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HomeMy WebLinkAboutResolution - 2018-R0144 - Milliman, Inc. And Marsh & Mclennan Agency - 04/26/2018Resolution No. 2018-RO 144 Item No. 6.18 April 26, 2018 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute for and on behalf of the City of Lubbock, a Professional Services/Consulting Agreement for health benefits brokerage and consulting services, by and between the City of Lubbock and Milliman, Inc. and Marsh & McLennan Agency LLC, and related documents. Said Agreement is attached hereto and incorporated in this resolution as if fully set forth herein and shall be included in the minutes of the City Council. Passed by the City Council on April 26, 2018 DANIEL M. POPE, MAYOR ATTEST: Qu'-'- --, Re t cca Garza, City Secret ry APP�ED A 7-ONTENT: Leisa Hutcheson Director of Human Resources & Risk Management APPROVED AS TO FO irst Assistant City Attorney RES.Agrmt-MMA LLC. [consulting] 04.05.2018 Resolution No. 2018-RO144 SERVICES AGREEMENT This Services Agreement is entered into between and among Milliman, Inc. (Milliman), Marsh & McLennan Agency LLC (MMA), and City of Lubbock (Client) as of June 1, 2018. Milliman and MMA have an existing contractual relationship pursuant to which Milliman provides certain services, including actuarial analysis, for the benefit of MMA's clients. In consideration for Milliman agreeing to perform certain services for the benefit of Client, and in support of the Consulting Agreement entered into between Client and MMA, Client agrees as follows: 1. Services Milliman will perform services under this Services Agreement as proposed and in accordance with Exhibit A attached hereto, including specifically (i) Comprehensive Assessment of Health Plans Report; (ii) Renewal Projection & Evaluation; (iii) Reserve Analysis; (iv) Financial Monitoring Report; (v) ACA Employer Impact Report; (vi) Medicare Part D Attestation and (vii) RDS Services. 2. Billing Terms The fee for Milliman's services shall be as proposed on Exhibit A at "City of Lubbock — Self Insured Platform Fee Schedule." Milliman shall submit its periodic billings to MMA, which MMA shall (after review and approval), submit the same to Client for payment. Client shall be obligated to pay MMA for such billings in a commercially reasonable manner; and MMA shall be liable to make payment to Milliman immediately upon receipt of such payments from Client. 3. Business Associate Agreement Under the Health Insurance Portability and Accountability Act of 1995 (HIPAA), employer plans operating as Covered Entities are required to maintain the privacy and security of their participants' Protected Health Information (PHI). Pursuant to its services under this Agreement, Milliman will receive PHI from Client. Accordingly, Milliman and Client agree to execute a Business Associate Agreement in the form attached hereto as Exhibit C. 4. Term The term of this Services Agreement will be June 1, 2018 and end May 31, 2019 and may be renewed annually for four additional one-year terms at the direction of the City Manager of Client. However, in no event will this Services Agreement exceed the term of the Consulting Agreement between the Client and MMA. Client or Milliman or MMA may terminate this Services Agreement at any time during this term by providing 30-day written notice to the other parties. This Services Agreement shall automatically terminate on notice to Milliman of termination of the Consulting Agreement by either Client or MMA. If this Services Agreement is terminated, MMA and Client shall be obligated to pay Milliman for services actually performed by Milliman prior to the effective date of termination. 5. Limitation of Liability Client agrees that Milliman, its officers, directors, agents and employees, shall not be liable to Client, under any theory of law including negligence, tort breach of contract or otherwise for any damages in excess of $75,000. In no event shall Milliman be liable for lost profits of the Client or any other type of incidental or consequential damages. The foregoing limitations shall not apply in the event of the intentional fraud or willful misconduct of Milliman. 6. Choice of Law The construction, interpretation and enforcement of this Services Agreement shall be governed by the substantive contract law of the State of Texas without regard to its conflict of laws provisions. In the event any provision of this Services Agreement is held by a court of competent jurisdiction to be invalid or unenforceable as a matter of law, the remaining provisions will stay in full force and effect to the extent appropriate and legally permissible, or as modified by such court. Any dispute arising between the parties in connection with this Agreement shall be resolved in federal district court, North District of Texas, Lubbock Division. In the event that federal court does not have subject matter jurisdiction over the claim, the dispute will be resolved in state court in Lubbock County, Texas. Each party hereby agrees to waive its right to a trial by jury in any dispute arising from or related to this Services Agreement. 7. Third Party Distribution While Milliman's work product is prepared solely for the use and benefit of the Client, the Client is a public entity and subject to open records laws. Such information may be disclosed if the information is considered "open" pursuant to the Public Information laws of the state of Texas. However, Milliman does not intend to benefit and assumes no duty or liability to any third parties who receive Milliman's work product and may include disclaimer language on its work product so stating. The Client agrees not to remove any such disclaimer language from Milliman's work product. To the extent that Milliman's work product is not subject to disclosure under applicable public records laws, the Client agrees that it shall not disclose Milliman's work product to third parties without Milliman's prior written consent; provided, however, that the Client may distribute Milliman's work product in its entirety to (i) its professional service providers who are subject to a duty of confidentiality and who agree to not use Milliman's work product for any purpose other than to provide services to the Client, or (ii) any applicable regulatory or governmental agency, as required. S. Contingent Effect The parties hereto acknowledge and agree that this Services Agreement shall be of no effect unless that certain Consulting Agreement by and between the Client and MMA shall have been approved by the City Council of the Client and other parties thereto. 9. Non -Arbitration Not withstanding the provisions of paragraph 7 above, the City reserves the right to exercise any right or remedy available to it by law, contract, equity, or otherwise, including without limitation, the right to seek any and all forms of relief in a court of competent jurisdiction. Further, the City shall not be subject to any arbitration process prior to exercising its unrestricted right to seek judicial remedy. The remedies set forth herein are cumulative and not exclusive, and may be exercised concurrently. To the extent of any conflict between this provision and another provision, in or related to, this document, this provision shall control. Milliman, Inc. By: a �1& Name: Ronald M. Cornwell Title: Prii1cipil Consultin Actuary Date: Address: 1120 South 101" Street, Suite 400 Omaha, NE 68124-1088 Marsh & McLennan Agency LLC Company By: Print Name: Date: Address: 8144 Walnut Hill Lane, Suite 1600 Dallas, TX 75231 ATTEST: Rebecca Garza, City Secretary City of Lubbock (Client) Daniel M. Pope, Mayor Date: Address: 1625 13th Street, Suite 104 Lubbock, Texas 79401 APERO D A ONTENT: Leisa Hutcheson, Director of Human Resources and Risk Management Milliman, Inc. By: JW LgAfW� Name: Ronal—dM. Cornwell Title: Pliiicipal & Consultin,g) Actuary Date: Ila Im — Address: 1120 South 10 1 " Street, Suite 400 Omaha, NE 68124-1088 Marsh & McLennan Agency LLC Company By: Print Da Address: 8144 Walnut Hill 1.,ane, Suite 1600 Dallas. TX 75231 ATTEST: Reb+ca Garza, City Secfetad City of'L bb k(Client) By:_CD�� Daniel M. Pope, Mayor Date: Address: 1625 1 ' )"' Street, Suite 104 Lubbock, Texas 79401 APP AS C TO ONTENT: TO LeisaNutcheson, Director of Human Resources and Risk Management Proposal for City of Lubbock Proposal to provide health and welfare actuarial & consulting services March 5, 2018 EXHIBIT A EMilliman 1120 South 10111 Street, Suite 400 Omaha, NE 68124 USA Tel +1 402 393 9400 Fax +1 402 384 5776 milliman.com Milliman Proposal EXHIBIT A Milliman, Inc. (Milliman) is pleased to present this proposal to City of Lubbock for employee benefit's consulting services. The objectives and deliverables requested are tasks and services that Milliman has a high level of expertise in performing and many years of experience in delivering. In short, we believe we are uniquely qualified to meet your needs: AS A PREMIER INTERNATIONAL CONSULTING FIRM, WE PROVIDE SUPERIOR ANALYSIS TOOLS, EXPERIENCE AND EXPERTISE. Recognized as an industry leader in the areas laid out in this response, Milliman is an independent firm of consultants and actuaries. We are not affiliated with other organizations that might impair our objectivity or our focus on your needs. We are experts at what we do. We do not do everything in every location, but the services we deliver are performed exceptionally well because our flexible internal structure allows us to assemble collaborative project teams with specialized expertise. At the same time, you can expect a local team to support your organization. In summary, we will provide you broad national expertise through the service and availability of a local office that understands City of Lubbock and their unique needs. Our work stands out for its thoroughness, relevance, and value. Milliman's innovative application of technology adds value through creative use of data, analytical tools, and effective client communications. Through information, expertise, and technology, we help you meet and exceed your goals in the design and operation of your benefit plans. Milliman benefits consultants listen to what our clients need and find responses that relate directly to what we hear. Our clients receive advice and services tailored to their circumstances, both in content and scope. We are not a firm of packaged solutions. Our clients use us because we consistently deliver the services they need in a uniquely personal, professional, and creative way. They trust us as partners in their success. Proposal for City of Lubbock Proposal to provide health and welfare actuarial & consulting services March 5, 2018 Milliman Proposal EXHIBIT A A. DETAILED COMPANY BACKGROUND Identification & Information Milliman, Inc. is a Milliman Global Firm. Founded in 1947 and incorporated in Washington State in 1957 as Milliman and Robertson, Inc., Milliman is located in 55 cities in principal cities worldwide. Owned and managed by approximately 460 Principals, Milliman has over 3,400 employees and revenue of $940 million in 2016, Milliman is considered one of the premier actuarial firms internationally. In the U.S., Milliman is recognized as an industry expert in assisting employers, governmental organizations, carriers, and providers with financial analysis, risk management, product development and rating and operational strategies. Milliman has built a reputation of high standards and creative solutions since its inception. Please refer to our website: www.milliman.com for additional details. The corporate headquarters contact information is: Milliman, Inc. 1301 Fifth Avenue, Suite 3800 Seattle, WA 98101-2605 (206) 624-7940 (206) 340-1380 Fax Federal Employer Identification Number: 91-0675641 LOCAL OFFICE INFORMATION AND BIOGRAPHICAL PROFILES Milliman, Inc. 1120 South 101 st Street, Suite 400 Omaha, NE 68124-1088 (402) 393.9400 (402) 384.5776 Fax ron.cornwell@milliman.com Milliman takes a team -oriented approach to their projects. Communication is vital and weekly meetings are held to review the status of each client to ensure that needs are being met most efficiently to the client's satisfaction. The project manager must sign off on each client deliverable before release as well as giving approval at critical steps in the process. Additionally, each deliverable is reviewed by a credentialed benefits consultants and actuaries to ensure accuracy, appropriateness, and a level of quality consistent with Milliman's philosophies. The project manager delegates many of the day-to-day aspects of the projects to the appropriate consultants, getting involved where needed. This allows us to keep our fees as low as possible, yet assure our clients that they are receiving a high level of expertise. Proposal for City of Lubbock Proposal to provide health and welfare actuarial & consulting services March 5, 2018 Milliman Proposal EXHIBIT A B. ACTUARIAL SERVICES Milliman is proposing the following actuarial services to be performed on an ongoing basis: ■ Comprehensive Assessment of Health Plans (CAHP) Report Designed for the mid -market employers, Milliman's CAHP Report is a customized report covering plan designs, employee contribution strategy, funding, and risk management. It includes the following: 1. Plan design benchmarking with national and local mid -market surveys 2. Demographic analysis 3. Contribution strategy benchmarking, with national and local mid -market surveys 4. Actuarial analysis of rates 5. Analysis of risks involved with different levels of stop -loss 6. General recommendations for each line of coverage Renewal Projection and Evaluation Reports Our renewal projection and evaluation reports contain multi -step processes to help you evaluate fully -insured renewals as well as begin preliminary budgeting on self -insured plans. This processes include the following steps: o Pricing Our BenefitsCFO suite of tools, incorporates the following information to accurately forecast your costs in the coming year and evaluate your renewals for your self -insured plans: • claims experience ■ historical enrollment ■ catastrophic claims ■ trend assumptions ■ plan design changes ■ provider contract changes ■ stop -loss premium ■ administration fees and expenses As fully credentialed health and welfare actuaries, we use your data to evaluate the renewal received from each carrier or third party administrator. Additionally, a trend analysis allows outliers or seasonality problems to be identified and addressed. When limited or no claims data is available, we rely on the Health Cost Guidelines, our proprietary actuarial model, census and plan designs to calculate a manual rate. If there is sufficient claim data available the manual rates are used as an additional estimate confirming the experience rate calculation. o Stop Loss Analysis Designed for groups that are currently self -funded, stop -loss analysis assesses the risks and costs for various stop -loss coverage levels. Using Monte Carlo simulation, we provide a graphic display of potential scenarios to determine what options fit the employer's risk preferences and help the employer determine if their current premium is appropriate. o Plan Design Analysis Milliman's extensive experience with healthcare providers and carriers offers a distinct advantage in designing health and welfare plans within the ever -changing dynamics of the healthcare industry. Using our experience in the industry, our consultants can help design a healthcare program that meets participant and Mercedes-Benz U.S. International Inc.'s needs. With healthcare costs on the rise, this analysis has gained increased importance for many employers. Milliman's proprietary actuarial models, Health Cost Guidelines and Dental Cost Guidelines are recognized as the industry standards for pricing insurance plans. Over 45 of the 50 largest health insurance carriers use the Guidelines to help them rate their plans. Using these models, our consultants and actuaries can readily value benefit design changes to ensure your healthcare program meets your financial constraints. With the recent increase in medical trend, this analysis has gained increased importance for many employers. o Premium Equivalency and Employer Contribution Milliman's fully credentialed health and welfare actuaries and consultants calculate your total annual cost by plan and tier and display variances to show the total dollar impact. This portion of the renewal shows Proposal for City of Lubbock Proposal to provide health and welfare actuarial & consulting services March 5. 2018 Milliman Proposal EXHIBIT A the relative value of plans and coverage tiers to make sure your plan rates equitably reflect the differences in cost. After the premium equivalencies are established, we model employee contributions according to your desired strategy. This is only one of Milliman's many customizable and interactive models that can provide immediate answers to "what if' types of questions with multiple variables. o Trend Analysis A trend analysis allows outliers or seasonality problems to be identified and addressed. In addition, our actuaries will review the renewal for proper calculation of reserves, benefit changes, large claims, retention, administration and profit. Reserve Analysis Using actuarial projection techniques to estimate incurred claims, our actuaries can help you can determine how much you should be holding in reserves and avoid IRS and DOL compliance issues. We incorporate the following into our reserve calculations: o incurred and paid claim triangles o enrollment history and projections o trend assumptions o various reserving techniques Financial Monitoring Report Milliman's Financial Monitoring Report (FMR) provides the answers a benefits manager needs to facilitate communications with participants, accounting and finance. FMR brings together claims experience, benefits paid, expenses, and gross and net costs, to name just a few items, in one financial report. It performs preliminary auditing of data to confirm accuracy of reports. Up-to-date forecasting leveraged through actuarial analysis turns "data" into "information" giving proactive management of expectations through finance. Affordable Care Act (ACA) Employer Impact Report (*May be used in place of the CAHP every other year*) Using our proprietary cost and utilization model with the applicable State Insurance Exchanges and the employer's eligible census information, our analysis provides: 1. Timeline: A Summary of changes under PPACA with percentage impact for each one. 2. 10-Year-Cost Projection: A 10-year cost projection of the employer's health care costs. 3. Exchange Migration: Potential 2014 employer cost scenarios relative to plan exchange employee migration and the associated costs. 4. Plan Termination Scenarios: Potential scenarios for the employer for 2014 relative to employer penalties if the employer decides to discontinue their employer -sponsored health benefits plan. 5. Plan Relativities with State Exchanges: Plan Relativities between the employer's current plan designs and the applicable State's Insurance Exchange. Relativities could change depending on each employee's household income level. ACA Employer Impact Study Requirements ■ An Employee Census - Should include ALL employees regardless if they are currently selecting medical coverage or not. ■ Zip Code ■ Age ■ Gender ■ Medical Plan Design Selected (if waiving coverage, enter in a "n/a") ■ Medical Tier — EE only, EE+Spouse, etc. (if applicable) ■ W4 Box 3: Single, Married, Or Married but withhold at higher single rate (optional) ■ W4 Box 5: Total # of Allowances (optional) ■ Average Number of Hours worked (this will differentiate between full-time and part-time) ■ Annualized Gross Income Proposal for City of Lubbock Proposal to provide health and welfare actuarial & consulting services March 5. 2018 Milliman Proposal EXHIBIT A ■ Annualized Taxable Income (optional) ■ Monthly Employer Premium Contribution ■ Monthly Employee Payroll Deduction ■ Total Monthly Budgeted Rate (Should be the sum of Monthly Employer Premium Contribution and Monthly Employee Payroll Deduction) ■ Active/Retiree Status ■ Employee FSA contribution amount ■ Employer HRA/HSA eligible contribution amount All Applicable Plan Design Summaries - Should have a plan design summary for all plans corresponding to #5 above. Medicare Part D Attestation Milliman's Medicare Part D actuarial attestation report provides an employer with the actuarial attestation required to seek reimbursement from the federal subsidy through RDS and to determine "creditable coverage" for participants. Medicare Part D became effective in January 1, 2006 to provide prescription drug coverage for Medicare -eligible seniors and disabled persons. Employers who sponsor retiree medical plans are eligible for a subsidy if they can demonstrate they meet certain criteria. In addition, employers are required to notify plan participants whether the plan qualifies as "creditable coverage" by the law's definition. Milliman's Medicare Part D report provides an employer with the actuarial information and attestation required by Medicare Part D for both requirements. This report uses plan design, premium levels, retiree contribution levels and participant information along with Milliman's Health Cost Guidelines. After acceptance and confirmation by the employer, we are registered as actuaries with RDS to complete the attestation online. C. PROJECT MANAGEMENT PLAN As described above, we work as a team to ensure we meet or exceed your expectations. With that said, Blaine Weber will be your primary contact and will be responsible for the management of the City of Lubbock deliverables with support as needed from Jason and Ron. Ron Cornwell has overall responsibility for the Omaha Health and Welfare Practice and will be involved with peer review and consulting as needed. Jason Speer has primary responsibility for management and review of all our deliverables. Blaine, with the support of Ron, Jason and the entire Milliman Omaha office of 15+ consultants will work closely with you in the following areas: • scheduling meetings and timelines • preparing data requests • soliciting the proper resources and expertise • utilizing the correct models • applying the correct actuarial methodology • primary contact for any questions In addition to the specific services mentioned, we will be available on an ongoing basis for future questions on these or other topics. Please note that Milliman holds quality and accuracy in the highest regard. We believe that documented peer review of all our deliverables is necessary to ensure the highest quality. Most, if not all, of our clients feel this is time and money well spent given the large financial ramifications of the decisions we advise them on. D. TECHNICAL CONSIDERATIONS Many of our technical capabilities are described within the preceding paragraphs. To summarize, • Health Cost Guidelines - used by 45 of the 50 largest health carries, Health Cost Guidelines is recognized as the industry standard for measuring group health costs. Proposal for City of Lubbock Proposal to provide health and welfare actuarial & consulting services March 5, 2018 Milliman Proposal EXHIBIT A • Our actuaries use the Benefits CFO suite of tools, to forecast costs and calculate reserves based on your unique claims experience. • Familiarity with insurance carrier systems reports - with extensive experience from previous clients, we are familiar with the format and structure of their reports and have developed a template for processing data efficiently that ensures we can keep the schedule and budget. • Research - as a large international firm we produce an extensive amount of research for our clients as well as general industry knowledge. Some of these are listed below and are produced on a regular basis or as the environment dictates o Client Action Bulletins o Benefits Perspectives newsletter o Research Reports o Industry surveys o Health Cost Index Report • Ongoing industry knowledge - given our position within the industry, we take a proactive role in monitoring our clients' needs and looking for opportunities for improvement. o Legislative: State and Federal o Trends o Carriers o Defined Contribution E. ACTUARIAL SERVICES COST PROPOSAL As you requested, for this project we are bidding on an annual fee basis according to the following schedule: CITY OF :•PLATFORM FEE SCHEDULE Milliman Self Insured Platform Fee: $1.56 PEPM Number of Employees: 2,421 Monthly Fee: $3,776.76 Annual Self Insured Platform Fee: $45,321.12 Medicare Part D Attestation: $3,000.00 TOTAL ANNUAL FEE: $48,321.12 • We have a long tradition of providing maximum value to our clients. Our clients tell us that our services are of the highest quality and our fees are a worthy investment for the service and expertise uniquely provided by Milliman. We trust you will feel the same. F. RDS SERVICES In Scope Application - one application per year with one unique benefit option identifier (UBOI) CMS Creditable Coverage Notice Load Cost Information Monthly Load Retiree ADD/UPD/DEL File Monthly Reconciliation Out of Scope Requesting payments Creating the following files:lnitial Retiree List (IRL) for application • Cost files • Retiree ADD/UPD/DEL files Proposal for City of Lubbock Proposal to provide health and welfare actuarial & consulting services March 5, 2018 Milliman Proposal EXHIBIT A • Covered Retiree List (CRL) for reconciliation Details of In -Scope Items: Application One Application with one UBOI per year 1. Initiate application 2. Discuss and possibly apply for extension. 3. Coordinate the completion of application steps 1-9 as described below. 4. The Milliman Omaha office completes the Attestation under separate fee (page 7 of proposal) 5. The Initial Retiree List (IRL) in the CSV file layout is sent to the Milliman Boise office by the City of Lubbock. The Milliman Boise office loads the file into RIDS. The method of submissions must be RDS Secure Website to RIDS Center. 6. Assign designees as discussed with City of Lubbock. 7. Review and possibly revise payment setup. Application Steps Step 1: Application Number Step 2: Benefit Option Step 3: Assign Actuary Step 4: Attestation Summary Step 5: Electronic Funds Transfer (EFT) Step 6: Payment Frequency Step 7: Retiree Electronic Data Interchange (EDI) Step 8: Plan Sponsor Agreement Step 9: Valid Retiree List CMS Creditable Coverage Notice One notice to CMS per year 1. Ensure participant mailing is complete. 2. Notify CMS that notices have been mailed. Load Cost Information Monthly 1. Receive RDS cost information from carrier. 2. Load cost information to RDS. 3. Notify the City of Lubbock and the carrier that cost information has been loaded. Load Retiree ADD/UPD/DEL File Monthly 1. Receive retiree ADD/UPD/DEL file in CSV format from City of Lubbock. 2. Upload retiree file on RDS website. 3. Notify the City of Lubbock and the carrier that the retiree file has been loaded. Reconciliation Please reference list of steps below: 1. Notify City of Lubbock that steps 1 and 2 need to be completed. 2. For steps 3 and 4, download Covered Retiree List (CRL) file from RDS. 3. Send CRL to City of Lubbock. 4. Receive updated final CRL from City of Lubbock. 5. Upload CRL to RDS. 6. Notify City of Lubbock that step 5 needs to be completed. 7. Receive cost file from City of Lubbock. 8. Complete steps 6-8. 9. Notify City of Lubbock that steps 9-12 need to be completed. Proposal for City of Lubbock Proposal to provide health and welfare actuarial & consulting services March 5, 2018 RDS SERVICES COST PROPOSAL Calendar Year Exhibit B 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 Esfimstsd Total Fees Sera File bads. payment requests Manor and City of Lubbock and CMS credtable mverag Reconciliation to be completed a8esfation, notices to be completed by mmpleted by City of Lubbm 2013 creditable raven a notices City of Lubbock and Manor and Maim 5ervim 0uartedy coat in formation 2014 Application and Creditable load, Monthly retiree Remnciliation due 3/1512016 Coverage Notices Complete add/upold.1 file load (Stsrts Mid 2015) Estimated E 10.800 Fee $ S 7700 $ 3100 ouainedy cost information load, Monthly retiree 5ervim adcVupd/d,l fib bad, and 2015 CMS creditable mvenge Remnciliation due 31152017 Application notice (Starts Mid 2016) Estimated Fee $ 1,900 S 8,600 S 3.200 $ 13,700 0uartedy cost infnmiafion load. Monthly nfirae 5ervim addf.pdfd.1 file bad, and 2016 CMS creditable mvarege Recondliation due 3115/2018 Application notice (Starts Mid 2017) Estimated Fee $ 2.000 S 8.900 $ 3,300 5 14.200 Ouarmdy cos[information load. Monthly refine Service addlupoldel file bad, and 2017 CMS creditable mvenge Remnciliafion due In r2019 Application -tic. (Starts Mid.18) Estimated Fee S 2.100 $ 9,200 E 3,400 E 14,700 0uartsdy cost irdormafion load. Monthly retiree addlupd/d.1 file load, and Reconciliation due Service CMS creditable coverage 3/152020 (Starts Mid 2018 Application nob. 2019) Estimated Fee E 2200 S 9500 S 3,600 S 15.300 Quanod' cost information load, Monthly load' file Mad, and Sarvim CMS .d/del CMS creditable coverage Reconciliationtlm 311512021 M19 Applimtian natim (5tsrt6 Mid 2020) Estimated $ 2,300 E 9.800 S 3.800 $ 15,900 Fee ouartsdr cost Inrermafion load, Monthly refine addlupd/del file bad, and Reconcillaban due 5ervim CMS creditable coverage 31152022 (Starts Mid 2020 Application notice 2021) Esfimatsd S 2,400 $ 10.100 E 4000 S 16,500 Fee Estimated Total Fees S E 9.600 $ 10,600 $ 14,100 $ 14.600 $ 15,100 E 15,fi00 E 13,700 S 3,800 E 4,OOD E 101,100 March 5, 2018 EXHIBIT C MILLIMAN, INC. BUSINESS ASSOCIATE AGREEMENT This BUSINESS ASSOCIATE AGREEMENT ("Agreement") is entered into effective the day of June 1, 2018 ("Effective Date") by and between City of Lubbock ("Client") and Milliman, Inc., on behalf of itself and its Affiliates ("Milliman"). RECITALS A. Client is a Covered Entity as defined under the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and is therefore subject to HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act of 2009 ("HITECH"), and the privacy standards adopted by the U.S. Department of Health and Human Services ("HHS"), 45 C.F.R. parts 160 and 164, Subparts A and E ("Privacy Rule"), the security standards adopted by the HHS, 45 C.F.R. parts 160 and 164, Subparts A and C ("Security Rule"), and the breach notification standards adopted by HHS, 45 C.F.R. part 164 Subpart D ("Breach Notification Standards"), as each may be amended from time to time (collectively, HIPAA, HITECH, the Privacy Rule, Security Rule and Breach Notification Standards shall be referred to herein as the "HIPAA Regulations"). B. Protected Health Information received from Client or created or received by Milliman on behalf of Client ("PHI") may be needed for Milliman to perform the services (the "Services") requested by Client and described in any underlying agreement between the parties (the "Underlying Agreement"). C. To the extent Milliman needs to access PHI to perform the Services, it will be acting as a Business Associate of Client and will be subject to certain provisions of the HIPAA Regulations. D. Milliman and Client wish to set forth their understandings with regard to the use and disclosure of PHI by Milliman so as to comply with the HIPAA Regulations. AGREEMENTS In consideration of the Recitals and the mutual agreements below, the parties agree as follows: Defined Terms. (a) Affiliates. As used herein, "Affiliates" means Milliman and each legal entity that is directly or indirectly controlled by, controlling or under common control with Milliman ("control" means the ownership, direct or indirect, of the power to vote 50% or more of any class of voting securities of a corporation or limited liability company, or the ownership of (b) Amendment. The parties agree to take such action as is necessary to amend this Agreement from time to time in order to ensure compliance with the requirements of the HIPAA Regulations and any other applicable law. (c) Independent Contractors. Milliman and Client are independent contractors and this Agreement will not establish any relationship of partnership, joint venture, employment, franchise or agency between Milliman and Client. Neither Milliman nor Client will have the power to bind the other or incur obligations on the other party's behalf without the other party's prior written consent, except as otherwise expressly provided in this Agreement. (d) Conflicts. In the event that any terms of this Agreement are inconsistent with the terms of the Underlying Agreement, then the terms of this Agreement shall control. (e) Entire Agreement. This Agreement shall constitute the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes all prior agreements, oral or written, and all other communications between the parties hereto relating to such subject matter. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed as of the date first written above. MILLIMAN, INC., on behalf of itself and its CITY OF LUBBOCK Affiliates - Bv4F6k BY Title Principal & ConsultingA_ctuM Titdri iucq 6i(ectoi �K4115r- Mjlm. C6l CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2018-336391 Milliman, Inc. Omaha, NE United States Date Filed: 04/09/2018 2 Name of governmental entity or state agency that is a parry to the contract for which the form is being filed. City of Lubbock Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 18-13972-MA Employer Health Benefits Consulting 4 Name of Interested Parry City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 UNSWORN DEC RATION My name is �y--- U "A ""\ ,and my date of birth is My address isll �GY�I�7/y�5�<ilY� ,C �� l/�lB'� ��, ���� �J• (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in (/� I cf- S County, State of VJMLC4,. on the C?1%ay of 20—&—. V (month) (year) //v- Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.5523