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HomeMy WebLinkAboutResolution - 2001-R0501 - Contract For Insurance Renewal - Bluecross Blushield Of Texas - 12/03/2001Resolution No. 2001-R0501 December 3, 2001 Item No. 25 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock, a Contract between the City of Lubbock and B1ueCross B1ueShield of Texas for insurance renewal for the City of Lubbock, and all related documents. Said Contract 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 this 3rd day of December , 2001. f Y SIT N, AYOR ATTEST: " 8 . C)N� Reb cca Garza City Secretary APPROVED AS`TO CONTENT: Mary Ho e Managing Director of Human Resources APPROVED AS TO FORM: William de Haas Contract Manager/Attorney Dh/Cedocs/B1ueCross Blue Shield.res November 26, 2001 Resolution No. 2001-RO501 December 3, 2001 Item No. 25 AMENDMENT #1 TO MINIMUM PREMIUM AGREEMENT (Blue Cross Blue Shield of Texas) This amendment to. the October 14, 1999, Minimum Premium Agreement between the City of Lubbock and Blue Cross Blue Shield of Texas, to provide group health insurance benefits for the City of Lubbock, effective as of January 1, 2002, the "Effective Date." WHEREAS, City entered into an Agreement with Blue Cross Blue Shield of Texas dated October 14, 1999, to provide group health insurance benefits for the City of Lubbock, and WHEREAS, both parties desire to renew and amend this Agreement; and NOW THEREFORE, for and in consideration of the mutual covenants herein, the parties do agree to amend the Agreement as follows: 1. Exhibit Number One is deleted and replaced with Exhibit Number Three attached hereto and made a part of this Agreement. 2. All other provisions contained in the Original Contract shall remain in full force and effect and shall not be affected by this Amendment. Executed as of the Effective Date. Windy Sitton Mayor ATTEST: _ 2 - e. — � 2a� Rebecca Garza City Secretary BLUE CROSS BLUE SHIELD OF TEXAS Jon W. Worley Chief Operating Officer West Texas Division Minimum Premium Agreement, City of Lubbock & Blue Cross Blue Shield of Texas I APPROVED AS TO CONTENT: —744� -4 ot Mary Hou Managing Director of Human Resources APPROVED AS TO FORM: ._A-. William de Haas Contract Manager/Attorney Minimum Premium Agreement, City of Lubbock & Blue Cross Blue Shield of Texas. Page 2 Resolution No. 2001—RO501 EXHIBIT NUMBER THREE Schedule Of Specifications For the MINIMUM PREMIUM AGREEMENT (the Agreement) between BLUE CROSS AND BLUE SHIELD OF TEXAS (BCBSTX) And CITY OF LUBBOCK (Employer, Policyholder) Group Number: 60167 The specifications are to apply for the period of time indicated herein and shall continue in force and effect until the end of the Policy Period, the Agreement is terminated or this Exhibit is superseded in whole or in part by a later executed Exhibit. Item I Contract Coverage This Minimum Premium Agreement will apply to benefits provided under the BCBSTX Group Contract(S) listed below: • Experience Rated Group PPO Managed Health Care Contract with Prescription Drug Program • Experience Rated Group Traditional Indemnity Benefit Contract with Prescription Drug Program • Experience Rated Group Comprehensive Dental Care Contract Item II Contract Year These specifications are for the current Contract Year, which shall commence on January 1, 2002 and end on December 31, 2002. Item III Accounting Period The current Accounting Period shall commence on January 1, 2002 and end on December 31, 2002. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, A Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association FORM NO. MPA/EX 1 60167JAN.02 Item IV Draft Authority Draft Authority shall be calculated monthly and shall be equal to the sum of the amounts obtained by multiplying the number of certificates exposed for a particular month by: A. $229.36 for each Employee or Retiree Only Health Certificate $380.74 for each Employee or Retiree/Child(ren) Health Certificate $424.31 for each Employee or Retiree/Spouse Health Certificate $584.86 for each Employee or Retiree/Family Health Certificate B. $17.85 for each Employee Only Dental Certificate $29.63 for each Employee/Child(ren) Dental Certificate $33.02 for each Employee/Spouse Dental Certificate $45.51 for each Employee/Family Dental Certificate The amounts shown shall apply for the current Contract Year. Item V Health Stop -Loss Insurance Health Stop -Loss Insurance applicable for benefits covered under the Health Contracts (excluding the Prescription Drug Program) is shown below. All monetary amounts and percentages shown shall apply for the current Contract Year. A. Specific Health Stop -Loss Insurance: Specified Paid Health Benefits in excess of the Point of Attachment which is $150,000 per Participant per Accounting Period. B. Aggregate Stop -Loss Insurance: None - not applied for. Item VI Settlement Payment Option The following Settlement Payment Options will apply: A. Specific Health Stop -Loss Insurance: 1. Monthly settlements 2. Time Period: 12 months 3. Applicable Contracts (from Item I): • Experience Rated Group PPO Managed Health Care Contract with Prescription Drug Program • Experience Rated Group Traditional Indemnity Benefit Contract FORM NO. MPA/EX 2 60167JAN.02 B. Aggregate Stop -Loss Insurance: Annualized Draft Authority percentage for deficit carry forward: 20.0% ITEM VII Termination Coverage Options The Termination Coverage Options shown below will apply for the Run -Off Period: Run -Off Administration Charge Factors for calculating the Run -Off Period: 1. $13.88 for each Employee or Retiree Only Health Certificate $23.04 for each Employee or Retiree/Child(ren) Health Certificate $25.68 for each Employee or Retiree/Spouse Health Certificate $35.44 for each Employee or Retiree/Family Health Certificate 2. $1.72 for each Employee Only Dental Certificate $2.84 for each Employee/Child(ren) Dental Certificate $3.16 for each Employee/Spouse Dental Certificate $4.36 for each Employee/Family Dental Certificate Run -Off Liability Factors for calculating the Run -Off Draft Authority: 1. $166.36 for each Employee or Retiree Only Health Certificate $276.16 for each Employee or Retiree/Child(ren) Health Certificate $307.76 for each Employee or Retiree/Spouse Health Certificate $424.20 for each Employee or Retiree/Family Health Certificate 2. $11.56 for each Employee Only Dental Certificate $19.20 for each Employee/Child(ren) Dental Certificate $21.40 for each Employee/Spouse Dental Certificate $29.52 for each Employee/Family Dental Certificate ITEM VIII Home Bank or Employer's Bank Information The name and address of the Employer's Bank and financial contact person shall be maintained on file in accordance with procedures established between the Employer and the Comptroller Division of the Accounting Services Department of BCBSTX. Item IX Administration Charge The Administration Charge for the Contract Year shall be calculated monthly by multiplying the number of certificates exposed for a particular month by: A. $22.93 for each Employee or Retiree Only Health Certificate $38.06 for each Employee or Retiree/Child(ren) Health Certificate $42.42 for each Employee or Retiree/Spouse Health Certificate $58.47 for each Employee or Retiree/Family Health Certificate FORM NO. MPA/EX 3 60167JAN.02 B. $2.63 for each. Employee Only Dental Certificate $4.36 for each Employee/Child(ren) Dental Certificate $4.86 for each Employee/Spouse Dental Certificate $6.70 for each Employee/Family Dental Certificate The amounts shown shall apply for the current Contract Year. Item X Health Contract Stop -Loss Premium The Health Contract Stop -Loss Premium is the sum of the Specific Health Stop -Loss Premium and Aggregate Stop -Loss Premium amounts calculated as follows (amounts shown shall apply for the current Contract Year): A. Specific Health Stop -Loss Premium shall be calculated monthly and shall be equal to the sum of the amounts obtained by multiplying the number of Health Certificates exposed for a particular month by: $ 9.93 for each Employee or Retiree Only Health Certificate $16.49 for each Employee or Retiree/Child(ren) Health Certificate $18.38 for each Employee or Retiree/Spouse Health Certificate $25.33 for each Employee or Retiree/Family Health Certificate B. Aggregate Stop -Loss Premium shall be calculated monthly and shall be equal to the sum of the amounts obtained by multiplying the number of Health Certificates exposed for a particular month by: NA Item XI Minimum Balance The Minimum Balance to be deposited by the Employer and held in the Employer's Account under the Banking Arrangement is $388,683 for the period beginning January 1, 2002 through December 31, 2002. Item XII Additional Charges/Fees/Rates The following charges and interest rates shall apply for the current Contract Year: A. The Daily Charge rate for the Contract Year shall be .0329% (which would equate to an annual percentage rate of 12%). B. Subrogation recoveries are subject to 15.0% of any amounts recovered. C. BlueCard® Program (Out -of -Area Program) fees shall be the lesser of 10% of the discount or $2,000 per claim (Refer to ARTICLE I, Benefit Checks, for additional explanation) FORM NO. MPA/EX 4 60167JAN.02 Item XIII Letter of Credit The Letter Of Credit is not required under this Employer's Agreement. Item XIV If this Exhibit of Schedule of Specifications is not rejected in writing by the Employer within thirty (30) days of its receipt by the Employer, it shall be deemed to have been accepted by the Employer and will be in full force and effect for the Accounting Period and Contract Year identified herein. SIGNED THIS DAY THE 12th OF December , 2001 Blue Cross and Blue Shield of Texas City of Lubbock J n W. Worley Windy itto , ayor Chief Operating Officqr West Texas Division ATTEST: Rebecca Garza, City Secretary APPROVED AS TO CONTENT: Mary Hous Managing Director of Human Resources APPROVED AS TO FORM: William de Haas, Contract Manager FORM NO. MPA/EX 5 60167JAN.02 Resolution No. 2001-RO501 December 3, 2001 Item No. 25 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock, a Contract between the City of Lubbock and B1ueCross BlueShield of Texas for insurance renewal for the City of Lubbock, and all related documents. Said Contract 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 this 3rd day of December ,2001. ATTEST: .�, crecaGarza City Secretary APPROVED AS -TO CONTENT: Mary Ho e Managing Director of Human Resources APPROVED AS TO FORM: William de Haas Contract Manager/Attorney Dh/CcdoesBlueCross Blue Shield.res November 26, 2001 Resolution No. 2001-RO501 December 3, 2001 Item No. 25 AMENDMENT #1 TO MINIMUM PREMIUM AGREEMENT (Blue Cross Blue Shield of Texas) This amendment to. the October 14, 1999, Minimum Premium Agreement between the City of Lubbock and Blue Cross Blue Shield of Texas, to provide group health insurance benefits for the City of Lubbock, effective as of January 1, 2002, the "Effective Date." WHEREAS, City entered into an Agreement with Blue Cross Blue Shield of Texas dated October 14, 1999, to provide group health insurance benefits for the City of , Lubbock, and WHEREAS, both parties desire to renew and amend this Agreement; and NOW THEREFORE, for and in consideration of the mutual covenants herein, the parties do agree to amend the Agreement as follows: 1. Exhibit Number One is deleted and replaced with Exhibit Number Three attached hereto and made a part of this Agreement. 2. All other provisions contained in the Original Contract shall remain in full force and effect and shall not be affected by this Amendment. Executed as of the Effective Date. CITY OF LUBBOCK Windy Sitton Mayor ATTEST: ".4 Rebecca Garza City Secretary BLUE CROSS BLUE SHIELD OF TEXAS . Lye -0-4-z Jon W. Worley Chief Operating Officer West Texas Division Minimum Premium Agreement, City of Lubbock & Blue Cross Blue Shield of Texas APPROVED AS TO CONTENT: —7/4x Mary Hou Managing Director of Human Resources APPROVED AS TO FORM: William de Haas Contract Manager/Attorney Minimum Premium Agreement, City of Lubbock & Blue Cross Blue Shield of Texas. Page 2 Resolution No. 2001—RO501 EXHIBIT NUMBER THREE Schedule Of Specifications For the MINIMUM PREMIUM AGREEMENT (the Agreement) between BLUE CROSS AND BLUE SHIELD OF TEXAS (BCBSTX) And CITY OF LUBBOCK (Employer, Policyholder) Group Number: 60167 The specifications are to apply for the period of time indicated herein and shall continue in force and effect until the end of the Policy Period, the Agreement is terminated or this Exhibit is superseded in whole or in part by a later executed Exhibit. Item I Contract Coverage This Minimum Premium Agreement will apply to benefits provided under the BCBSTX Group Contract(S) listed below: • Experience Rated Group PPO Managed Health Care Contract with Prescription Drug Program • Experience Rated Group Traditional Indemnity Benefit Contract with Prescription Drug Program • Experience Rated Group Comprehensive Dental Care Contract Item II Contract Year These specifications are for the current Contract Year, which shall commence on January 1, 2002 and end on December 31, 2002. Item III Accounting Period The current Accounting Period shall commence on January 1, 2002 and end on December 31, 2002. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, A Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association FORM NO. MPA/EX 1 60167JAN.02 Item IV Draft Authority Draft Authority shall be calculated monthly and shall be equal to the sum of the amounts obtained by multiplying the number of certificates exposed for a particular month by: A. $229.36 for each Employee or Retiree Only Health Certificate $380.74 for each Employee or Retiree/Child(ren) Health Certificate $424.31 for each Employee or Retiree/Spouse Health Certificate $584.86 for each Employee or Retiree/Family Health Certificate B. $17.85 for each Employee Only Dental Certificate $29.63 for each Employee/Child(ren) Dental Certificate $33.02 for each Employee/Spouse Dental Certificate $45.51 for each Employee/Family Dental Certificate The amounts shown shall apply for the current Contract Year. Item V Health Stop -Loss Insurance Health Stop -Loss Insurance applicable for benefits covered under the Health Contracts (excluding the Prescription Drug Program) is shown below. All monetary amounts and percentages shown shall apply for the current Contract Year. A. Specific Health Stop -Loss Insurance: Specified Paid Health Benefits in excess of the Point of Attachment which is $150,000 per Participant per Accounting Period. B. Aggregate Stop -Loss Insurance: None - not applied for. Item VI Settlement Payment Option The following Settlement Payment Options will apply: A. Specific Health Stop -Loss Insurance: Monthly settlements 2. Time Period: 12 months Applicable Contracts (from Item I): • Experience Rated Group PPO Managed Health Care Contract with Prescription Drug Program • Experience Rated Group Traditional Indemnity Benefit Contract FORM NO. MPA/EX 2 60167JAN.02 B. Aggregate Stop -Loss Insurance: Annualized Draft Authority percentage for deficit carry forward: 20.0% ITEM VII Termination Coverage Options The Termination Coverage Options shown below will apply for the Run -Off Period: Run -Off Administration Charge Factors for calculating the Run -Off Period: $13.88 for each Employee or Retiree Only Health Certificate $23.04 for each Employee or Retiree/Child(ren) Health Certificate $25.68 for each Employee or Retiree/Spouse Health Certificate $35.44 for each Employee or Retiree/Family Health Certificate 2. $1.72 for each Employee Only Dental Certificate $2.84 for each Employee/Child(ren) Dental Certificate $3.16 for each Employee/Spouse Dental Certificate $4.36 for each Employee/Family Dental Certificate Run -Off Liability Factors for calculating the Run -Off Draft Authority: $166.36 for each Employee or Retiree Only Health Certificate $276.16 for each Employee or Retiree/Child(ren) Health Certificate $307.76 for each Employee or Retiree/Spouse Health Certificate $424.20 for each Employee or Retiree/Family Health Certificate 2. $11.56 for each Employee Only Dental Certificate $19.20 for each Employee/Child(ren) Dental Certificate $21.40 for each Employee/Spouse Dental Certificate $29.52 for each Employee/Family Dental Certificate ITEM VIII Home Bank or Employer's Bank Information The name and address of the Employer's Bank and financial contact person shall be maintained on file in accordance with procedures established between the Employer and the Comptroller Division of the Accounting Services Department of BCBSTX. Item IX Administration Charge The Administration Charge for the Contract Year shall be calculated monthly by multiplying the number of certificates exposed for a particular month by: A. $22.93 for each Employee or Retiree Only Health Certificate $38.06 for each Employee or Retiree/Child(ren) Health Certificate $42.42 for each Employee or Retiree/Spouse Health Certificate $58.47 for each Employee or Retiree/Family Health Certificate FORM NO. MPA/EX 3 60167JAN.02 B. $2.63 for each. Employee Only Dental Certificate $4.36 for each Employee/Child(ren) Dental Certificate $4.86 for each Employee/Spouse Dental Certificate $6.70 for each Employee/Family Dental Certificate The amounts shown shall apply for the current Contract Year. Item X Health Contract Stop -Loss Premium The Health Contract Stop -Loss Premium is the sum of the Specific Health Stop -Loss Premium and Aggregate Stop -Loss Premium amounts calculated as follows (amounts shown shall apply for the current Contract Year): A. Specific Health Stop -Loss Premium shall be calculated monthly and shall be equal to the sum of the amounts obtained by multiplying the number of Health Certificates exposed for a particular month by: $ 9.93 for each Employee or Retiree Only Health Certificate $16.49 for each Employee or Retiree/Child(ren) Health Certificate $18.38 for each Employee or Retiree/Spouse Health Certificate $25.33 for each Employee or Retiree/Family Health Certificate B. Aggregate Stop -Loss Premium shall be calculated monthly and shall be equal to the sum of the amounts obtained by multiplying the number of Health Certificates exposed for a particular month by: NA Item XI Minimum Balance The Minimum Balance to be deposited by the Employer and held in the Employer's Account under the Banking Arrangement is $388,683 for the period beginning January 1, 2002 through December 31, 2002. Item XII Additional Charges/Fees/Rates The following charges and interest rates shall apply for the current Contract Year: A. The Daily Charge rate for the Contract Year shall be .0329% (which would equate to an annual percentage rate of 12%). B. Subrogation recoveries are subject to 15.0% of any amounts recovered. C. BlueCard® Program (Out -of -Area Program) fees shall be the lesser of 10% of the discount or $2,000 per claim (Refer to ARTICLE I, Benefit Checks, for additional explanation) FORM NO. MPA/EX 4 60167JAN.02 Item XIII Letter of Credit The Letter Of Credit is not required under this Employer's Agreement. Item XIV If this Exhibit of Schedule of Specifications is not rejected in writing by the Employer within thirty (30) days of its receipt by the Employer, it shall be deemed to have been accepted by the Employer and will be in full force and effect for the Accounting Period and Contract Year identified herein. SIGNED THIS DAY THE 12th Blue Cross and Blue Shield of Texas bwfilpA,�- 16n W. Worley Chief Operating Offic West Texas Division OF December 2001 City of Lubbock Lm/lawnw, ww"w - num" OMMY= ATTEST: Rebecca Garza, City Secretary APPROVED AS TO CONTENT: Mary Hous Managing Director of Human Resources APPROVED AS TO FORM: ��=- �" � William de Haas, Contract Manager FORM NO. MPA/EX 6 60167JAN.02