1;0.03 $0.03 $0.072 $0.02 TOTAL Itate Per 51,000 St1.29 St1.44 50.232 $0.22 Estimated [r0111me* 568.563,318 $48,563.318 $68,563.318 $68,563,318 Monthly Premium $19,883.36 $30,167.86 $15,906.69 $15.083.93 Annual Premium $238,600.35 $362,01.4.32 $190,880.28 $181,007,16 S Increase $123,413.97 ($47,720.07) ($57,593.19) % Increase :11.7% -20.0% -24.1% RATE GUARANTEE n1a 1 year 3 ears Z ears* *Slamkird s proadurrt cull Ix, guaranicerl for cur arldifir rml levo years if elcrrrrr.s experience Is trader 100% after the first Iwo Years` It is apparent that CIGNA'S renewal is uncompetitive in comparison to the two lowest bidders. Therefore, the Insurance Committee made and passed the motion to switch the MCSD life insurance coverage from CIGNA to Provident for the March 1, 1999 effective date. Provident provided a rate guarantee of three years for the proposed premium. Standard provided a two year rate guarantee with the option to renew at the same rate for an additional two years providing the claims experience for the group is less than 100% during the first two years of coverage. The Committee felt that Provident was the best option for MCSD because its proposal produced a guaranteed cost savings of approximately $44.000 per year over the current rate for the next three years. In addition, history has shown that the life insurance claims for (his group have exceeded the premium collected for the past two years. Accepting Provident's proposal will guarantee a consistent life insurance program for three. years. 40 e