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